Overexposure makes us sick of the swine flu

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The Article

It’s another day, and that means bewildered Canadians will have to face another deluge of media reports about the H1N1 swine flu. What will the virus do to pregnant women? Do we have a flu strategy? Who should get the vaccine?

This is the kind of information people need to have, but we’ve been engulfed in the media hype for so long now that many people are just plain sick of hearing about it. Frankly, most Canadians have had an overdose of the swine flu virus before they’ve even had a chance to catch it.

The possibility that H1N1 could create a modern, worldwide pandemic has led the overeager media to report every H1N1 study that emerges—the good news and the bad, the credible science and the junk. That means there’s a good chance that today’s information will contradict that from yesterday. The sheer volume of that information, in conjunction with its conflicting messages, has enhanced the public’s confusion more than contributed to its understanding.

Thanks to the media, washing your hands (long promoted as the first line of defence against contagious diseases) is now, much to the chagrin of scientists, up for public debate. A recent study in the Canadian Medical Association Journal questioned the value of handwashing in terms of flu prevention and referenced a government-commissioned report from 2007 that said handwashing for prevention was based on practical, rather than evidence-based considerations. Public health officials probably cringed when this hit the news, since it contradicts their current high-profile campaign to get Canadians to wash their hands to prevent the spread of the H1N1 virus.

The “handwashing doesn’t work” notion is just one report in one journal and it goes against years of medical evidence. But to the general public, one study in the media has the same credibility as the next and so the fear remains—maybe handwashing doesn’t make a difference.

A controversial, unpublished Canadian study suggested that people under the age of 50 who receive a seasonal flu shot are twice as likely to contract the swine flu as those who didn’t receive the vaccine. It doesn’t mean that the seasonal flu shot causes swine flu, only that there may be an association between having the shot and being more susceptible to the flu when exposed to it. Health authorities in Australia, the U. S. and Britain haven’t noticed this link, but Canadians reacted strongly to the message and, consequently, some provinces and territories altered their plans to deliver the seasonal flu vaccine. They will rely primarily on the swine flu vaccine.

But then a study in the British Medical Journal showed that seasonal flu shots may offer protection against H1N1 pandemic virus. The study was relatively small and didn’t necessarily show a direct cause and effect. But the big or fine details don’t matter much once people have heard the message that the seasonal flu vaccine might make them more susceptible to swine flu.

Our public health officials have also contributed to the public uncertainty by opting for a swine flu pandemic strategy that is, as they say, in a state of flux. Flexibility sounds reasonable on paper but, in practice, it’s often perceived as wishy-washy—and that doesn’t inspire the public’s confidence or that of the medical profession. One doctor told me that the constant flow of conflicting memos to her office from public health has become “a gong show.”

There is some good news that hasn’t been contradicted . . . yet. The U. S. Centers for Disease Control and Prevention has shown that older people, who had the flu prior to 1957, have some degree of immunity to swine flu. Tests of their blood serum show that they actually have antibodies to the swine flu virus. That doesn’t mean that they are immune, but they may have a greater degree of protection against the virus. This may explain why the swine flu tends to infect and hospitalizes more young people, while seasonal flu’s tend to attack the elderly.

Although the virus spreads like wildfire, the symptoms seen so far haven’t been much different than the seasonal flu. In fact, Dr. Will Johnston, a prominent Vancouver physician, says that his experience (and that of his colleagues) is “the H1N1 we are currently seeing produces, on average, a milder illness than the seasonal flu of previous years.” He also reports that Tamiflu, a drug that can fight the flu, is working beautifully if given when symptoms first emerge.

That’s the reality of the swine flu at present. It’s too bad that Canadians are already in the midst of a media-inspired pandemic—a pandemic of confusion. Much of the confusion stems from the growing trend for scientists and medical journals to release their data through the media. It gains fame and fortune for scientists, but it shifts the debate out of the scientific realm (where it should be) and into the public realm (where it shouldn’t be).

Got a fever? Maybe it’s time to turn off the TV and read a book.

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