October 18, 2005

The Flu is not Overhyped

Instapundit passes on a reader remark.

As a medical researcher, I want to make a gentle but sincere plea to the blogosphere to calm down this flu hysteria just a bit. The main way that flu kills is by predisposing its victims to "superinfection" by bacterial illnesses - in 1918, we had no antibiotics for these superimposed infections, but now we have plenty. Such superinfections, and the transmittal of flu itself, were aided tremendously by the crowded conditions and poor sanitation of the early 20th century - these are currently vastly improved as well. Flu hits the elderly the hardest, but the "elderly" today are healthier, stronger, and better nourished than ever before. Our medical infrastructure is vastly better off, ranging from simple things like oxygen and sterile i.v. fluids, not readily available in 1918, to complex technologies such as respirators and dialysis. Should we be concerned? Sure, better safe than sorry, and concerns about publishing the sequence are worth discussing. Should we panic? No - my apologies to the fearmongers, but we will never see another 1918.

Patrick Cunningham M.D.
Assistant Professor of Medicine
Section of Nephrology
University of Chicago

No matter the method of flu death in the hypothetical, the reality is that we've got a bug that, in its limited spread to human populations, has a 55% mortality rate. These are real corpses and not theoretical deaths prevented by magical medical infrastructure.

If it retains that virulence, vast swathes of humanity will fall. They will fall in the Gap because there's no money, no infrastructure, no medicine available. They'll fall in the Core too, because we're going to run out of things. A rampaging flu virus is going to cause a huge surge demand in a field that Core-wide has come under either partial or full socialism, whether de-facto or de-jure. We've been eating our seed corn on the medical front for a long time now and we don't really know how bad the rot has progressed.

The truth is that we simply are not going to know how bad the flu is until it actually mutates and we know its characteristics. If its virulence is undiminished and its transmission follows standard human flu patterns, the statistics give pause. According to this CDC FAQ sheet:

Each flu season is unique, but it is estimated that, on average, approximately 5% to 20% of U.S. residents get the flu, and more than 200,000 persons are hospitalized for flu-related complications each year. About 36,000 Americans die on average per year from the complications of flu.

Translating out from an estimated 300,000,000 residents of the US:
5% roughly equals 15,000,000
20% roughly equals 60,000,000
The normal human flu mortality rate is 0.06% to 0.24%
A mortality rate of 55% which is what we're getting with H5N1 would equal a US death toll of range of 8,250,000 to 11,000,000 if its virulence was unabated but its transmissability was brought up to H3N2 standards through random mutation or nihilistic genetic engineering.

Let's say, for the sake of argument, that our medical system is going to save 90% of the deaths that would otherwise occur. That's 825,000 to 1.1 million dead and tens of millions in hospital. Do we have the beds? Do we have the home care substitutes? The logistics of saving these large numbers is daunting. We're not ready. We're not even close.

Posted by TMLutas at October 18, 2005 11:56 AM