Wednesday, July 06, 2005

I think my head is going to explode

Thanks to Gina at RenegadeMom, I found another “oh sweet jesus the pandemic flu is upon us” article. This one from CNN last Friday.

I’m seriously irritated right now. Shallow breathing. Nauseous. Light-headed. Shoulders tense.

I feel like I’m the butt of some depraved reality life experiment, like the Truman Show, or The Matrix, or the episode of Spongebob Squarepants where Sandy Squirrel longs for her Texas homeland.

You know that old saying that if you repeat a lie often enough it will become truth? Well, the god-forsaken media have repeated the lie about how many Americans die from influenza so many times that it is nearly impossible to argue otherwise. It has become an accepted fact.

In this CNN article they state, “In an average year, influenza kills an estimated 36,000 Americans and puts 200,000 into the hospital.”

This is a commonly cited stat. But it’s an utter fabrication! May I say, it’s bullshit!

Arrgghhh! How can people make informed decisions about when to rely on medical interventions (such as vaccines) and when to rely on their otherwise good health to keep them feeling groovy?

Here are the facts, from the most reputable health monitoring agency in America – the Center for Disease Control. Their stats about deaths due to influenza come nowhere near this mythical 36,000.

Follow along with me if you’re skeptical. I will help shatter those rose-colored glasses…actually, in this case the glasses are black, like death, covering our ability to see clearly:

Go to this CDC webpage

Now go to the second PDF file in the list on this page, G00.1-L00 (1,110 pages) (or link from here)

You can now either search for the keyword “Influenza” and find 12 mentions of it, or, you can simply read the following list. Either way, you’ll get the identical information. These are all American influenza death statistics:

  • Influenza due to identified influenza virus: 99
  • Influenza with pneumonia, influenza virus identified: 38
  • Influenza with other respiratory manifestations, influenza identified: 59
  • Influenza with other manifestations, influenza identified: 2 (that’s not a typo, it’s two)
So far, that’s a total of 198 Americans who died in 2002 from identifiable influenza virus. Under 200 people. And more than half of those folks were over 80 years old! Just 16 kids under 10 died from influenza in 2002. Sixteen! Why in God’s name are we giving flu vaccines to hundreds of thousands of infants and children?!

But wait, there’s more. The CDC also lists the number of people who die from something that is called influenza but was not actually identified as such. Doctors who don’t test to see if the patient died from influenza but think that influenza was the cause. Here are those numbers:
  • Influenza, virus not identified: 628
  • Influenza with pneumonia, virus not identified: 291
  • Influenza with other respiratory manifestations, influenza not identified: 323
  • Influenza with other manifestations, influenza not identified: 14
And that’s it. Those are the actual deaths attributed to influenza from the actual Center for Disease Control in 2002. Again with these numbers, more than half were people who had already seen their fair share of days.

198 confirmed influenza deaths. 1,256 unconfirmed influenza deaths. From the CDC itself.

So where does the magic 36,000 deaths a year come from? You see, the CDC doesn’t require doctors to report deaths due to influenza, so they make up a number that feels right based on computer models and statistical projections. Please! The question begging to be answered is, “why?”

Why doesn’t the CDC require doctors to report cause of death when it’s influenza, but requires cause of death reporting for cancer, car accidents, gun shots, and so on and so on and so on? Why?

Of course, I don’t know why, but most people who don’t ask for information don’t want it. Is it possible that the CDC doesn’t want to know how many people in the USA die from influenza since, if the numbers really are as low as they appear based on the reporting that is done, the public may stop fearing the flu, stop getting their annual shot, and maybe even resist all of the anti-terrorist vaccines that will one day be forced on us all?

Back to all the noise about the imminent flu pandemic…experts predict up to 7.4 million people globally will die. They cite the avian flu as a real possibility to set the pandemic in motion. But so far, nobody has died from the avian flu – just a lot of birds living in pretty crappy conditions. When I did math a couple decades ago in school, I thought I learned that any number multiplied by zero was zero. I wonder how the computer model that came up with 7.4 million got that number.

Must drink scotch now.


    10 Comments:

    Anonymous Anonymous said...

