# How worried should we be about Swine Flu? **URL:** \ **Category:** Great Debates\ **Created:** [April 25, 2009, 11:07pm UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359 "2009-04-25T23:07:57Z")\ **Posts on this page:** 20\ **Page:** 10
**Author:** ![carnivorousplant](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnivorousplant/32/3563_2.png) [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)\ **Post date:** [April 30, 2009, 1:15am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/181 "2009-04-30T01:15:31Z")
> [@Frank](#): > > One can only hope, for **Angry Lurker** ’s sake, that his butler, parlourmaids, and cooks do not commute from, say, Mexico City. Surely one doesn’t spend that much money on the help. 🙂 ---
**Author:** ![dropzone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dropzone/32/7515_2.png) [@dropzone](https://boards.straightdope.com/u/dropzone)\ **Post date:** [April 30, 2009, 1:29am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/182 "2009-04-30T01:29:52Z")
> [@Siam\_Sam](#): > > It seems the Thai government, afraid of the hit the local pork industry could take, has made a request to the WHO that it be called the Mexican flu instead of the swine flu. So I can go back to eating pork but have to stop eating Mexican food? Cuz if I have to give up both I guess it means I’m on a zero-calorie diet. (When this blows over you guys have to try [Habas con Chile y Limon.](http://www.latinmerchant.com/productdetail.asp?ProductID=SSD0086)) ---
**Author:** ![Try2B\_Comprehensive](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/try2b_comprehensive/32/65_2.png) [@Try2B\_Comprehensive](https://boards.straightdope.com/u/Try2B_Comprehensive)\ **Post date:** [April 30, 2009, 2:07am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/183 "2009-04-30T02:07:35Z")
Yikes. No more ‘The Stand’ jokes out of me. For the record, I don’t think the flu is funny. I’m just not expecting an apocalypse based on all the available information. The virulence seems too low for catastrophic fatalities, and remember the big difference from the 1918 flu: this is 2009. Any reason to believe we are _more_ vulnerable now than then? ---
**Author:** ![carnivorousplant](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnivorousplant/32/3563_2.png) [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)\ **Post date:** [April 30, 2009, 2:26am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/184 "2009-04-30T02:26:00Z")
> [@Try2B\_Comprehensive](#): > > the big difference from the 1918 flu: this is 2009. Any reason to believe we are _more_ vulnerable now than then? We have antibiotics. Does influenza respond to them? We also have jet airplanes to spread it around. In 1918 we had a bunch of infantry shoved together into a barracks. ---
**Author:** ![DaphneBlack](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/daphneblack/32/5389_2.png) [@DaphneBlack](https://boards.straightdope.com/u/DaphneBlack)\ **Post date:** [April 30, 2009, 2:56am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/185 "2009-04-30T02:56:59Z")
We have a lot more knowledge about diseases in general and flu in particular. We have better communication and speed (including travel, which can go both ways). Our data about the spread of the disease is able to keep closer to the actual spread. In the first world, we are healthier and have much better medical care. We have anti-viral drugs that seem to help. The governments and health authorities around the world are taking it seriously and have procedures in place that can be put into operation quickly. We also have the media who seem to be doing their best to create as much panic as possible. The CDC is a much better source of information than news sites. ---
**Author:** ![Frank](https://avatars.discourse-cdn.com/v4/letter/f/3d9bf3/32.png) [@Frank](https://boards.straightdope.com/u/Frank)\ **Post date:** [April 30, 2009, 3:01am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/186 "2009-04-30T03:01:41Z")
> [@Try2B\_Comprehensive](#): > > Any reason to believe we are _more_ vulnerable now than then? I should think that depends on what part of the world you’re in. Certainly, the United States, for example, has gained 90 years worth of hygenic knowledge, medical knowledge, and pandemic knowledge, and has plenty of people who are trained to take advantage of all the knowledge. While I expect there to be more deaths in the U.S. due to this illness, my personal risk is about that of being struck by lightning, or less. If I catch it and die, it’s really going to be random chance, and I intend no more precautions than to be a bit more careful about washing my hands after handling grocery carts, doorknobs, and the like. ---
