H1N1 – The Pandemic that Barely Was
Photo Courtesy of The National Post
How you doing? Sniffly? Sneezy? Got a frog in your throat or a crick in the neck? Do you feel, to use the vernacular, like you want to barf up a lung?
Nope. “Fine.” That’s good to hear. And on that account, I say told you so.
With spring springing and the arrival of longer, warmer days and the promise of fun and excitement in the great outdoors, it’s time to take accounting of the pandemic flu season that just past. Or perhaps that should be non-demic.
I was serving on the Community Editorial Board of my local daily, The Guelph Mercury, this time last year. As the coming swine-flu-pocalypse was starting to break, I waxed sarcastically about the media’s attention to hysteria, and how when all the beans are counted, common medical sense will bear out and all the worry will have been for not.
So tell me, did you die in a swine flu pandemic this past winter? Did any of your friends and family?
The Flu Watch section of the Canada’s Public Health Agency’s website states the current situation thusly: “Over the last few weeks, all influenza activity indicators are either within or below the expected range for a normal flu season, marking the end of the second wave of H1N1 flu activity in Canada. There has been a significant decrease in the rates of H1N1 infection, hospitalization and deaths.”
But I wondered, at the peak what was the rates of infection, hospitalization and death in Canada. Cited by the CBC website in a post dated January 12th, 2009, Health Canada pegged the number of flu-related deaths for the 2008-09 flu season as somewhere in the neighbourhood between 4,000 and 8,000.
By comparison, the total number of deaths resulting from H1N1 in Canada between April 12th, 2009 and April 17th, 2009 is 428. A grand total of 8,678 people were admitted to the hospital for H1N1 and about an eighth of those, 1,443 people, spent time in intensive care. And if that still sounds pretty bad to you, consult the charts on FluWatch (http://www.phac-aspc.gc.ca/fluwatch/) and note how the worst was pretty much over by Christmas. In fact, infection rates had started to trend way down after November.
According to the World Health Organization, the most recent number of H1N1 deaths across 214 infected countries is 17,853. Now, that’s nothing to sneeze at (so to speak), but an article on CNN.com puts the annual number of deaths from seasonal flu at somewhere between 250,000 and 500,000; nine out of ten of those deaths are people over the age 65 (also known as some of the most susceptible people to the flu).
Even if we combine all the numbers, this is still a far cry from the between 2 and 7.4 million that was originally estimate to be killed by H1N1 last spring by the W.H.O. It’s also a far cry from the 40 to 50 million worldwide that were killed in the flu pandemic in 1918, which some considered would pale if the swine flu should come to the worst of the worst. But if H1N1 can be proud of one thing, it did beat the total number of fatalities inflicted by both bird flu (H5N1) and Severe Acute Respiratory Syndrome (SARS) – combined.
Of course, hindsight is 20/20, but there was a small, semi-vocal contingent last fall that “called it” so far as excessively gloomy forecasting about the impact of H1N1 is concerned. Now it’s time for the conspiracy theorizing to begin. “[The WHO’s declaration of a] Phase 6 [pandemic] acted as a switch that would allow bells on the industry’s cash registers to ring, risk-free, because many pandemic vaccine contracts had already been signed,” writes Der Spiegel, a German news magazine. “Germany, for example, signed an agreement with the British firm GlaxoSmithKline (GSK) in 2007 to buy its pandemic vaccine — as soon as phase 6 was declared.”
But in terms of quantified practicality, there’s a steep price tag attached to the H1N1 hysteria, and provincial governments and health organizations in Canada are just becoming aware of it.
According to the Vancouver Sun, approximately $8 million worth of H1N1 vaccine, over half of the 4.3 million doses allotted to British Columbian doctors, will expire. Only 40 per cent of the B.C. population got that vaccine, but it was believed that the medicine could be kept for 18 months in case of a flare up of the disease. Health Canada earlier this month said that the vaccine loses potency after six months. Nationwide, the cost of thrown out, unused, H1N1 vaccine could top $20 million according to the federal government.
The conspiratorial readers of Der Spiegel will surely be interested to know that GlaxoSmithKline saw a rise of 16 per cent in total earnings for the first quarter of 2010. That translates into $2.5 billion CDN thanks, in no small part, to the H1N1 vaccine. Is it any wonder that the Alberta government, with as many as 700,000 doses of leftover vaccine, is leading the push to recoup money spent on medicine that’s just going to go to waste?
Certainly, the limited number of casualties is no comfort to the people that lost friends and family to H1N1 and misery doesn’t love company for the thousands that die of the regular annual flu. But perhaps now is the time to think about when and how we use the term “pandemic.” And before pointing out that our advanced warnings, safeguards and long line-ups for shots probably stemmed the tide, one could offer that not nearly half the country got the H1N1 vaccine. If over half the population can refuse a vaccine and a pandemic still only turns out fewer than 500 casualties, it could be argued that it was a pretty weak pandemic to begin with.
Still, this is the benefit of hindsight. “You can’t predict the seriousness of pandemics in advance,” Anne Doig, president of the Canadian Medical Association told the National Post. “If you don’t get the vaccine ready and out there and it turns out to be a really nasty thing like SARS, then you’ve got people screaming that Public Health didn’t do its job.”
But then Chief Public Health Officer David Butler-Jones had this to offer: “People say in international airports you could always spot the Canadians because they were coughing into their sleeve,” he said. “Given how we were all brought up to cover our cough or sneeze with our hand, to see that behaviour change in a matter of months is really quite amazing.”
This seems more like a win for common sense medicine as covering your face, washing your hands and staying home from work when you’re sick stops the spread of all viruses, not just H1N1, to begin with. Can we agree that healthcare has gotten better in the 100 years between the last flu pandemic and now? And that, probably had more to do with the low mortality rate then the quick disbursement of the vaccine.
This time, there was far more grumbling about overreaction and conspiracy theories then there’s been with any other so-called pandemic yet. The hysteria over H1N1 probably ended up turning as many people off as it did getting people in long line-ups for vaccines. So perhaps among the lessons Health Canada should be noting – as they pat themselves on the back for their response technique – is the moral of the little boy that cried wolf. Because one of these days, the world health organizations are going to send up a red flag, and not only will this time be real, but no one’s going to have a mind to listen.
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