Too much knowledge can exaggerate the danger of a pandemic

[nebris]

From Vancouver Sun
By Stephen Hume
April 28, 2009

Amid the uncertainty over whether this swine flu outbreak will expand from a serious Mexican epidemic into the global pandemic long expected by public health authorities, one thing is certain.

As events unfold, the public will know more about the viral disease, its progress through human populations, what authorities are doing in response and what individual citizens can do for themselves, their families and their neighbours than at any time in human history.

This can be both a blessing and a curse.

A blessing because knowledge is power and planetary communications systems make it possible for medical experts and those responsible for public health to share and disseminate information more quickly and far more widely.

A curse because too much information arriving too quickly without adequate time for placing events in context can amplify public anxiety and, in the worst cases, create panic where instead there should be informed concern, prudent preparation and precaution.

For example, without diminishing the seriousness of a global influenza pandemic in medical terms or the fact that every pandemic results in some tragic outcomes for thousands, even millions, of individuals and their families, it's important to put those numbers into context.

The media, with their urge to simplify and to focus on immediate events, tend to aggregate raw numbers and to concentrate upon them as a measure of the seriousness and magnitude of the event being covered.

Thus we hear constant updates on the number of fatalities from multiple media platforms -- newspapers, radio, 24-hour TV news channels that update every hour, websites and bloggers who range from the highly informed to those who are already linking the current events to sunspot activity or suggesting it's an engineered virus released from germ warfare labs.

"Eighty-one dead in Mexico; U.S. declares emergency," read one of the headlines Sunday. Yes, 81 dead in Mexico is something to grieve and is cause for public concern. Each one of those dead represents the anguish of a family. Yet, as the aphorism goes, one death is a tragedy, a million deaths is a statistic. It's confusing the statistic for the tragedy that exaggerates fear.

We seldom hear daily updates on the numbers of those infected who have recovered, for example. Yet consider the much-cited Spanish influenza pandemic of 1918. It's common for commentary to cite infection rates and total associated fatalities.

It's estimated that about 28 per cent of Canadians and Americans contracted the Spanish flu. Worldwide, an estimated 2.5 per cent of the sick died of complications, which made the pandemic one of the most lethal flu outbreaks in recorded history. Certainly it was one that imprinted itself upon human consciousness for several generations.

But there's another way to look at those statistics. You might observe, for example, that they mean that even during the worst ravages of the 1918 flu, 97.5 per cent of those infected survived and recovered. Or that 72 per cent of the population -- even in the absence of the sophisticated public health planning and infrastructure that Canada and the U.S. have since built -- was not infected during the pandemic.

So, even if we had a repeat of the 1918 flu, the chances were seven out of 10 that you wouldn't catch it and if you did, the odds were better than nine out of 10 that you'd survive.

That was during the worst pandemic of the modern era and one which occurred in the days before the instantaneous communications of radio, television and the Web enabled quick public health responses.