Did we "cry wolf" on Swine Flu

On May 5, 2009, in influenza, public opinion, by Karen Grepin

It has been about 10 days since the Swine Flu broke out onto the world stage. While still spreading, it seems as though the epidemic may be abating, at least for now, and thankfully, the disease appears to be much more mild than initially feared. There have been about a thousand confirmed cases and a few dozen deaths. I thought Janet Napolitano summed it up well in saying that we have reason to be “cautiously optimistic” about the prospects for controlling the epidemic in the coming weeks.

I must say that I have been terribly impressed at how both the Obama administration as well as the World Health Organization handled the situation. Although everyone seemed to be quite aware of the possibility of a full blown epidemic, life went on as usual. It was a well controlled panic. I flew to Detroit this past weekend. Every now and again I would pass a traveller wearing a face mask or stand next to a coughing traveller. It was certainly at the back of everyone’s mind, but it did not stop us for living our lives. Had it got worse, we would have altered our behavior.

There is an emerging view, however, that the reaction to the epidemic had been over blown. This really bothers me.

Last evening I was watching the CBC news (a treat when I am home in Canada). There was a segment that pitted two public health official off against each other, one arguing that the global response has been justified (incidentally, it was the same public health official who had fallen ill from SARS a few years back when there was a break out in Toronto) and another claiming that everything had been blown out of proportion. On top of that, the last official argued, if we always responded this way than no one would ever take public health officials seriously, that we “cried wolf”.

When the epidemic emerged last week, we had no idea what we were dealing with. The epidemic initially appeared to be highly fatal (a common bias when one observes only really sick people in clinics), spreading, and previous epidemics, including the 1918 “Spanish” influenza, suggested that we had lots to worry about. Surveillance went into high gear, localized outbreaks were quarantined, and everyone from the World Health Organization to common businesses to regular people were encouraged to plan for the worst. No one knew how bad it would be. We reacted….well, textbook well. We don’t know if we had been prepared or not, because we got lucky with the virus, but we had to react.

I would say I know have a much more positive view of, and more confidence in, the public health system in the US and globally than before, not weaker. I might even be willing to give some of the credit for this to George W. Bush, which I never do, since many of the systems that were put into effect this past week were hold overs from his investments into bioterroism preparedness. Not everyone reacted optimally, perhaps including China which has quarantined a perfectly healthy group of Canadians in North Eastern China because they were from a country with Swine Flu or the 20 countries that have banned the import of Canadian pork products, but overall I would give the response a very high grade. And no one is willing to say that it is over, this virus will not likely disappear and could come back more deadly soon, and if it does, I sure hope we will be ready to react once again.

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