**Author:** ![XT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/xt/32/456_2.png) [@XT](https://boards.straightdope.com/u/XT)\ **Post date:** [April 30, 2009, 3:05am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/187 "2009-04-30T03:05:13Z")
[QUOTE=carnivorousplant] We have antibiotics. [/QUOTE] We have anti-viral medicines to. > [@](#): > > Does influenza respond to them? No, though they help with the secondary infections. This variety does respond to some anti-viral medicines though, at least IIRC. -XT ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [April 30, 2009, 3:09am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/188 "2009-04-30T03:09:34Z")
Look at it [this way](http://www.globalsecurity.org/security/ops/hsc-scen-3_flu-pandemic-deaths.htm). Seasonal flu typically has an attack rate of 5 - 15%. As no one already has immunity to this virus we can expect the usual pandemic attack rate of 25-50%. _If_ it has only the same mortality rate of normal seasonal flu we could then expect America to experience roughly 2 to 10 times the usual seasonal flu deaths - use just 3 and that’s an additional 120K people dieing in America alone. But there is no reason to believe that the mortality of a pandemic virus is as low as seasonal flu - in America so far the reassuring number is that it is 1%. > [@](#): > > Influenza-related deaths can result from pneumonia and from exacerbations of cardiopulmonary conditions and other chronic diseases. Deaths of older adults account for \> 90% of deaths attributed to pneumonia and influenza. In one study of influenza epidemics, approximately 19,000 influenza-associated pulmonary and circulatory deaths per influenza season occurred during 1976–1990, compared with approximately 36,000 deaths during 1990–1999. Estimated rates of influenza-associated pulmonary and circulatory deaths/100,000 persons were 0.4–0.6 among persons aged 0–49 years, 7.5 among persons aged 50–64 years, and 98.3 among persons aged \> 65 years. > > A different pattern may emerge in a pandemic. The 1918-19 pandemic affected mainly healthy young adults and seemed to spare those at the extremes of life. In the USA, the mortality rate during the 1918 pandemic pandemic was around 2.5%. Similarly, in 1957, the brunt fell on schoolchildren and young adults. > > The number of hospitalizations and deaths will depend on the virulence of the pandemic virus. Estimates differ about 10-fold between more and less severe scenarios. Published estimates based on extrapolation of the 1957 and 1968 pandemics suggest that there could be 839,000 to 9,625,000 hospitalizations, 18-42 million outpatient visits, and 20-47 million additional illnesses, depending on the attack rate of infection during the pandemic. Estimates based on extrapolation from the more severe 1918 pandemic suggest that substantially more hospitalizations and deaths could occur. The demand for inpatient and intensive-care unit (ICU) beds and assisted ventilation services could increase by more than 25% under the less severe scenario. > > Because the virulence of the influenza virus that causes the next pandemic cannot be predicted, two scenarios were presented by CDC, HHS and DHS based on extrapolation of past pandemic experience. The DHS estimates are suspect, since they appear to derive from a 1999 analysis that was based on the 1997 US population of 265 million. By 2005 the US population was about 295 million, so the DHS estimates are about 10% low simply due to the growth in population. > > According to the Centers for Disease Control and Prevention (CDC), it has been estimated that in the absence of any control measures such as vaccination and drugs, a “medium-level” influenza pandemic in the United States could kill 89,000 to 207,000 people, affect from 15 to 35 percent of the U.S. population, and generate associated costs ranging from $71 billion to $167 billion. Another Centers for Disease Control and Prevention (CDC) estimate suggested that, in the United States alone, up to 200 million people will be infected, 50 million people will require outpatient care, two million people will be hospitalized, and between 100,000 and 500,000 persons will die. These numbers are significantly higher than the estimates used by the Deparment of Homeland Security. The HHS notes that the death rate associated with the 1918 influenza applied to the current population would produce 1.9 million deaths in the United States and 180 million to 360 million deaths globally. It is most noteworthy that the “Low” scenario presented by HHS corresponds to the “High” scenario presented by DHS. There are big ifs here. The numbers now are not enough to tell us if it effects young helathies worse or less, if the mortality rate will be a more modest 1% or 2.5% or more. How long until evolution kicks in and this bug develops anti-viral resistance? A month? six months? The price of using it broadly, as advised by the CDC, is that we will select for resistant bugs … and I will unsuprised if it is sooner rather than later. I can tell you this much. We are already running into supply issues. The CDC has guidance on how to test advising viral transport media … we can’t get any more than the few we got. We have a confirmed case in our community. By guidance I would be testing dozens of kids a day. I am forced to use a means less ideal method to screen. If I can get those supplies delivered quickly. Our hospitals are not designed to deal with pandemic levels of illness. Even outpatient offices will be ill-equipped to handle visits especially if staff goes out ill along the way - which is assured to happen. Panic no. But hope that the virulence is lower than we fear and that it spreads slowly enough for us to get large amounts of an effective vaccine out. Uh, yeah. ---
