September 02 2009: Post 1
September 27 2009: Post 2
November 12 2009: Post 3
February 2010:Post 4
A little while ago I was thinking about posting something about the Coronavirus scare going around. Before I start:
First, I want to make it perfectly clear that I am just some guy on the Internet. Make of that what you should.
Second, I have nothing but sympathy for those who have suffered due to the current crisis.
So please keep these in mind as I repost four of the articles I wrote eleven years ago regarding the Swine Flu Pandemic. Thanks. [Note: I have not re-verified the links from the original articles below, so many of them are probably obsolete.]
September 02, 2009
On April 23rd of this year, the first death attributed to the H1N1
virus was confirmed after flu-like symptoms began showing up in the population
of Veracruz, Mexico, who happen to live near the Smithfield Foods pig farm
there. Testing later showed that the herd was clean, but the so-called
swine-flu virus continued to spread through the local human population.
Containment was not an option once the virus went international.
For several months the media went absolutely bonkers about this
pandemic and you could not turn on the TV without seeing reports of sickness
and death throughout the world from this "new" killer disease.
High profile cases reported on the quarantining foreign travellers
in China and group of tourists from India after they were sickened while on a
field trip to a NASA in the US.
Articles describing predicted vaccine shortfalls, rationing, and
National Guard “distribution assistance” began to appear in the mainstream
media. WHO declared the H1N1 outbreak a Level 6 pandemic, and then stopped
counting infections and instructed hospitals it was no longer necessary to test
for H1N1 because of the cost and time involved in doing so. The ECDC stopped
publishing infections and began reporting only on deaths starting August 11th.
The Obama administration recently published a report that 30,000
to 90,000 people could die from this illness in the US alone by the
time it ran its course. As of today, 2,992 people have died worldwide, and
there is a bill in the Massachusetts legislature that could allow swine-flu
related warrantless detainments of private citizens.
There. I’ve cherry-picked the last several months of swine flu
news to make it sound like we are all doomed. Are we?
Based on curve-fitting (I started compiling data about two weeks
into the crisis) of periodically published data from the WHO and ECDC, the one millionth serious infection
should have taken place sometime during the middle of this month. Hey, I know
this uses a lot of assumptions that make my effort only slightly better than a
wild guess. For example, if you plot morbidity rate, you see that it starts
high and gradually drops to below 0.5% (the fatality rate of “run-of-the-mill”
flu and pneumonia), levels out somewhere around 0.4%, and climbs back up to
near 1% (at this point the ECDC stopped publishing infection counts). Does this
mean that the virus a) is less lethal than regular flu and only looks worse
because of underreporting or b) the virus has mutated into a deadlier form (like the 1918 influenza pandemic)
.
I choose to think it is just cases being underreported. I mean, I
have had the flu a few times and I have never bothered a doctor about it. I can
only think of a couple of people that have, as a matter of fact. In addition,
when you think about all the people that will catch this and not report it because
of lack of insurance, can’t afford to take time off from work, or the fact they
live someplace where there simply are no hospitals, it seems like the morbidity
rate I calculate is at least an order of magnitude too high.
But if you do take the 0.4% number and assume that 3.5 billion
people - half the globe - eventually become infected over the next few years
(spreading at a rate akin to the 1918 outbreak) then that means that, over the
next couple of years, 14 million worldwide will die from this disease - 61,000
in the USA. It is a remarkable coincidence that my “back of the envelope”
61,000 number falls smack in the middle of the Obama administration’s range as
put out in their badly worded press release.
But comparing the number of people killed during the 1918 pandemic
to the population of the world at that time, and doing the same thing with the
current global population for even my probably-way-too-high-estimate, it seems
that the current outbreak is at least an order of magnitude less worrisome than
the one from nearly a century ago.
So why the panic? Why the incessant “1918” comparisons on the
news? If this is so much less serious than regular flu, why the rush for
inoculations? Why is Elmo helping
children in the Fight Against H1N1? If the situation is so out of control, why
don’t the infection and death graphs follow a severe and worrying exponential
curve, rather than the tamer path actually seen? Why does WolframAlpha show a mortality rate
of near 1% when a recent article stated that "800,000 have been infected
in NYC alone", but with only 54 deaths, this makes the real rate a hundred
times lower, doesn't it? Why do many reliable sources (look them up) say that
this will be no worse than any other flu season? If that is the case, why is
this so darn newsworthy?
