5 ms·

Pandemics are overhyped. In the recent years we had 2 "pandemic" strains of flu, both of which as it turned out, were greatly exaggerated for the benefit of the

by f055 13y ago

Pandemics are overhyped. In the recent years we had 2 "pandemic" strains of flu, both of which as it turned out, were greatly exaggerated for the benefit of the pharma companies. The truth is, thousands more people die of know diseases every year (even from seasonal flu) than from any other unknown "pandemic" viruses. But this is not "exciting" at all.

hga 13y ago
Really? Here are the last three big ones, and there was a bad one in 1889–1890 about which we don't know much except that "About 1 million people died": Hong Kong Flu (1968–1969), "killed an estimated one million people worldwide." http://en.wikipedia.org/wiki/Influenza_pandemic#Hong_Kong_Flu_.281968.E2.80.931969.29 http://en.wikipedia.org/wiki/Influenza_pandemic#Hong_Kong_Fl... Asian Flu (1957–1958), "Estimates of worldwide deaths vary widely depending on source, ranging from 1 million to 4 million." http://en.wikipedia.org/wiki/Influenza_pandemic#Asian_Flu_.281957.E2.80.931958.29 http://en.wikipedia.org/wiki/Influenza_pandemic#Asian_Flu_.2... Spanish Flu (1918–1920), "It infected 500 million people across the world, including remote Pacific islands and the Arctic, and killed 50 to 100 million of them—3 to 5 percent of the world's population at the time—making it one of the deadliest natural disasters in human history." "Most influenza outbreaks disproportionately kill juvenile, elderly, or already weakened patients; in contrast the 1918 pandemic killed predominantly previously healthy young adults." http://en.wikipedia.org/wiki/1918_flu_pandemic http://en.wikipedia.org/wiki/1918_flu_pandemic That was the big one, and if you talk to your elders they'll remember the first hand stories they heard about it. Few families escaped unscathed, I lost a great-uncle. A repeat would be catastrophic, and efforts to avoid it are not "overhyped", except by the always excitable media. To dismiss such a well documented, in living history threat as being "for the benefit of pharma companies" is beyond blind.
- bwooce 13y ago
  Agreed. This is why the scientists playing with creating influenza variants freak me out. I suspect they have the 1918 variant on hand, combine that with something a bit slower to present and we'd have a winner.
- mtts 13y ago
  However, the Spanish Flu had some things going for it that were rather unique and unlikely to ever occur again: vast displacements of vast numbers of people, vast numbers of people in poor health due to years of deprivation as a result of food shortages and young adults being in especially poor health (Normally men of fighting age are the healthiest members of a population. After four years in the trenches, not so much). The Spanish Flu clouds the issue somewhat, as it's always the first thing people think of when they hear the words "flu epidemic" but it's also the most unusual of all such epidemics.
  - hga 13y ago
    From the limited accounts I've read this doesn't explain well the US homeland experience, except of course by the late '50s the population was likely quite a bit healthier. The research on the recovered strain that reproduces in monkeys the "classic symptoms of the 1918 pandemic, and [dying] from a cytokine storm" is of concern (http://en.wikipedia.org/wiki/1918_flu_pandemic#Spanish_flu_research http://en.wikipedia.org/wiki/1918_flu_pandemic#Spanish_flu_r...), as are the intensely lethal strains that keep popping up, but fortunately with little to no human to human transmision.
  - cantos 13y ago
    Many people would have been displaced in 1918-19 (though I can't find a good number). I think mostly they would have been soldiers since it was largely fought outside of cities. In any case in 2013 there are more than 1 billion people [1] who travel internationally each year so that condition isn't unique to the spanish flu. [1] Wikipedia - tourism
    - mtts 13y ago
      Yeah, I meant soldiers. They travelled far, came into close contact with large numbers of other soldiers and then brought back the flu with them to their home communities when they were repatriated. Modern mass tourism is pretty bad as well, but it's a far cry from having all of the young men in your town getting shipped out and back in again.
      - 13y ago
mixmax 13y ago
No they are not - and a lot of people misunderstand why. It's true that in any normal year more people die from known diseases, and that pandemics are a rare occurrence. But when they happen they kill a lot of people. The 1918 flu pandemic killed 100 million people. 1 out of 20 inhabitants on the planet. And remember that this was back when we didn't fly around the planet giving a virus the possibility of spreading to the entire globe within a few days. That's why pandemics are so scary - when they kill they kill a sizable portion of the earths population.
- JunkDNA 13y ago
  While I'm in agreement that one can't dismiss them out of hand, I wonder how likely a 1918 Style pandemic really is. I don't believe we have had a pandemic on the scale of the 1918 flu in modern times. 1918 was a long time ago. The outbreak of HIV comes closest. It's easy to forget how much modern practices cut down on disease: wash hands, don't drink water people (or animals) poop in, sterilize (or dispose of) medical devices, store your food properly, don't live in a house also occupied by rodents, etc... That is all a great start, and we haven't even talked about antibiotics and other modern medical tech. Granted, access to all of this is far from uniform around the world. However, the situation has been steadily improving. Epidemiology and monitoring are also vastly better than years ago. I was working in pharma during the SARS outbreak and saw firsthand how fast research can move when people perceive something as an existential threat. Government and corporate red tape that normally gums things up immediately falls by the wayside (as does the usual academic quarreling over turf and recognition). Not wanting to see mass death has a way of focusing the minds of even the most recalcitrant beaurocrats in any organization.
