Tuesday, October 18, 2005

Avian Flu Hysteria   posted by Scorpius @ 10/18/2005 06:26:00 AM

For a long time now I have been meaning to post my thoughts on what I see as overhyping the avian flu situation. Luckily, a reader of Instapundit beat me to it and summed up nicely a lot of my thoughts.

As a medical researcher, I want to make a gentle but sincere plea to the blogosphere to calm down this flu hysteria just a bit. The main way that flu kills is by predisposing its victims to "superinfection" by bacterial illnesses - in 1918, we had no antibiotics for these superimposed infections, but now we have plenty. Such superinfections, and the transmittal of flu itself, were aided tremendously by the crowded conditions and poor sanitation of the early 20th century - these are currently vastly improved as well. Flu hits the elderly the hardest, but the "elderly" today are healthier, stronger, and better nourished than ever before. Our medical infrastructure is vastly better off, ranging from simple things like oxygen and sterile i.v. fluids, not readily available in 1918, to complex technologies such as respirators and dialysis. Should we be concerned? Sure, better safe than sorry, and concerns about publishing the sequence are worth discussing. Should we panic? No - my apologies to the fearmongers, but we will never see another 1918.

This MD hit almost all of the doubts I had: much better (and more sanitary) medical practices and supplies, the wide-spread use of antibiotics, and better general health of the populace.

But, this made me examine why there is this hysteria, and I think two points need to be raised about this. Researchers and medical doctors who study these diseases become convinced that their disease of interest is much more of a threat than any others. Be it pride, tunnel-vision, or a subconscious desire to attract more publicity or grant money to their area of research, these medical professionals have a general bias towards their particular virus or bacteria. Personally, in the two dozen virologists I have spoken too, I have seen this general propensity. I am not arguing they are wrong or corrupt, just that their dire warnings need to be considered in context.

Another factor to this hysteria concerns the general public and their view of viruses. Today the most talked about and intimidating virus, to laypeople, on the planet is HIV. A virus that people know has been around for at least two decades, is growing in total number of infections, and seems to mutate so fast that therapies become eventually useless against it and infected persons whither and die. But the comparison between HIV and avian flu is a flawed one.

When a virus, any virus, infects the body a "battle" is started between the virus transforming the infected person's biomatter into duplicates of itself and the bodies' immune system creating and mobilizing enough of the correct antibodies to combat it. If the virus wins, the immune system is decimated, secondary infections take over, and death is likely; if the body wins, the virus is generally defeated, and an immunity to that virus is set up. Avian flu falls into this model but HIV does not. The insidious nature of HIV is that it can survive the immune assault (by "hiding out" in the eyeballs) and has a high mutation rate, so the body is never rid of it.

This is where all the concern about the avian flu going through so many mutations to make it both transferable from human to human and airborne. Combine with that the previously detailed persistent nature of HIV, and you have a mental model of viral infection in the common person's mind that leads to hysteria.

Now, don't get me wrong, I am not arguing that everything will be perfectly fine, I am not that Pollyannaish, there will be infections. But, either most will recover, or few deaths will happen in segments of the population who are immune-compromised (the already ill, the elderly, the very young) or who do not have adequate access to antibiotics (the very poor). But our society has advanced to a point that these deaths will be few and far between.

If you want to talk about how to reduce even those few deaths, that is something to discuss, but we should stop the over hyping of this microorganism.

Update from Razib: Welcome Corner readers, and thanks for the link John.