Swine flu: (unfinished) story of the year

indigo girl · Dec 29, 2009

A very good summary on the pandemic thus far between what Branswell is

saying and what the Reveres have added. I remember how this all started

and how mysterious it was. It came out of Mexico. Who would ever have

thought to look in that direction? We were all focused on the east. But wait

one, maybe, we should have learned from the past. Didn't the catastrophic

1918 pandemic make its initial appearance in Kansas?

I had to dive back into past threads to find my first post on the novel flu

which was on April 21st of 2009. There on post #96, buried in mostly

H5N1 information, is the first hint that something really new was developing.

I sure never expected this new virus to so completely take over the disease

news the way that it did. Here I was blogging away on bird flu, and was

completely blindsided by a swine flu. It's not that I didn't notice or even think

that other influenzas could cause the next pandemic virus. I did post about

that possibility more than once, but because H5N1 was so very virulent, that

was the virus that I was most concerned about. Truly, I never thought that I

would be reading of case after case of pregnant women, and otherwise healthy

kids and young adults dying of a mostly mild to moderate flu virus. That was the

real surprise. It's been mostly mild to moderate except for random numbers of

severe cases in perfectly healthy people, that is. It's been bad enough that pre-

existing conditions have enabled this virus to kill people that normally should not

have died of flu such as relatively healthy people with controlled DM or mild

asthma or sleep apnea. It's those perfectly healthy people dying that have so

surprised me. Here is my old thread on bird flu with post #96 as the first

reference about the novel swine virus. As you read further into the thread from

there, it becomes obvious that this was the begining of the next pandemic.

https://allnurses.com/pandemic-flu-forum/pandemic-awareness-preparation-361932-page10.html

Here is what the Reveres have to say about what has happened so far:

I have a vivid recollection of the opening days of this pandemic and the sense of uncertainty -- indeed the knowledge from past experience that with the given set of facts before us, just about anything could happen. Branswell quotes Nancy Cox, CDC's flu chief, as saying, "I think this is one of those situations where everyone will want to stay tuned."
And stay tuned we did. Like the opening engagements in a war, it was unclear what was happening. The media were confused and that made the public confused and all for a good reason: the scientists were also confused. With new tools of analysis and information being communicated at a speed unprecedented in any previous influenza pandemic (the last was 41 years earlier and there was no internet), we were watching a pandemic unfold in real time but still not clear what we were seeing. It was clear from the outset the epidemiology was quite unlike seasonal influenza, but we still didn't know how the virus was going to behave clinically. Was it about as virulent as "regular" flu? Much more virulent, like a 1918 flu? More benign? We didn't even have a good way to count the cases or estimate the virulence. Some of this was inherent in the disease and some of it was the result of systematic disinvestment in public health. Either way, the uncertainty of a breaking pandemic was every bit as confusing as the classical "fog of war."
The current narrative, visible in Branswell's story, is that modern medicine has mitigated what could have been a much worse experience. I'm not so sure and we won't know for at least a year or two when we can assemble the available data in a form that allows us to make more sense of it. And the story isn't over, only the 2009 calendar year part of it. What will early 2010 bring?

For the full commentary see: http://scienceblogs.com/effectmeasure/2009/12/swine_flu_unfinished_story_of.php

The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.