  - graeme 13y ago
    As Nassim Taleb points out, you can't assess the likelihood of a high impact event merely from the fact that one hasn't happened for a while. We can identify reasons that disease transmission rates may be lower. We can also identify reasons a pandemic would travel more easily, such as air travel and more open borders in Europe. There are surely many factors that would only be identified as impactful after the fact. Likewise, we can't predict the virulence or transmissibility of any future virus. Pandemics belong in that class of rare events where it's impossible to predict the likelihood, the impact, or the timeframe. All this to say, you're correct that a 1918 pandemic is unlikely. But I don't think that's meaningful.
FoeNyx 13y ago
Around 250k to 500k people die from influenza epidemics each year (according to WHO, and the Doctor). The second wave of 1918 flu pandemic killed around 30M to 100M people from the 500M people infected. There's two factors to flu virus : spread and severity. The last influenza pandemic may have been "overhyped" and exploited by pharma companies, but we were also lucky that it had high spread but relative low mortality rate. The NCoV seems to have a high mortality rate. "Prevention is preferable to cure" (moreover when there isn't any cure ready yet).
- graeme 13y ago
  Why is this answer downvoted so heavily? Edit: my upvote seems to have moved it out of grey.
nodata 13y ago
If it hadn't been hyped, it would have killed loads of people. Preventing pandemics is expensive.
FollowSteph3 13y ago
Because nothing happened people thing it was over hyped. But in fact it's because people reacted that nothing happened. The following articles I wrote explains a lot more of the details of what influenza is and why people wrongly think it was over hyped http://www.followsteph.com/2009/10/29/its-only-the-flu/ http://www.followsteph.com/2009/10/29/its-only-the-flu/
- MortenK 13y ago
  Thing is the two strains that caused widespread panic, avian flu and swine flu, had a mortality rate equal to the standard flu. I.e it wasn't any more dangerous than what we deal with every winter season, yet people all over the globe got scared like cattle in a thunderstorm, with a lot of money changing hands as a result. While of course we shouldn't dismiss potential pandemic's, I think we'd all do well to exhibit at least a modicum of skepticism when faced with doomsday alarms, pandemic related or otherwise.
  - FollowSteph3 13y ago
    H1n1 is the same strain as the 1918 epidemic that killed hundreds of millions
Lost_BiomedE 13y ago
I agree that they are a bit overhyped. The exclusion to that is places that do not have access to antibiotics. Even though the 1918 Flu had cytokine-storm-like effects, a large majority of people died of secondary infection, preventable with antibiotics. There is also a relatively small window of time going forward before we have decent universal vaccines. That said, a lot of the work done to get us to where we are is a big part of why they are not as scary as the hype.
- hga 13y ago
  Are you sure about magnitude of the secondary infection role in the 1918 flu (which I'll note doesn't match the previous pandemic's death toll of "only" about a million)? It sounds plausible, except I distinctly remember reading about common mortality paths in the "young" population that were just too fast. Heck, I just read that the first useful genetic sample came from Brevig Mission, Alaska, where "it killed 72 out of 80 residents in a 5 day period." Pneumonic plague is that fast, I Am Not A Doctor but I'm unaware of any bacteria that's similarly fast and lethal. I'm not sure we can predict when we'll have universal vaccines, as I understand it we've only recently gotten some serious traction on them ... we hope. But it is possible we'll get them fairly soon.
  - deleted 13y ago
    [deleted]
  - Lost_BiomedE 13y ago
    Yeah. I just finished a 50 page research paper on it, so it is pretty fresh in my mind. I was surprised to find that it wasn't a greater killer. Yes, it is fast and lethal, but it did not account for most of the deaths. The pipeline on flu vaccines look very promising, and IMO, we will have an effective universal vaccine within ten years. The next generation of vaccines can be made by bacteria or other methods that do not require 1 egg for 1 vaccine. This makes them cheaper, much faster to produce, and easier to distribute. One test that amazed me was Inovio used a unmatched vaccine on the 1918 Flu with lethal dose in mice. All the controls died but none of the vaccinated.
josh-j 13y ago
They weren't overhyped. Your point is a common and old canard. The worry wasn't that avian flu or the swine flu would kill a lot of people in their current states, but that they would mutate into something considerably more dangerous. The swine flu, for example, was known to spread easily but wasn't _yet_ very lethal. The avian flu (H5N1) didn't _yet_ spread easily, but was very lethal. If the swine flu mutated into something more lethal or if the avian flu mutated into something more communicable, then everyone would probably know someone that died from either virus. And that's exactly the worry with these new crop of viruses, and why it's important to react with extraordinarily measures -- to prevent them from becoming something much worse.