    Dear Shattering,

    The "cause of death" records the immediate cause of death, such as "pneumonia" and "multi-organ failure", which may be secondary to other causes. Depending on the immediate causes of death, there may not be room on the form to include the causes of those causes--influenza, alcoholism leading to vomiting leading to vomit aspiration, etc. This combined with the non-reportability of influenza means that statistics are the only way to get to the likely figures.

    Now, there is a flaw in your logic; you say that there are few deaths in the age group under 10 and therefore we don't need to vaccinate children for influenza.

    DId it occur to you that the *reason* there are few children under 10 who die is *because* there is so much vaccination? The vaccinated children in general never become sick with the virus in the first place, but they also put an evolutionary pressure on the viruses to be less virulent--a more powerful virus would so disable its host that the host would go straight to bed and stay there, never encountering another susceptible, non-vaccinated person. Only those viruses weak enough that their hosts continue to run around and play for awhile encounter enough other kids that the virus gets a chance to infect another kid who hasn't been vaccinated. So only the weaker flus survive.

    Lastly, regarding bird flu, even with these so called 'inflated' death rates for ordinary flu, the death rate from ordinary flu is less than 1/2 of a percent. The death rate for Bird Flu, counting only this year's cases when the virus is much more "mild" than last year, is a whopping 34%!!! These are deaths from the flu itself (viral pneumonia and ARDS), without secondary bacterial pneumonia. This makes the bird flu as deadly as the black plague of the middle ages.

    But there's no vaccine (yet) for the bird flu, so that should make you happy.

    July 06, 2005  
    Blogger pogge said...

    ...so far, nobody has died from the avian flu

    The BBC seems to disagree, reporting that 53 have died in Vietnam, Thailand and Cambodia.

    July 06, 2005  
    Blogger Donna said...

    pogge - thank you for this link. I had read in March that 5 deaths had been attributed to avian flu in Thailand (I believe) but since that one story have only read that avian flu has not yet infected humans.

    For such a huge media story, and potential global health crisis, one would think that all of the various health agencies would be working with the same data...I wonder why different countries have different stats.

    July 06, 2005  
    Blogger Donna said...

    Thanks for the comment anonymous. I wish I had more time to respond...

    re: cause of death records. I guess my basic question is how 200 deaths due to influenza is extrapolated to 36,000 by modelling. If I were to extrapolate a vaccine injury rate of 36,000 based on just 200 reports to the CDC, that data would be laughed into oblivion (even though vaccine injury is widely known to be highly under-reported by doctors). It would never be held up as fact, the way 36,000 influenza deaths each year is touted.

    Re: kids under 10 not dieing from influenza since they're vaccinated. That's just not true. Kids have only been on the flu vaccine hit list for a couple of years. Old folks have been there much longer and have a significantly higher vaccination rate than kids. Yet the old folks make up the majority of deaths.

    Logically, this makes sense since old folks are more likely to be suffering from some other disease or illness or simply the effects of being old. Basically, if the flu doesn't kill them, something else will. Kids have, in general, sturdier immune systems to protect them.

    Re: comparing bird flu to other influenzas and the comparison of a 0.5% death rate versus 36% death rate...there are far too many differentiating factors to make this comparison. For one, the influenza stats are American, while the bird flu stats are from developing countries. Overall, the well-being and health of the two populations are likely too different to draw any conclusions.

    We also have no idea about exposure rates. In fact, we can't actually say with any confidence how many people exposed to the flu get it since very few people are confirmed with flu and many folks self-diagnose with flu when all they have is a garden variety bug.

    Re: bird flu as deadly as the black plague of the middle ages. Just think about life in the middle ages...we don't live in those same conditions anymore. We don't sleep with our livestock, throw feces into the road, drink contaminated water daily, etc, etc, etc. It just doesn't make sense to compare a pandemic from hundreds of years ago (or even 100 years ago when Canada was still a developing country!) to today.

    Finally, re: avian flu vaccine not being available. This is true, but is HAS been developed and is undergoing testing now. If fear is high enough, the government could easily decide to shorten the testing period and launch into a mass immunization campaign.

    I can back up every assertion with facts and stats from reliable sources.

    July 06, 2005  
    Anonymous Anonymous said...

