It was a little over a year ago (~ April 2009) that news reports about the H1N1 flu were spreading like wildfire. Assuming you haven’t been living under a rock for the past 13 months, then you’ve experienced first hand the paranoia, confusion and mass hysteria that accompanies an outbreak of infectious disease.
I think it’s safe to say that we all were pretty spooked when the first reports of this deadly illness started emanating out of Mexico. Then when the infection numbers started to climb in California and ultimately here in Canada, well there was a mad rush to do everything and anything possible to keep the flu away.
The Canadian government was quick to launch into flu prevention mode. In fact, the government committed to purchasing $400 million dollars worth of vaccine on top of launching a massive advertising campaign to convince everyone to run out and get vaccinated.
But something was lost amidst all this pandemic paranoia. It seemed that no one was prepared to take a deep breath and actually look at what we objectively knew about the H1N1 virus or flu viruses in general. Well that’s not true. Big government officials didn’t seem prepared to objectively look at the data, but many independent health researcher types (shameless self-promotion) did… and it was pretty alarming what was found.
Incidentally, my first two blog posts were flu-related, as we were right in the midst of the vaccination campaign. If you haven’t read them yet (and I know you haven’t, my readership wasn’t all that strong for the first couple months of existence), then I suggest you give them a quick look.
When you looked at the data, 3 themes emerged:
Theme #1: vaccination against the flu has an extremely checkered past. I covered this in some detail in my first two articles.
Admittedly, vaccinating against a particular strain of the flu seems more logical than the coin-flip approach taken the seasonal flu vaccination, however vaccinations don’t seem to be anywhere near as effective as basic hygiene.
Not only are vaccines less effective than handwashing, but the cost of the vaccination program wound up be far greater than $400 million. According to The Globe and Mail, the actual cost to Canadian tax payers will wind up being closer to $1.5 billion. It seems like it would have been a better use of that money purchasing soap and hand sanitizer for all Canadians than investing in a vaccine.
Theme #2: the World Health Organization (WHO) organization pulled the old pandemic switcheroo. This fact wasn’t, and still isn’t, common knowledge but the very definition of the term pandemic changed recently. Here, take a look at the change for yourself:
“An influenza pandemic occurs when a new influenza virus appears against which the human population has no immunity, resulting in several, simultaneous epidemics worldwide with enormous numbers of deaths and illness. With the increase in global transport and communications, as well as urbanization and overcrowded conditions, epidemics due the new influenza virus are likely to quickly take hold around the world.”
“A disease epidemic occurs when there are more cases of that disease than normal. A pandemic is a worldwide epidemic of a disease. An influenza pandemic may occur when a new influenza virus appears against which the human population has no immunity. With the increase in global transport, as well as urbanization and overcrowded conditions in some areas, epidemics due to a new influenza virus are likely to take hold around the world, and become a pandemic faster than before. WHO has defined the phases of a pandemic to provide a global framework to aid countries in pandemic preparedness and response planning. Pandemics can be either mild or severe in the illness and death they cause, and the severity of a pandemic can change over the course of that pandemic.”
Hmm… the only real change between the two definitions is the removal of the fact that a pandemic has to actually cause significant death or disease. Am I the only one who finds the change odd? I’d love to hear the rationale behind the decision to change the definition.
Maybe it’s just a coincidence the definition was changed during the middle of a global economic meltdown… in response to the discovery of the H1N1 strain in Mexico… a policy change that allowed vaccine makers to sell over $675 million worth of vaccine… well I’ll leave that one for the conspiracy theorists in the crowd.
To me, the bigger issue with changing the definition and not telling anyone is that everyone was operating under the old understanding of pandemic = death and disease. So when our health officials are labelling this a pandemic, of course everyone is going to freak out.
However, the biggest oversight in all the H1N1 hoopla is encapsulated by Theme #3: H1N1 is a relatively mild strain of the flu.
Now I know you you are thinking, “Wait just a minute… H1N1 was a deadly flu that killed so many youngsters”. Admittedly, almost 1/4 of all deaths from H1N1 were in individuals 25 years or younger, which is a much higher percentage than normal. But quoting a percentage of total deaths really paints a skewed picture.
Undeniably, more people than normal caught the H1N1 virus and getting the flu is never fun. But was the H1N1 strain a huge cause for concern? Not really. Particularly if we consider death the ultimate cause for concern.
Every year, Health Canada estimates that 500-1500 individuals die from the flu. Obviously the numbers vary and many more people die from flu-related complications than from the flu itself (in 2005, total deaths in Canada from influenza and pneumonia were 5,845 (Leading Causes of Death in Canada 2005). But it’s reasonable to conclude that a particularly virulent strain of the flu would kill at least 1,500 Canadians, if not more.
Since it’s been a full year of H1N1 acitvity in Canada, I feel comfortable reporting the number of total deaths: 427 (H1N1 Flu Deaths Canada). That’s it. This number would make the 2009-2010 flu season one of the MILDEST on record.
Surprised given all the mass hysteria? We really shouldn’t be… because the disease progression in Mexico gave us a pretty good indication of what we could expect.
I don’t think anyone would argue that Mexico was hit hardest by H1N1. Recall, the disease started in Mexico and Mexico didn’t have the time to vaccinate nor did it even have access to the vaccination when the flu was ravaging their country. Therefore, we could reasonably conclude that Mexico would show one of the highest death rates for any country.
At the very least, we should have expected to see fairly dramatic rates of infection and disease that carried on from April to at least September when the H1N1 vaccine finally hit the market.
Definitely reasonable to expect… but not at all what happened. In fact, here was data that was readily available LAST MAY 2009 on the H1N1 virus.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5817a1.htm
A big spike in infection (with far fewer confirmed cases than suspected cases), that quickly tapered off once massive hygiene and basic quarantine measures were put into place. Imagine that – effective health care without vaccines, just basic health precautions.
Did Mexico suffer later waves of H1N1 before getting the vaccine? Yup. Did a lot of Mexicans get the flu? Yup. Did a lot of people die? Nope. At last check, the Mexican numbers were about 1035 deaths out of 71K + confirmed cases… or a death rate of 1.45%.
I should point out that 71K cases is an extremely conservative estimate of total infections. Mexico has a population of 111 million. But let’s assume that death rate of 1.45% if valid. It is essentially the same death rate as we see in the normal seasonal flu.
So what can we learn from the big H1N1 scare? For starters, paranoia will always trump common sense. In all seriousness though, I think there is a significant health message in all of this.
Based on these numbers, I don’t see a convincing argument in favour of the effectiveness of flu vaccines. Canada and the US had access to the vaccine and had a mortality rate essentially identical to that of Mexico, who did not have the vaccine.
I am not a staunch anti-vaccine guy by any stretch, but I have yet to see any convincing evidence to suggest vaccines actually decrease incidence of disease or mortality from the flu. Given the spotty track record of flu vaccines, coupled with another underwhelming peformance during this latest health scare, I would have to strongly recommend that we reappraise our treatments for the flu.
I realize we tend to value pharmaceuticals over natural cures; however, the data on mega doses of vitamin D and flu prevention are too suggestive to ignore. I’m not sure that any substance will be able to fully eradicate the flu, but at the very least we need to allocate some research dollars into discovering whether vitamin D might provide far greater benefit than the vaccine… at a fraction of the cost.
Till next time, train hard and eat clean!
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