by f055 13y ago

hga 13y ago

Really? Here are the last three big ones, and there was a bad one in 1889–1890 about which we don't know much except that "About 1 million people died": Hong Kong Flu (1968–1969), "killed an estimated one million people worldwide." http://en.wikipedia.org/wiki/Influenza_pandemic#Hong_Kong_Flu_.281968.E2.80.931969.29 http://en.wikipedia.org/wiki/Influenza_pandemic#Hong_Kong_Fl... Asian Flu (1957–1958), "Estimates of worldwide deaths vary widely depending on source, ranging from 1 million to 4 million." http://en.wikipedia.org/wiki/Influenza_pandemic#Asian_Flu_.281957.E2.80.931958.29 http://en.wikipedia.org/wiki/Influenza_pandemic#Asian_Flu_.2... Spanish Flu (1918–1920), "It infected 500 million people across the world, including remote Pacific islands and the Arctic, and killed 50 to 100 million of them—3 to 5 percent of the world's population at the time—making it one of the deadliest natural disasters in human history." "Most influenza outbreaks disproportionately kill juvenile, elderly, or already weakened patients; in contrast the 1918 pandemic killed predominantly previously healthy young adults." http://en.wikipedia.org/wiki/1918_flu_pandemic http://en.wikipedia.org/wiki/1918_flu_pandemic That was the big one, and if you talk to your elders they'll remember the first hand stories they heard about it. Few families escaped unscathed, I lost a great-uncle. A repeat would be catastrophic, and efforts to avoid it are not "overhyped", except by the always excitable media. To dismiss such a well documented, in living history threat as being "for the benefit of pharma companies" is beyond blind.

