Trying to put the flu back into perspective

I made a comment on Twitter tonight that was directed at a fellow mom blogger that I follow who is dealing with flu in her family:

I received the following response from FluWatcher2009, a Twitter account that I believe is (at times) spreading misinformation and possibly increasing the already rapidly growing panic that has been manufactured by the media over the past several months:

As soon as I saw the "99%" statistic, I knew I had to look into it. But first, to answer the question this person asked, no, we don't know with 100% certainty that we don't have H1N1 - we weren't tested as only hospitals are doing the H1N1 tests. Neither my husband nor myself have been ill enough to warrant hospitalization. While I suppose it is possible that we've had H1N1 over the last few days, it's unlikely because of the symptoms that we've had and how quickly (or rather how *not* quickly) they came up. Anytime you see the symptoms of H1N1, it indicates that it develops quickly, in 3-6 hours. Our flu developed over several days. We've both seen different doctors and both specifically said they don't think it's H1N1. With the current state of things, I doubt very much that they would make that claim if they weren't pretty darn sure.

That actually wasn't the worst part of this person's post, though. The worst part was the statement that "99% of all current influenza being the H1N1 virus", which is a gross misrepresentation of the Center for Disease Control's (CDC) data in their flu report, which states:

"Over 99% of all subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses."

I had to do some further research to get a better understanding of what this means and I found a really wonderful article about the different types of influenza on MedicineNet.com that was perfect to help me decipher what the CDC meant, and coincidentally a very pro-flu-vaccine article. I am not a proponent of the flu vaccine for myself or my family, but if you are this article gives a very good and thorough explanation of influenza and vaccines - it was very informative.

The CDC's statistic is quite shocking when you read it at first: "Over 99% of all subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses." It sounds like EVERYONE with the flu has H1N1 until you break down what they are saying.

First, this percentage includes only "subtyped influenza A" viruses. So, in this statement there's no mention of or comparison to influenza B or C - the other two types of influenza. Influenza B is not discussed at any great length in the article like influenza A. Influenza C is not tracked or even a concern because it doesn't cause major illness or epidemics. However, the CDC breaks down the influenza A subtypes and influenza B in their table below the statistical statements.

Based on my obviously limited understanding of the types of influenza and the tracking methods being used, those cases that are tested (I assume most often upon hospitalization), that are found to be a subtype of influenza A end up being H1N1 over 99% of the time. Where I think this figure is misleading is that it doesn't include cases that were unable to establish a subtype and it leaves out those cases where subtyping wasn't performed, yet a diagnosis of influenza A was made. I did my own math (not my best subject) and I found that if you add in all of the influenza A categories, only 67% of reported cases were confirmed to be H1N1 - hopefully my math wasn't off. If subtyping was done on all, that number would probably be higher, but would it be "over 99%"?

I think most people jump to the conclusion that if you have the flu these days, you have swine flu. Perhaps it's a safe conclusion - you'll likely take a step or two back from someone who has the flu, which is good. But, as I like to do, I have to question the absolute assertion that most instances of the flu are H1N1. I have no doubt that a lot of what is going around is H1N1. However, you can't rule out other strains of flu being active as well - it's the season for the flu. Most people who get the flu don't go to the hospital and get tested. Many don't even go to the doctor unless they're having trouble of some kind. Therefore, reporting on these other strains may not be happening - just as mild cases of H1N1 may not show up in the statistics.

It doesn't matter whether you're pro-vaccine or anti-vaccine - I think it's important to keep the numbers in proper perspective. So much of what's being reported these days is put out there without proper context or background and it ends up sensationalizing a situation that is already causing unnecessary panic. I'm definitely not immune to it. I have had an overwhelming "ticking time bomb" feeling ever since Matt started getting sick and then I did, too. To help combat my personal panic, I went to the Public Health Agency of Canada's (PHAC) FluWatch site to see what's really going on. Because my biggest concern is my son, it helps me to read that since April 26th across Canada, there have been 605 hospitalizations of children under 16 for influenza, 95.2% of which were H1N1. Additionally, 4 deaths of children under 16 from H1N1 have been reported in that time. Though every hospitalization is extremely scary and every death is such a tragedy, it's reassuring to know that the number is so low.

