Avian Flu, Another View

Glenn Reynolds posts this email from a reader who should know:

As a medical researcher, I want to make a gentle but sincere plea to the blogosphere to calm down this flu hysteria just a bit. The main way that flu kills is by predisposing its victims to "superinfection" by bacterial illnesses - in 1918, we had no antibiotics for these superimposed infections, but now we have plenty. Such superinfections, and the transmittal of flu itself, were aided tremendously by the crowded conditions and poor sanitation of the early 20th century - these are currently vastly improved as well. Flu hits the elderly the hardest, but the "elderly" today are healthier, stronger, and better nourished than ever before. Our medical infrastructure is vastly better off, ranging from simple things like oxygen and sterile i.v. fluids, not readily available in 1918, to complex technologies such as respirators and dialysis. Should we be concerned? Sure, better safe than sorry, and concerns about publishing the sequence are worth discussing. Should we panic? No - my apologies to the fearmongers, but we will never see another 1918.

Patrick Cunningham M.D.
Assistant Professor of Medicine
Section of Nephrology
University of Chicago

This follows much of what I have been thinking. (Way to go, Doc! You agree with an poorly-informed layman!) This is not 1918. Contra Reynolds, most deaths in 1918 seemed to be caused by pnumonia. And there now exists a vaccine for the most prevelant kind of pnumonia.

An interesting program concerning local strategies on dealing with a influenza pandemic was aired this weekend on our local PBS affiliate. As a major Pacific port city, we will probably see the disease before the rest of the country.* One of the points made was one my mother used to make: by the time a person shows symptoms, they have been contagious for a couple of days. This means that quarantine would be used at first to slow the progress of the disease, but effectively abandoned after very few days.

Instead, the worker suggested "social distance." That is, the closing of schools, theaters, and businesses. For a high-tech worker like myself this may not be such a burden. But what a dislocation for the retail economy!

*If it comes. I know that it's not a certainty, but contingency plans are about possibilities.