bwooce 13y ago
Agreed. This is why the scientists playing with creating influenza variants freak me out. I suspect they have the 1918 variant on hand, combine that with something a bit slower to present and we'd have a winner.
mtts 13y ago
However, the Spanish Flu had some things going for it that were rather unique and unlikely to ever occur again: vast displacements of vast numbers of people, vast numbers of people in poor health due to years of deprivation as a result of food shortages and young adults being in especially poor health (Normally men of fighting age are the healthiest members of a population. After four years in the trenches, not so much). The Spanish Flu clouds the issue somewhat, as it's always the first thing people think of when they hear the words "flu epidemic" but it's also the most unusual of all such epidemics.
- hga 13y ago
  From the limited accounts I've read this doesn't explain well the US homeland experience, except of course by the late '50s the population was likely quite a bit healthier. The research on the recovered strain that reproduces in monkeys the "classic symptoms of the 1918 pandemic, and [dying] from a cytokine storm" is of concern (http://en.wikipedia.org/wiki/1918_flu_pandemic#Spanish_flu_research http://en.wikipedia.org/wiki/1918_flu_pandemic#Spanish_flu_r...), as are the intensely lethal strains that keep popping up, but fortunately with little to no human to human transmision.
- cantos 13y ago
  Many people would have been displaced in 1918-19 (though I can't find a good number). I think mostly they would have been soldiers since it was largely fought outside of cities. In any case in 2013 there are more than 1 billion people [1] who travel internationally each year so that condition isn't unique to the spanish flu. [1] Wikipedia - tourism
  - mtts 13y ago
    Yeah, I meant soldiers. They travelled far, came into close contact with large numbers of other soldiers and then brought back the flu with them to their home communities when they were repatriated. Modern mass tourism is pretty bad as well, but it's a far cry from having all of the young men in your town getting shipped out and back in again.
    - 13y ago

mixmax 13y ago

No they are not - and a lot of people misunderstand why. It's true that in any normal year more people die from known diseases, and that pandemics are a rare occurrence. But when they happen they kill a lot of people. The 1918 flu pandemic killed 100 million people. 1 out of 20 inhabitants on the planet. And remember that this was back when we didn't fly around the planet giving a virus the possibility of spreading to the entire globe within a few days. That's why pandemics are so scary - when they kill they kill a sizable portion of the earths population.

JunkDNA 13y ago
While I'm in agreement that one can't dismiss them out of hand, I wonder how likely a 1918 Style pandemic really is. I don't believe we have had a pandemic on the scale of the 1918 flu in modern times. 1918 was a long time ago. The outbreak of HIV comes closest. It's easy to forget how much modern practices cut down on disease: wash hands, don't drink water people (or animals) poop in, sterilize (or dispose of) medical devices, store your food properly, don't live in a house also occupied by rodents, etc... That is all a great start, and we haven't even talked about antibiotics and other modern medical tech. Granted, access to all of this is far from uniform around the world. However, the situation has been steadily improving. Epidemiology and monitoring are also vastly better than years ago. I was working in pharma during the SARS outbreak and saw firsthand how fast research can move when people perceive something as an existential threat. Government and corporate red tape that normally gums things up immediately falls by the wayside (as does the usual academic quarreling over turf and recognition). Not wanting to see mass death has a way of focusing the minds of even the most recalcitrant beaurocrats in any organization.
- graeme 13y ago
  As Nassim Taleb points out, you can't assess the likelihood of a high impact event merely from the fact that one hasn't happened for a while. We can identify reasons that disease transmission rates may be lower. We can also identify reasons a pandemic would travel more easily, such as air travel and more open borders in Europe. There are surely many factors that would only be identified as impactful after the fact. Likewise, we can't predict the virulence or transmissibility of any future virus. Pandemics belong in that class of rare events where it's impossible to predict the likelihood, the impact, or the timeframe. All this to say, you're correct that a 1918 pandemic is unlikely. But I don't think that's meaningful.