I guess the perspective I needed was that Brandon - and, really, all of us - has a much greater chance of something totally random happening to him than getting seriously ill or worse from the swine flu.

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The hysteria and panic are really getting to me

In 1991, the world got its first look at what the media could do if it was given the opportunity to hold our attention on one topic 24 hours a day, 7 days a week. For weeks, we watched reporters every night in Saudi Arabia and other Middle East countries as they talked about smart bombs, the invasion of Kuwait and the Iraqi dictator, Saddam Hussein. My brother was in Saudi Arabia during the first Gulf War, so I remember watching the news incessantly, wanting to keep tabs on what was happening, hoping that he would be okay. Then the war ended. But the media didn’t stop. They moved on to other sensational topics – O.J. Simpson and the white Bronco, the OJ trial, Bill Clinton/Monica Lewinsky and many more.

A few years ago, there was a media fixation on shark attacks. One or two people in Florida died and, for some reason, this launched national (and even international) coverage of every shark sighting for months, whether there was an attack or not. At one point during all of the shark hoopla, I saw a report that indicated that the number of attacks for that particular year was no more than previous years. (WHAT!?) It was completely average. Were there more sightings? Perhaps, but that’s what happens when people are looking. Eventually, once people started catching on that nothing truly unusual was happening, the sharks got to go back to being sometimes vilified sea creatures instead of front page news. I don’t say this to make light of the deaths that occurred. However, this is a good example of a situation that was blown way out of proportion.

Kind of like the current media frenzy around the H1N1 (swine) flu.

I’m frustrated…and approaching the point of being pretty upset. Monday morning (Oct. 26), I walked into work and several co-workers told me about a 13-year-old girl had died from the swine flu over the weekend.

The Ottawa Citizen reported it. It blatantly states in the first line of the article, “A pre-teen girl from Eastern Ontario died this weekend in an Ottawa hospital of the H1N1 flu virus.” Well, that certainly doesn’t leave much room for doubt. However, later in the article, they admit that the cause of her death was not yet established.

The Ottawa Sun reported it. I have to give the Ottawa Sun some props – though not much – for at least being slightly less provocative and stating that “A pre-teen girl believed to have had the H1N1 virus — but no pre-existing medical condition — died on Saturday at CHEO.” The Sun elaborated that she tested positive for influenza A and all recent cases of this type have been identified as H1N1.

Do I doubt that her death was due to H1N1? Not exactly – I just want them to be 100% certain it is before they publish. It’s extremely tragic for a girl so young to lose her life this way. My heart goes out to her family. The tragedy is compounded when the media is sensationalizing her death. This story made me angry because it even caused a hint of panic in my own family. The good part of this happening is that I’m more carefully evaluating the information that’s out there and how it’s presented. My focus: question everything (even the naysayers).

Here’s the thing (and these are my personal opinions; you can disagree and I’m not gonna try to change your mind): I don’t get flu shots. Ever. (Well, okay, I got it when I was pregnant, because my doctor badgered me into it. If I had it to do again, I would say no.) In my opinion, the flu is not a serious enough illness to warrant a vaccination. (I’m not too keen on the idea of the chicken pox vaccine either, but I still need to research that one.) By the way, I’m not anti-vaccine, but I’m not going to take unnecessary ones.
Given the crapshoot nature of the flu shot, I’m not inclined to bother with it. Additionally, I want my body to build up immunity.

I hated biology and didn’t understand much of it at all, but I have a personal theory that if I let my immune system do its job without trying to “boost” or “help” it along, I’ll hopefully be better off in the long run. I don’t take Echinacea or ColdFX when I feel a cold coming on. I’ve known people who take those things and they’ll go a long time without getting sick and then something truly nasty comes along that takes a while to get over. I don’t see that pattern in my own illnesses. I generally have mild to moderate illnesses that I can fight off within a few days.

