so much for pandemic: h1n1 flu already declining in mexico

This past week, we've witnessed the mainstream media at its typically irresponsible worst. When I saw the word "pandemic," I thought, you've got to be kidding me.

Sure enough, cases of so-called "swine flu" are already declining in Mexico. A total of 19 people have died from the disease in Mexico to date.

The World Health Organization quoted in this CBC story cautions that viral outbreaks can decline before increasing again. But they also increase before declining, and they can decline and continue declining.

We're supposed to be "vigilant". But this supposed vigilance is just the ordinary precautions we should always take. Avoid close contact with sick people. If you're sick, avoid contact with other people. Wash your hands.

When WHO raised its pandemic alert level from 4 to 5, that only meant human-to-human spread of the virus had been confirmed in at least two countries. Given that flus spread like this all the time, it's hardly a cause for panic. But media loves panic, and media consumers love a change of story after being beaten senseless with economic gloom and doom.

This column by Andre Picard, health columnist for the Globe and Mail warns against panic. Sadly, Picard's own employers have been among the worst offenders, using the word "pandemic" immediately and generally fear-mongering at every opportunity.
Yet, the media seems to have lost sight of one of the key lessons of SARS: Beware the numbers game.

During SARS, journalists tracked the number of cases, suspected and confirmed - not to mention the body count - obsessively.

Yesterday, the swine flu numbers game kicked into high gear, with hour-by-hour updates. This is misleading and unhelpful, neglecting the basic science of epidemics: Infections rise according to a predictable pattern, following an increasingly rapid curve until they hit a peak, then tail off. This is precisely what is happening with swine flu. There is no question that in the days - and likely weeks - to come, the number of confirmed infections and deaths will increase. This is not, in itself, a cause for panic. It is entirely predictable.

SARS was essentially a hospital-acquired infection. Virtually everyone who contracted the disease, after a traveller brought the pathogen from Hong Kong to Toronto, did so in a hospital, or was infected by a close relative who worked or was treated in a health-care facility.

There was never a threat in the general community. And, in the end, there were only 44 SARS deaths in Canada. (This is not to minimize these deaths, but to provide context: There are about 12,000 deaths annually in the country caused by other hospital-acquired infections.)

To reiterate, swine flu remains a travel-related infection that has affected relatively few people.

So far, the outbreak of swine flu news coverage has been far more severe than the outbreak of the disease itself. The good news is that there are stark differences in the response of politicians and public-health officials to swine flu, compared with SARS.

When SARS came along in 2003, Canada's public-health infrastructure was in disarray, relations between provincial and federal health officials were poisonous, and Canada spent more time bickering with the World Health Organization than working in tandem. This time, there is a co-ordinated response and it is led by people with expertise in infectious disease.

David Butler-Jones, Canada's chief public-health officer - a position created in direct response to the SARS debacle - and his provincial and territorial counterparts are singing from the same hymn book. Similarly, the response of politicians has been impressive. Federal Health Minister Leona Aglukkaq has shown quiet leadership, demonstrating enough smarts to defer to public-health experts.

The change has been even more spectacular in Ontario. The final report of the SARS inquiry described Ontario's public-health system as "broken, neglected, inadequate and dysfunctional," but today the Ontario Agency for Health Protection and Promotion is not only functional, but on the leading edge. The agency sent out an alert about a worrisome disease outbreak in Mexico on April 21, before the swine flu was identified as a new pathogen. It is hard to imagine how it could have done more.

Public-health officials have communicated well, delivering the message that we need to be concerned about the possibility of a pandemic flu, but not alarmed by what has occurred. The message has, unfortunately, sometimes been lost in the media frenzy.

Candace Gibson, an associate professor of journalism at the University of Western Ontario, noted there is an unofficial rule in medical literature (where multi-author papers are common) that there should never be more authors than subjects.

Similarly, Prof. Gibson says, there should never be more stories about a health threat than actual sick people.

With swine flu, hopefully, that balance will be achieved not with more death, but with a little more restraint.

Update. I wrote this off the top of my head, without much thought to context. Fortunately, wmtc readers are less lazy. Please read the first comment for more.

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