Fumento: No More Crying Spanish Flu (Forbes)

[Guest guest]

Commentary: No More Crying 'Spanish Flu'

by Fumento, 05.20.10, 12:01 PM EDT

Flu season is over, and the fatalities weren't that high. Now can we stop the

hysterics?

Flu season has officially ended. We had about 12,000 fatalities, a third the

usual number according to Centers for Disease Control and Prevention estimates.

Yet almost all infections were H1N1 swine flu. The World Health Organization

(WHO) has confirmed 18,036 swine flu deaths over the past year, somewhat shy of

the 250,000 to 500,000 it estimates die annually of seasonal flu. So it's hard

to imagine that a year ago top public health officials and the media were

comparing swine flu to the Spanish flu of 1918-19. That pandemic killed about 50

million worldwide and 675,000 Americans, what would today be equivalent to 175

million globally and 2 million Americans.

Unless, that is, you're aware that this is now the third " Spanish flu " has been

proclaimed since 1993, the equivalent not of crying " Wolf! " but crying " Wolf

pack! "

Let's review.

At a media briefing on April 29, 2009, with all of eight worldwide deaths

reported, World Health Organization " swine flu czar " Keiji Fukuda declared: " In

the 1918 Spanish Flu the patterns were similar. " Yet the only similarity

mentioned was that both started as mild. A week later U.N. flu coordinator

Nabarro, who four years earlier predicted as many as 150 million deaths from

avian flu type H5N1, also invoked the Spanish flu at a press conference. Again

he only cited the mildness of swine flu. And in between those dates WHO

spokesman Hartl, at a virtual press conference, warned that while cases

were ebbing, the Spanish flu also ebbed in spring, only to return in autumn

" with a vengeance. "

So mildness and declining cases are a portent of horrible events to come?

Others made imaginative efforts to connect the two flus. One major wire service

observed that both viruses " are of the (A) H1N1 subtype, " that both " appear to

have originated in animals " and " researchers believe the Spanish Flu spread to

people from birds. " It didn't say that an H1N1 strain has circulated as seasonal

flu every year since 1977 and that wild aquatic birds are the natural reservoir

and spreader of all influenza A viruses.

Laurie Garrett, author of the 1985 book The Coming Plague, used swine flu in her

Newsweek cover story to preach that our environment, left unchanged, " will one

day spawn a severe pandemic that will dwarf that of 1918. "

Naturally public health officials now insist the swine flu would have been

vastly worse but for their warnings and efforts. But virtually no vaccine was

available until after the epidemic peaked in October and hand-washing campaigns

probably had little effect, insofar as there's little evidence hand hygiene

prevents flu spread. So WHO Secretary-General Margaret Chan offered the ultimate

excuse: We were " just plain lucky. " Anger over the misspent money and misspent

fear has led to the forming of a panel to investigate her agency, but don't

expect much from it--Chan appointed the members.

Forbes readers knew all along swine flu was a soggy pork chop, because that's

where I published my first piece on the " porcine panic " --two days after Fukuda's

declaration and a week before Nabarro's. Either I'm the new Nostradamus or I'm

simply not an alarmist. (Hint: I've never made a dime at the race track.)

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The Previous " Spanish Flu "

The " Spanish Flu " was avian flu H1N1. Nabarro's top estimate of 150 million

deaths was merely Spanish flu deaths extrapolated to today's world population.

Osterholm, director of the federal Center for Infectious Disease

Research and Policy estimated in 2005 in The New England Journal of Medicine,

that there would be 180-360 million deaths worldwide and 1.7 million here if

bird flu became readily transmissible between humans. He restated those figures

during countless national TV appearances. His source: An extrapolation to

today's population from the worst estimates of Spanish Flu fatalities.

Garrett, in a mid-2005 award-winning article wrote " Scientists have long

forecast the appearance of an influenza virus " that would kill " unimaginable

numbers " and that avian flu has shown all the earmarks of becoming that

disease. " She added that while bird flu was commonly being compared to Spanish

flu, in fact " avian flu is far more dangerous. "

But bird flu has stubbornly refused to go pandemic at all, peaking at 79 deaths

in 2006. None of the experts pointed out that we've been rubbing shoulders with

it since at least 1959, when it was discovered in poultry.

And Before That ...

The " Spanish flu " before that was SARS (Severe Acute Respiratory Syndrome) in

2003. , who headed a team of international doctors that snuffed

out smallpox and is now a professor at s Hopkins University, compared the

two diseases and expressed great worry. The Global Health Council declared SARS

could kill 60 million people worldwide, about the same number Spanish Flu did.

The Washington Post published an article syndicated throughout the country under

such headlines as " Spanish Flu Shows How a Disease like SARS Could Sweep the

Globe. " It did concede there were differences--such as " SARS is deadlier. "

Ultimately SARS killed just 774 people worldwide, and no Americans. Yet the myth

that it was a devastating killer lives on, such that two years later a reporter

for a nationally televised news program informed watchers " The toll from avian

flu could dwarf SARS and [sure enough!] even the 1918 Spanish Flu. " And

illustrating that Spanish flu isn't the only disease being abused in

comparisons: s Hopkins University Press, a year after SARS disappeared,

published a book titled Twenty-First Century Plague: The Story of SARS.

Yes, hindsight is 20/20, but at the beginning of both the SARS and avian flu

outbreaks, not just that regarding swine flu, I proclaimed them hysterias.

Again, if I knew, others knew or should have known.

So Why Did They Do It?

The sole reason for invoking a horrific flu outbreak from 90 years ago rather

than the far more recent and vastly milder pandemics of 1957-58 and 1968-69 is

just that. Spanish Flu was the worst.

Yet the reason for that may have had a lot less to do with the genetics of the

virus than its perfect storm timing.

In 1918 people were in far poorer general health than we are today and we know

that's a powerful factor in infectious disease severity. " Between 14 and 17

million people die each year due to infectious diseases--nearly all live in

developing countries, " according to the Global Health Council.

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The world war contributed in many ways to the toll. That included malnutrition

from food shortages (Germans were literally starving) and soldiers being packed

together in box cars, ships and trenches. In fact, " Spanish " flu was first

identified in the crowded environs of Fort Riley, Kan.

Also, since 1918 we've developed flu vaccines, antivirals, pneumonia vaccines

and antibiotics. Those last two are vital because secondary bacterial infections

cause the vast majority of flu deaths. Both Osterholm and Garrett have argued,

as Garrett wrote, Spanish flu " was a direct killer " and " Had antibiotics

existed, they may not have been much help. " Wrong. Even at the time medical

journals reported that bacteria normally administered the Spanish Flu's coup de

grace. Much recent research has confirmed it.

SARS may indeed have been a deadlier pathogen than Spanish flu. But regardless

of the severity or contagiousness of a new virus, it will never again have those

" wonderful " conditions of 1918-19 in which to spread and kill.

Ultimately all our health officials and media are doing is inducing complacency

that could be devastating if and when a real health emergency arises. It's time

to retire the Spanish flu wolf pack. And yes, the plague one along with it.

Fumento is director of the nonprofit Independent Journalism Project,

where he specializes in health and science issues and misinformation cascades.

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