**Author:** ![XT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/xt/32/456_2.png) [@XT](https://boards.straightdope.com/u/XT)\ **Post date:** [April 30, 2009, 3:11am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/189 "2009-04-30T03:11:51Z")
[QUOTE=Try2B Comprehensive] Any reason to believe we are more vulnerable now than then? [/QUOTE] Well, I’d say that it depends. On the one hand we have better medicines and a deeper understanding of how and why such outbreaks occur. On the other our travel infrastructure allows really nasty and fast spreading virus’s to be literally transported around the world in hours or days…making us much more vulnerable. So…it’s a toss up. My gut feeling is that our knowledge and understanding today along with the various drugs available make us (in the US, Canada, Europe, Japan, ect) less vulnerable over all…that’s why something like SARS was so devastating in China and parts of southeast Asia but not so much in the US, Canada or Europe. At a guess this outbreak of flu will hit Mexico relatively hard…while the in the US there will be a lot of fear, and perhaps a moderate amount of people infected, but no where near the same scale of deaths. -XT ---
**Author:** ![Tangent](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tangent/32/3098_2.png) [@Tangent](https://boards.straightdope.com/u/Tangent)\ **Post date:** [April 30, 2009, 3:24am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/190 "2009-04-30T03:24:42Z")
Some big news regarding schools in Texas: Early today the University Interscholastic League (basically the organization that oversees most public school competitions in Texas–everything from football to science competitions to band and One Act Play) suspended all athletic and academic competitions for the entire state until at least May 11 because of the swine flu. ([link](http://www.wfaa.com/sharedcontent/dws/spt/stories/043009dnspouillede.191610a.html)) Also, this evening the Fort Worth ISD (80,000 students) announced that it is closing all schools until at least May 11 because of the flu. I am floored by the Fort Worth schools closing. I teach in a suburb-city adjacent to Fort Worth (actually some of my district lies within Fort Worth city limits) so this is happening close to home for me. ---
**Author:** ![Leaper](https://avatars.discourse-cdn.com/v4/letter/l/4bbf92/32.png) [@Leaper](https://boards.straightdope.com/u/Leaper)\ **Post date:** [April 30, 2009, 4:13am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/191 "2009-04-30T04:13:56Z")
If they weren’t so close to Mexico, I’d say it was a massive overreaction. I’ve still got a mild, mild feeling that it is. But I’m pretty far from there (though even in this state, six cases have been reported). Really, the hype DOES make it hard to moderate one’s reactions to what it should be. The problem is, it makes the easiest reactions either to dismiss it entirely (bad) or run around in a panic (even worse). ---
**Author:** ![C3](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/c3/32/3108_2.png) [@C3](https://boards.straightdope.com/u/C3)\ **Post date:** [April 30, 2009, 4:20am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/192 "2009-04-30T04:20:13Z")
**DSeid** , from your link: > [@](#): > > Another Centers for Disease Control and Prevention (CDC) estimate suggested that, in the United States alone, up to 200 million people will be infected, 50 million people will require outpatient care, two million people will be hospitalized, and between 100,000 and 500,000 persons will die. We only have 300 million people in the U.S. They’re predicting a 66% infection rate? Why higher than the highest range of the usual pandemic rate that you give? ---
**Author:** ![jk1245](https://avatars.discourse-cdn.com/v4/letter/j/49beb7/32.png) [@jk1245](https://boards.straightdope.com/u/jk1245)\ **Post date:** [April 30, 2009, 5:06am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/193 "2009-04-30T05:06:04Z")
Another thing to remember is that you want the response to lead the actual event. Kind of like severe weather; you want tornado warnings before your house is blown away. Pandemic response plans are largely based on curtailing the spread. That needs to be done before it’s too late. It does seem like WHO and CDC are acting like it’s severe already. That’s largely because a significant response before it gets out of hand is better than being cautious and moving too late. That said, based on what I’ve seen, this is a significant threat. Not yet an emergency, but with more potential to get to that level than anything in several decades. I’ll qualify that by saying I am not a flu expert or an infectious disease expert, but I do work with experimental therapeutics for a variety of conditions. Flu vaccines are an area we’ve seen a significant ramp up in recent years. I’m still confident that the quick response will prevail, but it still could get fairly ugly, especially in developing countries. ---