Another problem I have with the hysteria around the flu (any kind) is that people are so concerned about it spreading. Despite the fact that we KNOW how to prevent spreading it – wash hands, stay home when sick, avoid coughing on others, etc., etc. – people often ignore these simple things. The worst culprit of spreading illness is that people go to work when they’re sick, or take their kids to school, daycare, and other activities before they’re fully recovered. We all want to be active and engaged in life. We refuse to miss out. We think we’re essential at the office every single day – or our employers aren’t very understanding of sick days. Whatever the reason, it’s clearly not good enough when it comes to the flu. Of course, you might be contagious before you even know you’re sick. That’s when the other sanitary things we know to do should kick in.

One of the major objections I’ve had to the media coverage of this virus/vaccine is that so many statistics are being reported without context. An article in the New York Times stated that “The number of children who have died of the new virus climbed rapidly to 76 this week, already nearing the 88 child deaths for the entire 2007-8 flu season.” I read that and – in the spirit of questioning everything, my first question: How many kids have had the regular flu this season versus in the 2007-8 season? My second question: How many children had swine flu? My third question: Was every single child diagnosed with H1N1 tested or are these diagnoses based on analysis of symptoms? I wouldn’t know to ask that question if I hadn’t found this CBS Unplugged report about the CDC’s diagnosis and tracking of cases of H1N1:

Now, I’m not one of the crazies out there who say the government and big pharma are in it together, though clearly they both have a vested interest in people getting the H1N1 vaccine. Big pharma makes money off of this – big money. The government leaders could lose re-election if people don’t take the vaccine and we have a mild season of illness. If enough people get the vaccine, and we have a mild season of illness, then everyone thinks the vaccine did the trick.

Do I think there is genuine concern from the government/health officials about this situation? I hope so. Do I think this warrants “pandemic” status? Or national emergency status? Not necessarily. Those are debatable points I’m not going to debate. I’ll just say this: When you read about the 1918-1919 Spanish flu, this outbreak of H1N1 pales in comparison to this point. Could it get that bad? Sure. Can it be prevented? I think so. I hope so. Is the vaccine the only way? Not in my opinion.

Now, back to our little panic.

On Tuesday (Oct. 27), my husband sent me an email he got at work – which was basically a PSA – about the H1N1 vaccine. He’d heard about the 13-year-old girl and started wondering if we should get Brandon vaccinated. His concern made me decide to research the issue more thoroughly. I spent at least three hours reading, watching videos, reading more – trying to find something that made me feel safe about getting my son vaccinated. I came to the conclusion – and I only figured out how to adequately express this tonight – that I know what I risk by not getting Brandon vaccinated. However, I don’t know what I risk by giving him the vaccine. That uncertainty simply isn’t good enough for me. (It doesn’t make me feel any more comfortable when the makers of the vaccine have been granted immunity from any future liability.) The vaccine may be perfectly safe, but no one really knows that for sure and I’m not willing to test it out on my child.

While I had made up my own mind, I did share the research with my husband so he could weigh in and we could discuss it.

My personal resolve not to get him vaccinated was tested almost immediately. I got an email Wednesday morning from Matt telling me that Brandon (as well as all the other kids at his daycare) had been around a child from another daycare who was diagnosed with H1N1. I have to admit that I’m feeling Brandon’s forehead for fever anytime he is tired or fussy. But, in the end, this new development didn’t change my mind. Matt has come to the same decision as well, so we’re in agreement.

In writing this, it is not my intention to disparage anyone’s beliefs or opinions about this issue. I believe very strongly in questioning authority and situations like this when there is so much fear, uncertainty, doubt and misinformation being spread. The media has and still is creating hype and panic that is unwarranted and doesn’t make sense to me. (Yes, waiting in line for 6 hours for a shot is included in my definition of panic.) Frankly, I’m getting fed up with the media on this one. There are just too few journalists out there who are actually raising substantive questions.

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