With all of the data out there pointing in different directions I
really don’t know. I have a couple of theories, though neither fit the observed
facts. One is an equal mix of “unlikely” and “crazy”. The other is just
“full-on tinfoil-hat crazy”. I am not going to post them, though, because I am
interested in what you think and I don’t want to tilt the discussion in any
direction.
So tell me what you think, because I am at a loss. Should we
worry? Is everything OK? What data am I missing? What’s the real deal here?
September 27, 2009
For those of you following the H1N1 pandemic news, here is some more
information for you regarding the "crisis" (also see previous
H1N1 post if you are interested).
My (admittedly very basic)
analysis shows that the number of daily worldwide
deaths due to swine flu has plateaued at 50 or so. As a matter of
fact, the 7-day moving average may actually be trending downward, but that is
not real clear yet. A huge majority (90%) of the world's population lives north of the
equator and this might just be the calm before the flu-season storm.
Who knows?
The US has 4.6% of the world population, but
accounts for 14.7% of the reported H1N1 deaths. This is most likely due to
better identification and reporting than due to population densities. Assuming
things stay steady, this seems to imply about 2,700 Americans can expect to die
from this each year for the next 3 years (the expected duration of the
pandemic). This is about 20 times less than administration’s mid-range
estimate, and will bump up the overall death rate in the US by 0.1%. The
overall death rate from flu alone will increase by 4.8%.
Run-of-the-mill flu and
pneumonia kills about
60,000 Americans every year.
As a comparison to the 2,700
estimate, 4,000 die
per year in the USA in house fires and 600 die per year in
lightning strikes. So my day-to-day concern is somewhere between those two
things. Mind you, I am not a statistician or a medical doctor. I only can look
at the information presented by official, unbiased sources and try and figure
out how to interpret the numbers in a way that is meaningful to me.
Of course, if millions of
people call in sick to work all at the same time our already wounded economy
might be temporarily affected a tiny bit. But this might be offset by the huge
amount of money being pumped into the works for vaccines, cold and flu
remedies, face masks, advertising, etc, etc.
Maybe there is something to
worry about, but maybe not. Any thoughts?
November 12, 2009
At left is a graph I have been updating since a few weeks
into the Swine Flu Pandemic. I was going to post it a few days ago but didn't
get around to it (laziness, mainly). Recent headlines from MSNBC and other
places have galvanized me into posting quick article.
Most of the information I have been getting has been through
the European Center for Disease Control. I stopped getting my information from
the CDC in the U.S. because I like the daily, more globally-concerned format of
the data from the ECDC better.
The headline that caught my attention was “Swine Flu has
sickened 22 million in the U.S.”. My numbers show that serious illnesses from
this outbreak should be closer to 2 million, and that's world-wide. I thought,
okay, this is a typical wild exaggeration by the media designed to capture my
attention. After all, to avoid overworking emergency rooms, they stopped
general testing for H1N1 months ago (at the recommendation of the CDC) when a
patient showed up with flu-like symptoms, so how could they claim these
numbers?
The sub-headline read “CDC: 4,000 in U.S. died, including
540 kids, between April and mid-October”.
4,000?! I “knew” that number was way off because my curve
fitting shows roughly 1,000 in the U.S. should have died over the past six
months, pretty close to today's ECDC published number of 1,004. But sicknesses
can be misinterpreted – deaths cannot. So what is the deal?
Apparently the CDC has been under-reporting the numbers for
a while. They knew they were wrong, but, in the absence of the correct numbers,
they have been publishing gross underestimates for a while. I am looking
forward to tomorrow's ECDC update and how they explain the discrepancy.
FWIW: I am not a conspiracy theorist. Sometimes people just
make mistakes or do the best they can with the data they have – this is most
likely what is going on here. It would have been nice to know that the error
bars were so huge. Even knowing that the data were “plus or minus 100%” would
have been a vast improvement.
As I wrote in my previous H1N1 posts, it looks like there
are a lot of different data out there that can be used to “prove” anything
regarding this outbreak. I am genuinely puzzled and concerned here. I plead
genuine ignorance on my part – no passive-aggressive shenanigans or accusations
of malfeasance are implied.
Any help to make sense of the situation would be
appreciated.
February 10, 2010
I think this will be my last H1N1 Epidemic Update.
The ECDC seems to have stopped publishing daily updates in
favor of weekly ones (unless I am missing it), and the news seems to have
stopped reporting on it, I can only assume that the epidemic is over.
BTW, I have no idea why the spikes in the graph are there,
but I suspect it is a reporting issue.
Nothing really too much more to say other than my
condolences go out to those that have been effected.