**Author:** ![Freudian\_Slit](https://avatars.discourse-cdn.com/v4/letter/f/5daacb/32.png) [@Freudian\_Slit](https://boards.straightdope.com/u/Freudian_Slit)\ **Post date:** [April 30, 2009, 5:12am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/194 "2009-04-30T05:12:30Z")
> [@Siam\_Sam](#): > > The positive side of swine flu: We’re getting a lot more cute pictures of pigs in the newspapers now. I haven’t seen any! Cite! ---
**Author:** ![Siam\_Sam](https://avatars.discourse-cdn.com/v4/letter/s/d78d45/32.png) [@Siam\_Sam](https://boards.straightdope.com/u/Siam_Sam)\ **Post date:** [April 30, 2009, 5:18am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/195 "2009-04-30T05:18:33Z")
> [@Freudian\_Slit](#): > > I haven’t seen any! Cite! Okay, here. I’m holding up the newspaper for you. 😃 That Thai doctor I said was hospitalized here with swine flu? Now the government is insisting he (or she?) does not have it after all, but rather just the regular, run-of-the-mill flu. It’s just coincidence the doctor was in Mexico City recently. Hmmm. The US Embassy here did send out an e-mail pointing out among other things that as of yesterday (Wednesday) no swine flu had been reported in Thailand by the World Health Organization. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [April 30, 2009, 5:49am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/196 "2009-04-30T05:49:54Z")
> [@C3](#): > > … They’re predicting a 66% infection rate? Why higher than the highest range of the usual pandemic rate that you give? My understanding in context is that the CDC made a range of estimates. That was their high end estimate and I think it was based on high end estimates of the attack rate during the 1918 Spanish flu. Truth be told it is possible that modern travel could make it worse. Or not. Again what is most notable is what we cannot yet know. In past pandemics, before modern travel, pandemics traveled in “waves” - a first peak, and then some months later a resurgence and sometimes another wave after that. How much of that was caused by the length of time it took to circle the globe? How much by seasonality, dieing down some in Summer and resurging in Fall as kids got back in school? Will modern travel do away with waves as they more or less “lap” each other? Would Summer slow a real pandemic down? ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [April 30, 2009, 10:45am UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/197 "2009-04-30T10:45:58Z")
> [@carnivorousplant](#): > > We have antibiotics. Does influenza respond to them? No. Antibiotics work on bacteria. The flu is a virus. ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [April 30, 2009, 12:03pm UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/198 "2009-04-30T12:03:12Z")
It is odd that the government and medical authorities are making it sound more severe than most civilians think it will be. That must make us all nervous. We see 90 cases and think so what. They start closing schools and pounding the airwaves with PSAs. ---
**Author:** ![Alex\_Dubinsky](https://avatars.discourse-cdn.com/v4/letter/a/dbc845/32.png) [@Alex\_Dubinsky](https://boards.straightdope.com/u/Alex_Dubinsky)\ **Post date:** [April 30, 2009, 6:27pm UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/199 "2009-04-30T18:27:11Z")
> [@C3](#): > > **DSeid** , from your link: > > > [@](#): > > > > Another Centers for Disease Control and Prevention (CDC) estimate suggested that, in the United States alone, up to 200 million people will be infected, 50 million people will require outpatient care, two million people will be hospitalized, and between 100,000 and 500,000 persons will die. > > We only have 300 million people in the U.S. They’re predicting a 66% infection rate? Why higher than the highest range of the usual pandemic rate that you give? In an epidemic, the vast majority get the virus. A fraction of them actually show any symptoms. A fraction of those are at risk, etc. Infection does NOT equal “runny nose, and symptoms.” That’s a very common misconception. You could have the flu right now for all you know. ---
**Author:** ![Bryan\_Ekers](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bryan_ekers/32/183_2.png) [@Bryan\_Ekers](https://boards.straightdope.com/u/Bryan_Ekers)\ **Post date:** [April 30, 2009, 6:32pm UTC](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359/200 "2009-04-30T18:32:25Z")
Aw, man, I just ate the last of my Y2K tuna and now _this?!_ [Previous page](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359.md?page=9) [Next page](https://boards.straightdope.com/t/how-worried-should-we-be-about-swine-flu/494359.md?page=11)