Monday, April 10, 2006

Scottish swan: don't under react

The death of a swan in Scotland is due to H5N1 and the British media are in high gear. Not tabloid style "death is coming," but "don't panic" high gear. If the question is, "when is it time to panic?", the answer is surely easy: never. But if anything is likely to make me panic it's people who don't know telling me not to panic. So if the British press and the government want to induce panic, they should just keep doing what they are doing, spreading misinformation and false assurances in the name of providing good information and appropriate reassurance.

A case in point.
According to Sir David King, telling the world that a global flu pandemic is inevitable is totally misleading. Sir David said the likelihood of the H5N1 virus mutating into a human-transmissible virus is very low.

Sir David was talking to Jonathan Dimbleby on ITV (TV Station in the UK). He said “We have got a virus in the bird population that has gone on since 1996, and in Asia particularly there has been a lot of contact between human beings and the birds that have got that virus. Despite this, the human virus has not developed."

Sir David added that he was fairly optimistic that bird flu was not present in wild birds (in UK). According to him, one swan in Scotland does not necessarily mean the virus has come to stay. He stressed that H5N1 is not present at all among farmed birds in the UK (poultry farms). (via Medical News Today)
Sir David doesn't know the likelihood of H5N1 mutating to a form likely to be easily transmissible. No one does. He doesn't know why it hasn't happened yet or how long, on average, pandemics gestate before bursting forth. No one does. He doesn't know if the virus is in the UK to stay. No one does, but if he wants to put money on that one, I'll be glad to take him on.

The article (dateline UK) goes on to say a couple of other things, with false certainty, that are not yet established in the scientific literature:
For the virus to make a person sick it has to reach deep down in the lungs - a very difficult task (for the virus). Most human flu viruses infect the upper-respiratory tract. H5N1 infects deep down in the lower-respiratory tract. For people to become sick, they need to surround themselves with a huge number of bird flu viruses so that some of them manage to make their way down into the lower-respiratory tract. For that to happen, you have to spend a long time in the presence of sick birds, handling them.

If a H5N1 infected person coughs or sneezes, hardly any of the viruses are expelled (because they are so deep down). That is why it is virtually impossible for one human to make another one ill with bird flu.

For the virus to spread easily among humans, it needs to change (mutate) so that it infects the upper-respiratory tract (nearer the throat). However, if it does this, because it would located further up, it would be much easier to treat.
Some of these things might or might not turn out to be true. They are based on articles from Science and Nature we posted about a couple of weeks ago that are now being grossly over interpreted and do not say the things they are widely reported to say. Meanwhile the British press is engaged in an orgy of reassurance and "don't panic" stories. Better they, and the government, should engage in a much more open discussion about the possibilities.

Instead the contradiction between the British government's official statements and leaked plans are glaringly obvious. They clearly know the potential, because cheek by jowl with "over reaction" stories come leaks from within the government that they have already set out plans for mass graves, school closing and other measures should they be needed. We are also planning in the US, but for the most part we are doing it in the open. Without that matter-of-fact openness about the gravity of the problem it is hard to get local authorities to engage. The result is they seem to have fluffed this new case pretty badly with an appearance of non-chalance and the public is being whipsawed between polar opposites of "don't worry" and "death is coming." Neither is the proper perspective for rational planning. And planning and a calm head are essential.

The British government is publicly under reacting.