The Talking Cure

Discussion of swine flu may have been hysterical, but it was necessary.

Travelers wear face masks to ward off swine flu

Apparently, President Obama told some good jokes at a recent dinner. The British Parliament is mired in an expenses scandal. (One politician charged the government more than $3,000 to repair a leaking pipe under his tennis court.) In China, they’re marking the anniversary of the earthquake that left some 80,000 people dead or vanished a year ago, and in France, a young tennis star has tested positive for cocaine. But swine flu? The world’s media have moved on.

Two weeks ago, there was almost nothing else to read about and nothing else to look at, either. As I noted at the time, papers were filled with photographs of uniformed Mexican policemen, guns and face masks at the ready, not to mention all the snarling pigs. But as of May 10, there were 2,532 confirmed cases of swine flu in the United States, mostly mild, and three deaths—all people with other illnesses. A handful of cases have showed up elsewhere around the world, but outside Mexico, as of this writing, just two have been lethal. Given that an average of 200,000 Americans are hospitalized for the ordinary flu every year—up to 20 percent of the population contracts flu annually—the numbers for swine flu infection do seem rather low in the context of phrases like lethal pandemic and deadly virus.

No wonder the anti-panic backlash started rather quickly, fast on the heels of the panic itself. Last week, a rather senior former European health official was (privately) declaring the whole thing a crock of nonsense, ginned up by the World Health Organization as a fundraising gimmick. Someone else told me, as if with absolutely certainty, that the publicity was in fact a plot by the pharmaceutical companies: Look no further than the massive surge in demand for Tamiflu and Relenza. Face masks never did catch on in most places, so the rumors of a plot by the face mask production companies never caught on, either. Instead, we’ll surely conclude that the whole thing was a plot by the media, designed to increase Web viewership on sites that featured herds of stampeding pigs.

To which the correct response should be: So what? Before “that panic was ridiculous” becomes the conventional wisdom, let’s be frank about it: Where infectious diseases are concerned, panic is good. Panic is what we want. Without panic, nothing happens. Up to 500 million people will get malaria this year, and more than 1 million of them will die, mostly in very poor countries. Yet there is no fear of malaria in the rich world; there is no hysterical media coverage, and thus there is still no satisfactory prevention or cure.

By contrast, designs for preventions and cures for swine flu are already, after a mere two weeks of hyperattention, well on track. The U.S. Centers for Disease Control and Prevention has not only developed a test kit to detect the presence of the H1N1 virus that causes the flu; it has already shipped this test kit to all 50 states, plus Puerto Rico and several other countries. Genetic sequences of the virus have been analyzed and databased. A vaccine will probably be ready in time for flu season next fall. Boxes of Tamiflu have been transported to guarded warehouses around the globe, where they await distribution.

Should the panic-mongers turn out not to have been crying wolf and should the virus worsen in the coming weeks, there are still plenty of potential obstacles to effective prevention. The methods presently used to make flu vaccine are ridiculously old-fashioned (they involve chicken eggs), and in a truly lethal epidemic, we would certainly run out. No one has really worked out the morality of that Tamiflu distribution, either: If the United States and Europe distribute their stockpiles to their own citizens only, then no one in the developing world will get any. Our hospitals aren’t prepared for mass casualties, and our health care system would probably crack under the strain. Would doctors accept uninsured patients with a lethal flu virus? Possibly not.

So if the H1N1 virus mutates into something really dangerous, we’ll all be in trouble. But not in as much trouble as we would be if it hadn’t been for that brief, possibly ludicrous but nevertheless useful moment of mass hysteria that brought us such terrific headlines over the past couple of weeks.