FoeNyx 13y ago

Around 250k to 500k people die from influenza epidemics each year (according to WHO, and the Doctor). The second wave of 1918 flu pandemic killed around 30M to 100M people from the 500M people infected. There's two factors to flu virus : spread and severity. The last influenza pandemic may have been "overhyped" and exploited by pharma companies, but we were also lucky that it had high spread but relative low mortality rate. The NCoV seems to have a high mortality rate. "Prevention is preferable to cure" (moreover when there isn't any cure ready yet).

graeme 13y ago
Why is this answer downvoted so heavily? Edit: my upvote seems to have moved it out of grey.

nodata 13y ago

If it hadn't been hyped, it would have killed loads of people. Preventing pandemics is expensive.

FollowSteph3 13y ago

Because nothing happened people thing it was over hyped. But in fact it's because people reacted that nothing happened. The following articles I wrote explains a lot more of the details of what influenza is and why people wrongly think it was over hyped http://www.followsteph.com/2009/10/29/its-only-the-flu/ http://www.followsteph.com/2009/10/29/its-only-the-flu/

MortenK 13y ago
Thing is the two strains that caused widespread panic, avian flu and swine flu, had a mortality rate equal to the standard flu. I.e it wasn't any more dangerous than what we deal with every winter season, yet people all over the globe got scared like cattle in a thunderstorm, with a lot of money changing hands as a result. While of course we shouldn't dismiss potential pandemic's, I think we'd all do well to exhibit at least a modicum of skepticism when faced with doomsday alarms, pandemic related or otherwise.
- FollowSteph3 13y ago
  H1n1 is the same strain as the 1918 epidemic that killed hundreds of millions

Lost_BiomedE 13y ago

I agree that they are a bit overhyped. The exclusion to that is places that do not have access to antibiotics. Even though the 1918 Flu had cytokine-storm-like effects, a large majority of people died of secondary infection, preventable with antibiotics. There is also a relatively small window of time going forward before we have decent universal vaccines. That said, a lot of the work done to get us to where we are is a big part of why they are not as scary as the hype.

hga 13y ago
Are you sure about magnitude of the secondary infection role in the 1918 flu (which I'll note doesn't match the previous pandemic's death toll of "only" about a million)? It sounds plausible, except I distinctly remember reading about common mortality paths in the "young" population that were just too fast. Heck, I just read that the first useful genetic sample came from Brevig Mission, Alaska, where "it killed 72 out of 80 residents in a 5 day period." Pneumonic plague is that fast, I Am Not A Doctor but I'm unaware of any bacteria that's similarly fast and lethal. I'm not sure we can predict when we'll have universal vaccines, as I understand it we've only recently gotten some serious traction on them ... we hope. But it is possible we'll get them fairly soon.
- deleted 13y ago
  [deleted]
- Lost_BiomedE 13y ago
  Yeah. I just finished a 50 page research paper on it, so it is pretty fresh in my mind. I was surprised to find that it wasn't a greater killer. Yes, it is fast and lethal, but it did not account for most of the deaths. The pipeline on flu vaccines look very promising, and IMO, we will have an effective universal vaccine within ten years. The next generation of vaccines can be made by bacteria or other methods that do not require 1 egg for 1 vaccine. This makes them cheaper, much faster to produce, and easier to distribute. One test that amazed me was Inovio used a unmatched vaccine on the 1918 Flu with lethal dose in mice. All the controls died but none of the vaccinated.

josh-j 13y ago

They weren't overhyped. Your point is a common and old canard. The worry wasn't that avian flu or the swine flu would kill a lot of people in their current states, but that they would mutate into something considerably more dangerous. The swine flu, for example, was known to spread easily but wasn't _yet_ very lethal. The avian flu (H5N1) didn't _yet_ spread easily, but was very lethal. If the swine flu mutated into something more lethal or if the avian flu mutated into something more communicable, then everyone would probably know someone that died from either virus. And that's exactly the worry with these new crop of viruses, and why it's important to react with extraordinarily measures -- to prevent them from becoming something much worse.