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Posts Tagged ‘seasonal flu’

Never again say “just the flu”

Posted by Henry Bauer on 2020/04/14

Trying to understand whether CoVID-19 really is a disease caused by the new (in humans) virus SARS-CoV-2 has instead made me realize that I never had a proper understanding of so-called “normal” “seasonal flu”.

Now I’ve learned that “influenza A and B viruses can cause epidemic disease in humans” whereas “type C viruses usually cause a mild, cold-like illness”.
And it is not only new viruses jumping to humans from other species that cause exotic dangerous diseases like SARS or MERS; influenza viruses too have natural reservoirs in other species, in particular aquatic birds, and can cause disease in a range of mammalian species including pigs, seals, horses, and humans (https://www.afro.who.int/health-topics/influenza).

During the so-called “flu season”, we often respond to inquiries about minor discomforts by saying, “it’s just the flu”, but we really should say, “it’s just a cold”, because flu — influenza — is not at all a negligible matter; it can result in significant illness and mortality and can spread rapidly around the world in seasonal epidemics. “Pandemic influenza is caused by a new or novel influenza that is introduced into a population where few people are immune. . . . The 1918 pandemic (influenza A/H1N1) which infected an estimated 500 million and killed 50-100 million people worldwide has been the most devastating pandemic to date . . . [while the] 1957 Asian Flu pandemic (influenza A/H2N2), 1968 Hong Kong flu pandemic (influenza A/H3N2) and the 2009 (influenza A[H1N1]pdm09) result[ed] in far fewer deaths” (https://www.afro.who.int/health-topics/influenza).

What we — meaning I — have been thinking of as “normal seasonal flu” is potentially much more deadly than I had realized. Between 1976 and 2006, annual influenza-associated deaths “with underlying pneumonia and influenza causes” averaged 6300 in the USA. But what makes flu so dangerous is that it can greatly exacerbate other “underlying” challenges to health; so the number of annual influenza-associated deaths with underlying respiratory and circulatory causes averaged 23,600, ranging in individual years from 3300 to more than 48,000; for instance, nearly 41,000 in 2001-2 and more than 95,000 in the two years 2003-5 (Morbidity and Mortality Weekly Report 59 [2010] # 33).

The substantial mortality of “normal flu” hints at the problem of trying to understand whether what is happening nowadays can or must be properly attributed not to influenza but to a novel strain of a Corona virus. When it is “only” a matter of the flu, of course we do not see the sort of panic that the news currently brings us daily about overwhelmed healthcare systems, lack of protective equipment for caregivers, tragic individual deaths, and so on.

But what I just wrote happens not to be true. It turns out that such rather panicked communal behavior was in fact described in the 2017-18 flu season, with no other virus than influenza being blamed:

“medical centers are responding with extraordinary measures: asking staff to work overtime, setting up triage tents, restricting friends and family visits and canceling elective surgeries, to name a few. . . . The hospital’s urgent-care centers have also been inundated, and . . . outpatient clinics have no appointments available. . . several hospitals have set up large ‘surge tents’ outside their emergency departments to accommodate and treat flu patients. . . . some patients had to be treated in hallways . . . . Nurses are being ‘pulled from all floors to care for them’ . . . . Many nurses have also become sick, however, so the staff is also short-handed. . . ‘More and more patients are needing mechanical ventilation due to respiratory failure . . . .’ (Amanda Macmillan, “Hospitals overwhelmed by flu patients are treating them in tents”, TIME, 18 January, 2018).

Just like now, it seems. Yet I do not recall anything like the present media-wide, nation-wide hysteria accompanying these conditions — even though the death toll being ascribed to CoVID-19 seems unlikely to end up any higher than that attributed to “flu” in 2017/18: the Centers for Disease Control & Prevention (CDC) estimated the number of “influenza-associated” deaths then at 61,000 — which happens to be the same as the current estimated projection for CoVID-19, down from much larger numbers projected a few weeks ago.

The many uncertainties in the 2017-18 estimate are illustrated by the range of the “95% confidence interval”: 46,404 – 94,987 (https://www.cdc.gov/flu/about/burden/2017-2018.htm): not far from 100,000 Americans might have died of flu in that season.

Why did not the mass media as a whole pick up the story about the 2017-18 epidemic after it was published, including on-line, by TIME magazine? Is it just that a novel non-influenza virus thought to have come from China is more newsworthy than “just another bad flu season”?

The last question is, of course, of much less immediate interest than the issue of trying to find out whether the contemporary pandemic really is owing to a novel corona virus originating in China, as opposed to being a misdiagnosed pandemic of “seasonal flu”.

That question may be well-nigh intractable, unanswerable with any degree of certainty, because of many uncertainties that are unlikely ever to be resolved, given the lack of sufficiently specific and genuinely trustworthy data. The reports of mortality from the CDC reflect the data available to them, and there is no obvious other source for such data. The CDC’s publications do not make it possible to specify the actual individual causes of death: deaths of patients suffering from influenza as well as other respiratory diseases and cardiovascular problems are designated “influenza-associated”, and similarly with patients dying of pneumonia, no matter what other than influenza might have been the precipitating cause of the pneumonia.

In the absence of better data than that available from the CDC, we will have to be satisfied with less than demonstrable certainty in seeking to answer the salient question, whether the global pandemic attributed to CoVID-19 might in fact be owing instead to a particularly virulent strain of influenza, or perhaps even some other virus.

But does it really matter, which virus is responsible for what is now happening? After all, the same practical measures — careful personal hygiene, social distancing — would be taken toward trying to limit the spread of whatever the infectious agent is.

In the long run, of course a vaccine could only the effective if it targets the actual cause, but that bridge cannot be crossed now, it lies more than a year in the future.

Irrespective of now or later, though, it does matter very much if we come to believe something about this pandemic that is not true. The consequences of being wrong could do damage in unforeseeable ways far into the future. The inescapable precedent for that is the case of HIV.

More than three decades ago, it came to be almost unanimously but wrongly believed that HIV causes AIDS (for overwhelming proof, see THE CASE AGAINST HIV). Among the consequences have been immeasurable physical and psychological harm to innumerable people; the establishment, as more or less routine medical practice, the use of inevitably toxic substances as though they could kill viruses without killing the host’s cells that the virus uses for its own replication; and the mistaken but widespread belief that testing HIV-positive is in itself proof of active infection with HIV.

That last belief seems to have become generalized to the extent that at present a positive test for “CoVID-19” is accepted without further ado as proof of infection, even as none of the tests have been established as valid in the only way that could be trustworthy, namely, the prior isolation of pure virus direct from an infected individual. How long-lasting the sad consequences of such mistakes can be is illustrated by the fact that no HIV test has yet, after some 35 years, been established as valid for diagnosis of active infection. The mistaken belief concerning HIV has even survived the open fact that a vaccine against HIV had been projected within a couple of years of 1984 but has never eventuated despite much effort.

A very informative and accurate recounting of the HIV blunder, in the context of the “CoVID-19” pandemic, has recently been posted by Celia Farber (“Was the COVID-19 Test meant to detect a virus?”, 7 April 2020).

Posted in consensus, media flaws, medical practices, prescription drugs, science policy, scientific culture, scientism, unwarranted dogmatism in science | Tagged: , , | 2 Comments »

 
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