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Behind the Swine Flu Emergency
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By declaring H1N1 a national emergency, Obama’s made it political—which is a shame, says infectious disease specialist Kent Sepkowitz. What we should really be talking about is how to get vaccinated for an even more deadly pandemic.
Now that Obama has formally declared swine flu a national emergency, he has moved the virus from the realm of public health into the too familiar and greedy world of politics. Rather than hearing those quaint details about how to cover a cough or watching local shmokel not-ready-for-TV doctors say whether to go to the ER, we now will get the standard he says-she says spouting off, the snorts and whistles from the professional snorters and whistlers, the straight insider-trading dope from the guys in the know. Instead of that background footage of content laboratory technicians looking under microscopes, get ready for scenes of brisk lawyers hurrying up the steps of a courthouse.
The 2009 novel H1N1 influenza virus pandemic story is nothing if not a ringing endorsement for vaccination of human beings.
It’s a shame that the medical end of the story is now destined for the backseat, because thus far, despite all the hyperventilation, the epidemic has played out as predicted. This is an extremely contagious, mostly mild disease, and none of us has a whiff of immunity to it (except perhaps geezers vaccinated 35 years ago—the cute feel-good portion of the story). Swine flu has spread through the country just like, well, influenza. Just about everyone has or will get it unless the much touted vaccine arrives in time.
Instead we’re focusing on the chess match, the eternal micro-discussion of what everything really means: whether Obama is playing it up now to gin up support for his health-care initiative; whether the Republicans should stand up against something as flagrantly pinko as universal vaccination; what the cost in votes and press might be of standing here or moving there. The declaration of an official national emergency has reduced the H1N1 epidemic to something like the aftermath of a grim tornado—the president choppering in, a governor in a fleece coat and hardhat, a few lost souls picking through the rubble, some cute kids wearing PJs wandering in the bright daylight. I already miss the old days when figuring whether to stock up on Tamiflu was the moral crisis of the day.
• 8 Diseases Scarier Than Swine Flu
• Why You Love Being Scared of Swine FluSwine flu is of course deeply steeped in politics, perhaps more than any other disease. Its first lap around the block, in 1976, doomed poor hapless Gerald Ford, when a novel swine strain killed a single soldier in Fort Dix, New Jersey, and seemed poised to cause even more harm. So the temperate Ford listened thoughtfully to his advisers, carefully weighed the pros and cons, and ordered the entire country to be vaccinated, just weeks before the presidential election. He even rolled up his sleeve for a jab to show how safe and hygienic the whole thing was. But instead of a hero, he turned out looking like a doofus—only a few more cases of severe disease occurred despite the threat of a killer epidemic, plus the vaccination itself caused a handful of unexpected but devastating complications. Ford soon lost the election by a whisker to Jimmy Carter. No swine, one could argue, no Carter. No Carter, no Reagan. No Reagan—please don’t get me started.
But really the story of swine is its demonstration of what happens when a new disease hits for which we have no vaccine. The 2009 novel H1N1 influenza virus pandemic story is nothing if not a ringing endorsement for vaccination of human beings. Ironically, this comes at a moment when the anti-vaccination people are in full voice, with celebrities and their tweet-brigade marching against shots and elixirs and all manner health-care interventions, even as we are witnessing a disease affect millions, perhaps billions, all because we haven’t quite got that vaccine ready yet.
Not that this inconvenient fact will chill the anti-vaccination fervor. In that regard, the anti-vaccine people resemble their bizarre-o world inverse twins—those who deserve everything the health-care system has to offer and right this instant, including and not limited to the few drips of vaccine currently available. One is sinned against for being offered, the other sinned against for an offer too small, but each shares the same dim vision. They fail to see the epidemic for what it is: a series of aimless unfortunate circumstances without reason or fault, without a grand design, a conspiracy, or a 10-year plan. Rather, it is a complicated set of facts thrown before us at exactly the wrong time, to be dealt with cautiously, anxiously, and mostly in the dark—just like the rest of adult life. When the novel H1N1 dust settles (and settle it will, probably in a month of so) the experience will give us an incredibly important public health lesson: vaccination works. It is certain, however, to be a lesson roundly ignored—it is the virus after all that is novel, not the public’s response to it.
Kent Sepkowitz is an infectious disease specialist in New York City. He has contributed to The New York Times, Slate, and, oh-so-briefly, O Magazine. He also writes academic medical articles that are at times pretty tough sledding.
