PSA on H1N1: I am going to be harsh

This morning’s New York Times has a disturbing report about the spread of the H1N1 virus.  This strain of flu is proving to be especially dangerous for pregnant women:

Dr. Schuchat expressed particular worry about pregnant women. As of late August, 100 had been hospitalized in intensive care, and 28 had died since the beginning of the outbreak in April.

“These are really upsetting numbers,” she said, urging obstetricians and midwives to advise patients to get swine flu shots as soon as they become available.

Doctors are also reporting that some parents are not planning to have their little human vectors vaccinated because these parents stupidly want their children to develop “natural immunity” and because they are afraid of the vaccination:

Confirming the centers’ anxiety that many Americans are reluctant to get swine flu shots, Consumer Reports released a poll late Wednesday showing that half of all parents surveyed said they were worried about the flu, but only 35 percent would definitely have their children vaccinated. About half were undecided, and of those, many said they feared that the vaccine was new and untested.

One worrying aspect, said Dr. John Santa, the director of health ratings at Consumer Reports, was that 69 percent of parents who were undecided or opposed to shots said they “wanted their children to build up their natural immunity.”

“Your body produces exactly the same antibodies, whether it’s from a ‘natural’ infection or from a vaccine,” Dr. Santa said. “If your child is the one that dies, you’ve paid a very high price for ‘natural’ immunity.”

Ok, this s%^& really pisses me off.   I get the most ridiculous, hysterical emails every frickin’ day from former PUMAs who really should know better, claiming that the H1N1 “pandemic” is really a global conspiracy to panic people and keep them in their place.  I will admit that when I first heard of this virus, from Obama no less, I too was skeptical.  It seemed a little too Code Orange for my taste, especially since he was getting his first taste of media pushback at the time.  But a little investigation convinced me that this is no faux terrorism alert.  The only global conspiracy that is going on is being perpetrated by the H1N1 virus itself to infect as many hosts as it can get its grubby genetic material into.

And human beings are the perfect baby virus incubators.  Little influenzas just love our warm, moist respiratory systems.  H1N1 likes our gastrointestinal tract too.  What joy!  Because once it gets into an unprotected body, where the local antibody cleanup crew has never seen them before, they get down to business and multiply like crazy and then have an orgy of genetic material swapping with each other.  Yes, YOU parents who refuse to vaccinate your precious vectors may be allowing the virus to mutate into something even more deadly.

Anyway, I can’t spend a lot of time on this because I have to get to work but here are the salient points that you should know if you can’t tell if the H1N1 virus is really serious:

1.) The H1N1 virus is serious because it is the result of antigenic shift instead of antigenic drift. Imagine the seasonal flu genetic material looks like the typical English qwerty keyboard to your body.  The seasonal flu virus can rearrange the letters and your body will adapt because it is somewhat familiar with the typography.  Now, imagine one day a new flu comes in lugging a keyboard in Cyrillic.  The body has to get used to making antibodies with a new alphabet.  This is what we’re dealing with.  The new genetic material is unlike anything your immune system has seen before.  Before your antibodies can get the hang of typing in Russian, the virus will have a perfect opportunity to overwhelm your system.  That is what happened during the 1918 flu outbreak.

2.) Pandemics mean there is more likelihood of a deadly mutation.  A global pandemic means that the virus is hanging around barnyards in third world countries like Afghanistan, mixing sheep and pig and fowl and human genetic material altogether.  And that genetic material spreads all over the world much more quickly via planes, trains and automobiles than it did in 1918.  Add to the mix the well known fact that the influenza virus is promiscuous.  It swaps its genetic material and mutates at a higher frequency than many other viruses.  It uses your body as a petrie dish.

3.) Vaccine makers aren’t going to be able to make huge profits from this bug. Nope.  They signed contracts with the government years ago during the Bush administration to provide the government with vaccine.  During pandemic flu outbreaks, it is very difficult to provide sufficient flu vaccine for everyone.  So, targetted groups get the vaccine.  For example, school children are likely targetted groups because anyone who has one in their possession knows that they are unclean and careless little beasts that cough and sneeze all over each other.  Health care workers will get it.  People with vulnerable immune systems will get it.  You and I will probably NOT get it.  I already asked when I went for my seasonal flu shot.  The companies that make the vaccines turn it over to state and federal government agencies and they decide whether you make the targetted groups list.

4.) The vaccine is as safe as a seasonal flu vaccine. Seriously.  The vaccine has undergone clinical trials for saftey and efficacy and has been approved by the FDA.  I know that back in the 70’s, there was another Swine Flu vaccine that triggered Guillaume-Barre syndrome in some participants.  And that is still a risk for people who have had Guillaume-Barre in the past.  (I’ll have to check to see if this is true for seasonal flu vaccine as well) But even with that caveat, the risk of an adverse side effect is tiny compared to the risk of getting seriously ill from H1N1 and passing that on to some other person.  People with a history of Guillaume Barre syndrome should consult their doctors to see if the risk is serious enough to be excluded.  The flu vaccine should be available to you at the end of the month.  It takes 21 days to build up full immunity to the virus.

Now, to those of you who are still convinced that this is some kind of global conspiracy to numb people into a sense of terror and passivity, I have only one thing to say: GET A GRIP!  I will be very relieved if after all of the precautionary measures we have taken that this virus turns out to be wildly overblown.  If I look like I have egg on my face next year for being such a Chicken Little, I can live with that.   (There’s still no reason to panic but you should follow the instructions of your local public health officials even if they sound restrictive.)   But it it turns out that some of you out there didn’t vaccinate your kids because you listened to the ignorant nutcases who sent you email and as a result, a lot more people got sicker than they should have, I will be very angry.