    Dear Shattering,

    I agree that vaccine injury is highly under-reported by doctors. In actuality whenever someone has an adverse drug reaction of any kind, doctors are supposed to fill out a form so that the manufacturer and the FDA can track drug safety. But this is rarely done. You as the consumer can do so as well:

    http://www.fda.gov/medwatch/

    As for old folks dying more than children due to their chronic diseases, this is true. However without vaccination children do die of flu more commonly than adults in their prime. Remember too that because vaccination of children for flu is fairly new, many older children who are not vaccinated are immune to human flus because they have recently had a human flu related to the one 'going around'.

    You can see an example of this with the current Cambodian human Influenza B outbreak--the younger children are being affected and the older ones are mostly not affected, probably because they have already had a milder version of the strain that is circulating and are already immune to it.

    Only 107 humans have had H5N1 bird flu so far, which leaves the rest of us as vulnerable to bird flu as those young Cambodians are to the Influenza B.

    You are right that we don't know much about exposure rates. We do know that Vietnam had far more cases of human influenza than of bird influenza, so they are capable of identifying when someone has the symptoms. They have even gone back to re-look at samples for those cases (with a false alarm about 1000 of them at one point) to see if any were H5N1 and were missed, but so far they have found no missed cases. This lack of missed cases is why they think that the virus is still not easily transmitted from one human to another, and why they think there are not a lot of unidentified cases out in the community; a large sample of the year's flu cases has been looked at and none of these milder flus were of the bird type.

    As far as the comparison of bird flu to the black death, you are right, the conditions when the black death killed 33% were primitive. But today, in Vietnam, with conditions that are much much better than the european middle ages (even if they look primitive to us), and with intensive care in Hanoi that is as good as ours in the US, this virus *still* kills 33% of the people that are infected. (Overall it has killed 54 of 107 infected, but that is for all cases since 2004. The ones in 2005 show a 33% mortality.)

    Because we have no vaccine proven to prevent the disease, and because we have a shortage of the expensive drugs that can treat the disease, in some ways we are as bad off as if it were the middle ages. Our advantage is primarily in having clean water, sewer and heat, because in a pandemic the intensive care units will be swamped and essentially unavailable. So, the level of care during a pandemic will be primitive. Our advantages are not at the level of treating the sick, but at isolating the sick from the well and from further infections, because of our public utilities.

    I'm sure you know that many people who die of human flus die of bacterial infections that move in and take over after the virus. With bird flu, the virus kills directly--either via viral pneumonia (which cannot be treated with antibiotics), or via a phenomenon called 'cytokine storm', where the immune system gets stuck in an 'always on' condition. Like sharks in a feeding frenzy, the immune system cells start attacking anything and everything, resulting in multi organ failure and death. Unfortunately we don't know enough about this phenomenon to say anything about how to prevent it--don't know what drugs to give or what foods to eat.

    If you give something to knock the immune system down, the virus takes over. If you give something to boost the immune system to knock down the virus, the immune system goes haywire and destroys the patient.

    Tamiflu directly attacks the virus without messing with the immune system. But one of Tamiflu's ingredients comes from a tree grown in China, so even if we had manufacturing capacity to make it, we'd be at the mercy of world trade to get the factory feedstock. And in a pandemic world trade may well shut down.

    Mercury is no longer used in flu vaccines, but they still contain egg proteins in trace amounts, so the main reason not to get a vaccine is if you are allergic to eggs. Depending on the severity of your allergy, some folk can get a benadryl shot (ouch!) to control the allergy and get the vaccine anyway. In a case where the bird flu pandemic kills a fraction of a percent of those made ill, allergic people would be safer to avoid the vaccine. But if bird flu retains anything at all comparable to its 33% killing strength, then even the allergic may find it worth taking the risk of a vaccine.

    Right now one of the big questions about the vaccine though, is whether it will have any protective benefit. Normally to make vaccine you grow the virus in fertilized eggs, harvest the eggs and purify the viral proteins, and use the proteins in the vaccine to generate an immune response. But H5N1 is so deadly to chickens that it kills the eggs too soon. So they have to use a less virulent strain and there's no guarantee that its proteins are similar enough to the killer flu to offer any protection. There's also an issue that since no one has had a flu of H5 type before, most people will probably need a booster shot, which makes the supply of vaccine that much tighter even if they can make one.

