Pandemic Hogwash

Here, infectious disease specialist, Dr. Neil Rau, talks about why he thinks this alert may be overblown, just a little.

Q: As of Friday last week, there were 29,669 confirmed cases in 74 countries and regions, including 145 deaths. It’s hard to ignore the numbers. Is this pandemic alert hogwash or not?

A: It does spread very easily but the key piece that is missing is virulence. It’s not killing people with enough frequency to cause a serious global health impact. We’re not seeing a run on hospitals, people off work sick or school outbreaks.

Q: If this flu isn’t a level six pandemic, what is it?

A: If you’re going to call this pandemic anything, it’s mild. Publicly, I think this would be the mildest of mild pandemics. Why bother declaring it at all?

Q: If it’s so mild, should we just be ignoring this and shutting our ears to all the bad news?

A: I think we need to watch this. On a hospital level, we need to be ready to intervene and treat these people if they need it. But on a day to day level this is not of interest. All the old advice on how to prevent the flu still applies. Wash your hands frequently. Cover your cough. Stay off work when you’re sick and tell others to do the same.

Q: What has been the response to the WHO’s decision to label H1N1 a pandemic? Are people panicking?

A: Eight weeks ago there was panic. I think people are appreciating that this is a mild virus. There’s an emerging cynicism directed at the World Health Organization.

Q: How can the WHO get away with calling it a pandemic if it’s not? Have they redefined the word?

A: I think to do this now is a premature step. People call it pre-cautionary but I’m not convinced it’s really helping anyone. It’s an error rather than erring on the side of caution. It needlessly frightens people.

Q: If I were a conspiracy theorist, I would be suspicious of the drug companies who stand to profit from declaring this a pandemic.

A: More than a drug company conspiracy; there’s a pandemic preparedness industry that’s been built. A lot of people have been waiting for the big one. I will say that there is a vested interest in keeping concern alive. The problem is you can’t sit on the edge of your chair forever.

Q: What do you think of Canada’s measured response to the situation?

A: Unlike the WHO, there has been a more reasonable approach taken at a Canadian level.

Q: Will the WHO’s pandemic alert affect our activities now or in the future?

A: I don’t think it’ll change anything, I just think that hospitals are on high alert. It’s a waste of resources to try to contain something that is not containable. Plus, the economic and personal cost is huge.

Q: What does the future of H1N1 look like?

A: The truth is this is going to run its course. It’s not containable but frankly it’s not that dangerous. It’s going to circle the globe. It will cause more occasional deaths but relative to the number of people exposed to this virus, those deaths will be few and far between.

Q: What really scares people is that this virus might mutate into something far worse. Is this a valid concern?

A: I don’t think the virus is going to suddenly change and become a meaner monster. It may become an established seasonal flue strain over time and then it’ll probably be replaced by something else.

Q: If the seasonal flu kills an estimated 250,000 to 500,000 year and swine flu has killed only 145 total, why isn’t seasonal flu declared a pandemic?

A: You can’t have a pandemic annually then it would become a rather tiring declaration. A pandemic is supposed to be a calamitous novel event of great health impact.

Interview conducted, condensed and edited by Margo Varadi.