And I have your email addresses.

For more information:

The Centers for Disease Control

The World Health Organization

She’s a supergeek, supergeek, she’s supergeeky (Check this for podcasts and youtube videos describing the 1918 Influenza and how the flu virus behaves in general.  Choose your comfort level of science.)

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Thursday: Chrysler, Cytokine Storms and Crowd Control

Eight years of the Bushies have left me paranoid.  I suspect there is a dosier on me in the Department of Homeland Security, I worry about being able to get on planes, and periodically I say “Hi!” to the NSA when I’m on the phone.  It’s hard for me to see myself as a threat to anyone but distrust has become ingrained in many of us since 9-11.  I don’t like to think ill of our government but something feels deeply weird about the recent flu pandemic.

But before I get to that, the big news today is that Chrysler is on the verge of bankruptcy due to the recalcitrance of bondholders to strike a deal with Treasury.  That’s right, banks and hedge funds have been holding out expecting that the government will sweeten the pot instead of forcing the automaker to bankruptcy court where assets will be sold and thousands of jobs lost.  What happens to Chrysler will surely happen to GM and when that happens, I would expect to see a lot of very angry autoworkers who will see their way of life disappear due to the unchecked greed of bank and hedge fund managers. And this is partially due to the gentle handholding that the Bush and Obama administration have been giving the banks since they lost all of our money.  It could get really ugly.  James Kwak at Baseline Scenario has more to say about banks and the government in a Cuban Missile Crisis scenario that will make your blood boil.  Just go read it.

Back to the flu thingy.  Mexico has now issued directives on crowd control due to the “pandemic” swine flu:

The president said a shutdown of a broad range of public services and activities would start Friday and continue through Tuesday, encompassing the long Cinco de Mayo holiday weekend. Most federal offices will be closed; restaurants, schools and museums will remain shuttered; and spectators will be barred from all professional soccer matches.

Churches are expected to be nearly empty on Sunday.

The measures came as the World Health Organization raised its alert level on swine flu to Phase 5 on Wednesday, based on the flu’s continuing spread in the United States and Mexico. Phase 5, the next-to-highest level in the worldwide warning system, has never been declared since the system was introduced in 2005 in response to the avian influenza crisis. Phase 6 means a pandemic is under way.

Worldwide, at least 10 countries have confirmed cases of swine flu.

“All countries should immediately activate their pandemic preparedness plans,” Dr. Margaret Chan, the W.H.O. director general, said at a news conference in Geneva. While she emphasized the need for calm, at times she spoke as if a pandemic had already begun, saying, for instance, “W.H.O. will be tracking the pandemic.”

Now, I’m not a health professional but this seems to me to be a bit of overkill.  I have to assume they know something I don’t but so far there is no evidence that this particular flu triggers a cytokine storm.  A cytokine storm is what killed young healthy adults during our worst flu pandemics in the past.

triggering a cytokine storm

It was the reason for half of the deaths from the 1918 Spanish Flu and was also present in the Asian and Hong Kong flus of the recent past.  A cytokine storm is what happens when your immune system takes it up to 11.  The body sort of overreacts to the flu antigen and unleashes an immune system “storm” of macrophages, T-cells and other elements of its defense arsenal.  Usually, there is a feedback mechanism that tells the body to stop before it goes too far and damages itself.  In cytokine storms, the feedback mechanism doesn’t get triggered so the body can’t stop itself.  People with robust immune systems, where all systems are ‘go’ most of the time, tend to fare the worst during these kinds of flu.

But here’s the thing.  As recently as yesterday, the CDC bulletin on Swine flu makes no reference to a cytokine storm.  It just looks like a normal seasonal flu with the expected symptoms.  The people most at risk are the typical populations: kids under 5, senior citizens, people with compromised immune systems.  Nevertheless, Mexico is closing up shop, going on siesta and cancelling tickets to their soccer games.  It seems a bit extreme.  The only thing I can think of that would provoke this kind of reaction is that the vaccine makers didn’t see this one coming and they don’t have a vaccine ready.  So, we’re all kind of vulnerable- to a typical flu.  If you get it, you can expect to be sick and uncomfortable.  You probably won’t be able to take the cheap anti-virals to make it less bad.  And if you fall into one of the high risk groups, it could be serious.  But other than that?  It’s not like 1918. There won’t be body laden carts driven by lackadaisical smartasses crying, “Bring out your dead!”

Having a country on lockdown seems counterproductive to me, especially in a bad economy.  Not all of us can work from home and some of our employers have made that pretty impossible these days anyway.  I suspect that such a directive could make the economic crisis exponentially worse.  But yesterday as I went into work, there were signs posted on the doors telling people to not enter the buildings if they had a runny nose, sore throat, fever or cough.  I considered for a moment whether my scratchy throat was due to spring pollen or some deadly plague and decided that going through the medical review team gauntlet was probably not worth the day off and went in.  But still, you have to wonder why we go to these extremes over a typical flu.  Maybe we’re just covering our asses.  Maybe we just can’t deal with illness these days when everyone expects a quick cure and a shot for everything.  Or maybe it’s just a perfect excuse to keep everyone scared and indoors.

I told you I was paranoid.

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