    If a vaccine is available and if it has passed safety testing, given that it contains no mercury, then I see no reason not to accept it. But the only way to find out if it actually works is to expose vaccinated people to the killer flu and see if they stay well--an experiment that would be highly unethical, but that will happen de-facto as vaccinated people become accidentally exposed during an outbreak.

    (I hope nobody from Abu Ghraib (sp?) reads this or that unethical experiment might happen anyway, given all the ethically unsavory activity going on there...)

    July 06, 2005  
    Blogger Donna said...

    Thanks anonymous (2). Your articulate and reasoned comments are very helpful and educational. I know I get a little "breathy" sometimes with my blog. I appreciate your level-headedness.

    My background is not in science or medicine, but in social marketing and communications campaigns to change public values and behaviours. I have spent 9 years studying the vaccination culture, watching it grow as one disease after another is vilified as a terrifying killer.

    Meningitis, hepatitis b, chicken pox, and the flu all come to mind as infections and diseases that are either rarely deadly or rarely contracted - but fear around them grows with the marketing of the vaccines which, in all cases, only temporarily keep us from contracting the disease.

    The avian flu may indeed be the "big one." My big frustration comes mostly from the fear tactics being used to get people all excited about it. As individuals, we are helpless to do anything, relying on government and industry to make the right decisions on our behalf.

    Given what we've seen the US gov't do "for our good" over the past 4 years, I find it very hard to have any faith in gov't doing the right thing. Too many close ties to industry and alterior motives that have nothing to do with public health and everything to do with shareholder profits.

    Think about this for a second. The companies that are investing in the R&D to make the avian flu vaccine want to make back their investment. They won't make a cent if people don't demand the shot once it's available. I know this is simplistic, but really, do we need all of the thousands of news stories (generated by gov't press releases) about the possibility of an avian flu pandemic? News should be about reporting facts, not opinions about what may happen at some future time.

    The media's role in creating the environment of fear that gov't relies on to get citizens to give up rights, is appalling.

    Although I am personally, in my own family, not a vaccine supporter, I do believe that every individual should have the right to choose their preferred way to be and stay healthy. Sadly, with gov't fear campaigns and media complicit in the promotion of fear, individuals are not adequately informed of risks and therefore informed consent does not and cannot exist (either to demand or refuse medical interventions such as vaccines).

    One final note: about unethical medical experiments..take a look at my post titled "Better to be a rat than a grandma." Recent news from Canada shows that drug testing is often not being done ethically. In downtown Toronto...no need to travel to Abu Ghraib!

    July 06, 2005  
    Anonymous Anonymous said...

    Dear Shattering,

    --My background is not in science or medicine, but in social marketing and communications campaigns to change public values and behaviours. --

    These are valuable skills. Maybe I can co-opt you to the Avian Flu cause? But not to promote vaccines, as you'll see...

    --Meningitis, hepatitis b, chicken pox, and the flu all come to mind as infections and diseases that are either rarely deadly or rarely contracted - but fear around them grows with the marketing of the vaccines which, in all cases, only temporarily keep us from contracting the disease.--

    I submit that some of these are rarely a problem *because* of the vaccine programs, via evolutionary pressure explained during one of my previous posts to this thread. I'd like to point out also that we nearly made the disease polio extinct last year, but now we have an epidemic of the disease in Indonesia, where it has infected at least 100 children (an unknown number of whom are now permanently crippled). What happened was radical Moslem clerics in two remote counties in north Africa convinced their congregations that the polio vaccine was actually a western plot intended to sterilize the children, not protect them. The result of this was an outbreak of polio in that area, which apparently now has been carried to a primarily Moslem area in Indonesia by someone traveling from this tiny infected pocket of Africa. So now the polio genie is back out of its bottle, because of illogical resistance to vaccinations on the basis of paranoia and some tin-pot Imam's desire to keep his flock from seeing something good come out of the evil West.

