Lets Reflect Calmly on the Flu Outbreak
-JP Saleeby, MD
Of course with the memories of the devastating effects of the post WWI flu pandemic of 1918 with the worldwide death rate somewhere between 30 and 40 million people (only 0.5 million deaths in America) we have a right to be concerned and implement effective action. We don't have the right however to become alarmists and panic mongers. This serves neither our patients or our health care system. We can take concerted efforts to control the spread and handle cases that present to our EDs, but we don't have to strike panic in the hearts of the public. Lets take lessons from the 1976 Swine Flu debacle as well as those pearls of wisdom learned from 1918. Lets also put into perspective the death rates of more "mundane" or less sexy health / medical issues our nation / world faces each day.
The Spanish Flu pandemic of 1918 cost the world some estimated 40-million people. Those at the CDC in 1976 estimated some one-million deaths from that years epidemic. In reality there were only 200 cases confirmed with only one death. There was actually more death and destruction that occurred in the process of containment. With the vaccination program in 1976 some 500 cases were reported of the devastating consequence of viral immunizations called Guillain-Barre syndrome which resulted in 25 deaths. So here we have a clear example of where the American public was herded down the wrong path due to irrational panic and the "treatment" was actually worse than the disease. It was also reported in Pittsburgh that three elderly people standing on the long lines for their flu vaccines died of acute heart attacks succumbing to the stress of it all. Again panic claimed three-times the lives of the virus itself. Lets not repeat that in 2009.
There are other things to consider as caution must be taken when reporting and discussing this years flu epidemic. Economic impacts on the travel industry, aviation, travel agencies, hotels, and restaurants for example are feeling the heat quite possibly unnecessarily. Even the lowly pig farmer is suffering mostly due to the misunderstanding of the disease process. The debacle of the Swine Flu epidemic of 1976 which just didn't pan out embarrassed our federal government and cost the job of the director of the CDC. So let us proceed cautiously.
Putting things in greater perspective lets look at other issues that are maybe less glamorous today but still impact our health care system. Possibly this will give us reason to become more interested in conquering these great threats. Lets take world-wide malaria. Malaria kills almost 3000 people a day in sub-Saharan Africa (mostly children) that amounts to almost 1.1-million deaths a year. Those are numbers we should be ashamed of and they just don't make the headlines today. Lets look at the impact of auto accidents on our highways. Some 115 deaths occur each day as a consequence of motor vehicle accidents and that come to 42,000 deaths a year. Many of those deaths are caused by drunk drivers. Alcohol impaired drivers make up some 32% of deaths on the highway (13,500 motorists per year die at the hands of the drunk driver).
So before we get crazy over a "flu pandemic" that may not even pan out, lets take some quiet time to reflect on the facts and reality and realize what we are truly facing and handle it with poise and rational behavior.
-JP Saleeby, MD is medical director of the ED at MPH in Bennettsville, SC.