Wednesday, March 29, 2006

Fear itself

I am sorry to keep beating up on poor Marc Siegel but he keeps asking for it. Here is his latest from the Mercury News:
According to a significant study published in the prestigious British journal Nature recently, the H5N1 bird flu virus is at least two large mutations and two small mutations away from being the next human pandemic virus. This virus attaches deep in the lungs of birds but cannot adhere to the upper respiratory tract of humans. Since we can't transmit the virus to one another, it poses little immediate threat to us. (Mercury News)
I suggest he read the Nature paper before commenting on it (or he can read the Effect Measure post on it if reading the paper itself is too arduous). I would love it if he would explain the meaning of a "large mutation" and a "small mutation" and where in the article it says that we are two of each away from the next pandemic virus. I have just re-read it and it says no such thing. I would love it if he would explain where it says the virus attaches deep in the lungs of birds, since only human tissues were used in the study. I would love it if he would tell me where the paper says we can't transmit the virus to each other.

Ironically, Dr. Siegel goes on to say that fear causes the public to blur the distinction between birds and people, which he just did (to be fair, he confused them). And he goes on to explain why even if there were a pandemic, all is well:
Not only do we have vaccinations, antibiotics, anti-viral drugs, public information networks, steroids and heart treatments that were lacking in 1918 to treat victims of the flu; in addition, the growing worldwide immunity to H5N1 may lessen the outbreak in humans even if the dreaded mutation does occur.
The mortality from Acute Respiratory Distress Syndrome (ARDS) that H5N1 brings on is not much different today than it was in 1918, even in an intensive care unit (should there be a bed avaialble). There is no vaccine. Antibiotics don't work for the primary viral pneumonia that is currently killing bird flu patients. And steroids and heart treatments? A bit off topic, unless he is talking about the full dress critical care facilities that we will only providing to a privileged few since our capacity will be outstripped in a thrice. As for public information networks, it is just their information he was complaining about.

Then there is some gibberish about pigs ("a soup of viruses"). Try parsing the logic of this paragraph:
If H5N1 spreads in pigs (a soup of viruses) and exchanges genetic material with another human flu virus before passing to humans, the result is likely to be far less deadly. The swine flu fiasco of 1976 is an example of the damage that can be done by fear of a mutated virus that never quite lives up to 1918 expectations. About 1,000 cases of ascending paralysis occurred from a rushed vaccine given to more than 40 million people in response to a feared pandemic that never arrived.
Since this virus (and the 1918 one) passed directly from birds without an intermediate host, Siegel's allusion to the pig mixing vessel theory is a bit beside the point. But then it's followed with a logical non sequitur about the 1976 swine flu affair. And as I have pointed out to him before, the 1000 cases of Guillain-Barré syndrome (the ascending paralysis he alludes to) are not much different than what we would expect in a non vaccinated population of 40 million.

There is more:
In this country I have heard from more than one farmer and several poultry companies that the price of poultry has already dropped 50 percent in some places. Imagine what will happen if a bird in the United States gets H5N1 bird flu. Our fear is growing at such a rate that our own poultry industry, No. 1 in the world, is likely to be destroyed. We are already petrified by fear of mad cow disease, another case where a species barrier protects us.
A species barrier protects us from mad cow disease? Really! Since when? Reading this, it seems Siegel is almost in a panic about the effect of bird flu on the poultry industry.

As he would be the first to point out, sometimes fear clouds your judgement.

Update: Marc Siegel has posted a long reply to me in the Comments. I have responded there. Take a look.

Comment on comments: I have scrubbed the Comments thread of some of the more personal back and forth regarding another site (if I missed some, let me know by email). It was off-topic and not exactly what I would call a "community building" trend. I will be the first to admit this thread had a tendency to jump the tracks now and then and some commenters deplored this. I am not so bothered. The blogosphere can be a wild place (one of its charms for some of us) and word choice and style of argument are different than professional publications. But the level of rigor and respect for facts and truth shouldn't differ. Indeed I think they are higher because there is the possibility of many voices, not just one person's. I've learned from all who have contributed (even those whose views I disagree with).

The bird flu problem is an urgent concern for many people, as the frayed tempers and temper fraying remarks show too well. That many take it very seriously is not inappropriate, however, nor is it avoidable. It is one of the facts of the situation as it now stands. I won't call for temperance or tolerance or even complete civility all the time (not that it would do any good to call for it), but I can intervene when things are spiralling out of control, which is what I am doing now. The Reveres aren't changing their style or mode of expression, so don't fear if you like it and don't get your hopes up if you don't.

The Reveres want this to be a venue for argument -- forceful when necessary -- as well as dialog. There is too much we don't understand and too little time to pussy foot around with niceties. Marc Siegel's public contentions are fair game, as are anyone else's, including ours.

But now we've all had a bit of a blow off, time to move on and get back to work. Lots to do.