    --The avian flu may indeed be the "big one." My big frustration comes mostly from the fear tactics being used to get people all excited about it. As individuals, we are helpless to do anything, relying on government and industry to make the right decisions on our behalf. --

    Okay, now this is where you and I have fundamentally different assumptions. My assumption is that this is a problem that is fundamentally too big for our centralized government to deal with, that aggregated resources will be depleted and regions will suffer temporary isolation, and so we must take on a pioneer spirit to be sure that we as individuals are prepared. If we as individuals are prepared, then we can help our communities prepare on a local and regional level for the lack of central support. Some of us here blowing the horns of alarm are trying to wake up the *individual* to take action because the government is not willing or able to step up to the plate on this issue. We are *not* helpless recipients of aid, waiting for the government to act, we are the people, owners of the government, and we are acting on a grass-roots level to act and save lives while the government scratches its nuts and decides what to do.

    The point is not to use fear tactics for some nefarious government purpose, but to alert people to the fact that this is a *genuine* threat and that they are *not* powerless to do anything about it. If the government can provide a vaccine or tamiflu, that's great, but in reality such things are likely to be in such short supply that neither you nor I will have access. Everything else that can be done is in our grasp to do, and we *should* do it. But we can only be moved to action if we are informed of the threat, and what you seem to see as alarmism is an effort to get people to recognize what is coming and that they are not helpless to defend themselves.

    This includes not only stockpiling a cache of supplies in case we are quarantined for a few weeks, but coming up with a plan, if we own business, for how we will deal with temporary infrastructure breakdowns, workers out sick, closure orders for quarantine, etc. If we don't own a business, it is about talking to people we know who do, and convincing them that they need a plan before this crisis occurs. For non-critical businesses (retail clothing, for example) the plan may involve having resources to survive a 2 month ordered shutdown. For a grocery it may mean carrying extra inventories of storable staples and having excess capacity in the suppply chain.


    --The companies that are investing in the R&D to make the avian flu vaccine want to make back their investment. They won't make a cent if people don't demand the shot once it's available. --

    This is true, and this is the reason we still have the unwieldy 1950's slow-poke technology that we are currently using for vaccines. There's no profit in this market and so all but two of the manufacturers have left it. In fact, the US government is having to figure out a way to guarantee that they will buy excess bird flu vaccine in order to entice companies to attempt to make it, knowing how uncertain the need is and to cover the possibility that some of the vaccine may be made with the wrong strain.

    --News should be about reporting facts, not opinions about what may happen at some future time.--

    So, I suppose you never read the astrology page?

    So far as we can tell, the laws of physics haven't noticably changed in the past few centuries, and the laws of biology that derive from them have been likewise pretty constant. The projections being made are based on the notion that things that happened in the past are pretty good predictors of how similar situations will unfold in the future.

    So they are not just 'opinions' as are common in the world of marketing and politics; they look at data from past pandemics (particularly the pandemic of 1918, whose virus acted similarly to what has been seen so far in H5N1 patients) and apply those percentages to the current population numbers to get their projections.

    --The media's role in creating the environment of fear that gov't relies on to get citizens to give up rights, is appalling.--

    That's true, but here in the US most of the epidemiology and public health wanks are annoyed that the media is *not* covering what is seen as a serious threat, and therefore individuals and businesses are *not* preparing with realistic plans to deal with the problem with or without government help.

    I'm not advocating some kind of revolt against government here, just some individual action so that when the government finally does come forth with an outline plan that includes 'shut down the mall if x cases occur', the businesses in that mall can say, 'okay, for that contingency, this is what we're going to do, these are the contracts with flu-bailout clauses we've made so we don't have to take and pay for inventory we can't sell during those months, here's how the mall is going to save money by shutting down utilities and pass that savings on to the tenants to help keep us solvent...' Or whatever businesses have, in aggregate, decided to do to protect themselves economically along with their workers' lives.

    The goal in raising alarm is that if a quarantine is called, families go home to their well-stocked kitchens and spend a month playing twister while the virus runs out of available contacts to infect, while those in critical jobs who cannot stay home have adequate personal protection not to catch the disease and bring it home--be that protection barriers (masks etc.), vaccine, or other drugs.

    I'm the same anonymous as the two prior posts, fyi. You could probably tell because I'm so longwinded.

    So, have I converted you to our cause?

    July 06, 2005  
    Blogger Donna said...

    I’m going to work backwards with your post since I may run out of time before getting to address all the points you made – some of which I’m quite excited about. Others which I think I should just post a new entry on my blog to address.

    To start, I have been moved from my position of “the avian flu news is unnecessary” to “there could be a good reason to get people excited about the avian flu.” You put forward some good arguments for public info campaigns, especially related to the “how can we as individuals prepare for such an event.”

    I live on the coast of British Columbia. Every time there is an earthquake in California, or a major quake elsewhere in the world, we’re reminded that we are overdue for “the big one.” But these newscasts and interviews don’t instill panic – they do just as you described needs to be done for the “potentially” looming the (avian) flu pandemic. They remind us what we need to do to be prepared. So far, I’ve seen no coverage of this sort. Just doom and gloom projections of deaths and lacks of hospital beds, etc.

    **********
    Which leads me to your comment that my background could be useful to you. My big question, of course, is who are you!? Why are you posting such reasoned and eloquent comments and not giving me an opportunity to check your blog…or your website…or google comments you’ve posted at other blogs?

    I would be interested in further discussions with you, but unless you’re high profile whistle-blower who is keeping your identity secret so you can continue to infiltrate industry or gov’t, then why not expose yourself?

    ********
    I said: News should be about reporting facts, not opinions about what may happen at some future time.

    You said: So, I suppose you never read the astrology page?

    You’re joking, right? Please tell me you understand the difference between front page news and section C entertainment. Unfortunately, this kind of flawed analogy, even if it seems obvious to anyone reading this blog, is the kind of argument that people who are less “aware” will grab onto and remember, and repeat. It’s crazy-making!

    ********
    I said: we are helpless to do anything, relying on government and industry to make the right decisions on our behalf.

    You said: We are *not* helpless recipients of aid, waiting for the government to act, we are the people, owners of the government, and we are acting on a grass-roots level to act and save lives while the government scratches its nuts and decides what to do.

    Hallelujah for you and all the folks who are taking this issue into your own hands. Seriously. You are not like the vast, vast majority of citizens though. The world (especially the USA, if I can throw in a political comment) needs many more people who are ready and willing to stand up and start grassroots movements. Until this post, though, I didn’t understand that part of your strategy is to empower people with preparation facts. That, in my opinion, is what has been lacking in all that I’ve seen in mainstream media coverage. Hooray for you – whoever you are.

    ********
    The whole polio/vaccine thing. Too big to address in comments. I’ll do a blog entry. (I may have already done one…) The Coles Notes version is that polio was *not* almost eradicated by the vaccine. Even the vaccine-makers admitted in the 1950s/1960s, when polio was at it’s worst, that every case of polio was actually caused by the vaccine. And with the redefinition of what polio is, since the vaccine was released, we actually have no solid ground for drawing any conclusions. This is too short a response. I’ll get back to it when I have time.

    *********
    Anyone else reading this? Feel free to chime in. The more opinions, the better. Anonymous and I could learn a thing or two from others – the actual people we’re hoping to bring along in our campaigns!

    July 07, 2005  
    Anonymous Anonymous said...

    Dear Shattering,

    By 'us', I mean those of us who are contributing to the flu wiki (www.fluwikie.com), which is trying to be a compendium which individuals and businesses can use to empower themselves against this threat. I am not one of the editors there, however.

    I'm not a high powered whistleblower, but I do have professional reasons for at least making some effort to remain anonymous.

    The astrology thing was most definitely a joke. It just seemed to me that your description of putting forth unfounded guesses about the future as if they were fact was a perfect description of that avocation.

    How do you eat an elephant? One mouthful at a time. That vast population out there waiting to be saved can slowly be converted to a population saving itself. We just need our Ro of conversion to be faster than the virus's Ro of infection. (Ro--'are naught'--is a theoretical optimum of how fast a disease transmits.)

    July 08, 2005  
    Blogger DemFromCT said...

    Shattering, there's been communication links added to the Flu Wiki in the ethics section. Feel free to drop by, inspect and comment in the Forum.

    And yes, the flu wiki is a pubic health experiment in empowerment

    July 09, 2005  

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