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Why You Love Being Scared of Swine Flu
Kent Sepkowitz is an infectious disease specialist in New York City. He has contributed to The New York Times, Slate, and, oh-so-briefly, O Magazine. He also writes academic medical articles that are at times pretty tough sledding.
What are you smoking? Are you a snorter or a whistler? Did you sleep through the aftermath of Katrina when due to red tape and total imcompetency, physicians were not premitted to treat people dying in the NO airport waiting to be evacuated because they had not been cleared by FEMA. Declaring a national emergency frees up resources and allows medical personnel to make common sense, life saving decisions if hospitals become overwhelmed.
It is clear from this piece of tripe that you haven't been keeping up and that you didn't do your homework but chose to be an opportunist who is willing to exploit the situation for his own benefit. No reasonable, educated person is going to believe that taking pre-emptive steps related to what has become an epidemic is in anyway related to proposed healthcare legislation.
xlntcat has an xlnt point: Did the author neglect to read why the president had to declare H1N1 a national emergency? This is a necessary legal step. Why did Daily Beast give space to a doctor spreading dangerous disinformation????
And a weirdly anger Doctor at that.
The swine flu vaccine was always political. If you spend about 2 trillion bailing out Wall Street and Goldman alone is declaring some 16 billion in bonuses, then how can you only spend 2.5 billion or even less on a vaccine??? The government should have contracted with more makers or made the stuff itself, paid much more for it to ensure a huge supply fast. If many people die, this is political, it was done on Obama's watch and right now it seems he's just covering his backside since the vaccine is in very short supply. The other thing that's terrible is you know the distribution of it will also be fraudulent with many important people getting the vaccine early. Hate this stuff and it makes you feel the country is just crap.
The White House is trying to downplay the creation of a national emergency -- saying it was largely administrative. The fact of the matter is VP Biden was open about the dangers in the begining of this crisis, the President told us to wash our hands and we will be fine. Now to date over 1,000 people have died and over 20,000 have been hospitalized.
President Obama did not make this serious medical problem a priority and the perception is that the new boss isn't much differant than the last one.
A comment as BS as the author's.
The flu is a serious danger every year. This one just happens to kill healthy young people. Should we be concerned? I am very concerned. My 20yr old college student,asthmatic, previously pneumonia-ridden because of the flu,son refuses to get vaccinated because he believes the it will make big pharma rich. Try dealing with that!
All I know is so far the REAL work, as opposed to fancy talk, of providing willing people vaccination against H!NI has been a joke. Obama and others declared months ago that we would be ready in the fall. Yet, not only do we have less than 1/3rd of the available vaccine they promised by now, but their methods of distribution for that 1/3rd are chaotic and inefficient. Unlike many people who still seem confused and conflicted about whether they should be vaccinated, my family is 100% clear we want our three kids (and us if they ever get enough vaccine to allow us to be protected) to be vaccinated. So we have been proactively and aggressively seeking ways to do so since day one. Yet as of today we are still without a solution.
Absolutely none of our doctors or any other local doctors in our area have any clue when if ever they will get the vaccine. They point you to various State and County public health organizations most of which still say they don't have a clue either. Then we read in the paper that our County had received a supply to distribute through the schools and all but two schools had opted-in to do it, but they won't public the list of which schools. So we track down our school principal to see if he's opted-into the program and he says yes, but that they have yet to give him any idea when IF EVER they will actually let them do it. Apparently there is contradictory bureaucracy that makes it almost impossible for a school to administer the vaccine (in our county at least). Each school has to have a certain ratio of doctors and qualified nurses to run the program, but they can't hire these professionals on a temp basis, they can't have local volunteers who are qualified and the county can't supply them. So by default, only the largest districts with enough people already on-staff can effectively participate and even then only after they send them all to special training. A smaller district like ours is apparently SOL unless they eventually change the rules they have set up. That was over a month ago and still no word of any vaccination on the horizon...
I could go on and on with all the fruitless efforts we've taken to actually find a way to get vaccinated. We tracked down a county clinic setting up appointments for the vaccine (only for our two older kids; neither we nor or 4 year-old are eligible based on their rules), about 45 minutes from where we live and of course only do for 4 hours a week during the middle of the school days. But our appointment has been reset 3 times because they keep calling saying they didn't receive the vaccine yet despite what they were told to expect. In fact, we haven't spoken to a single person who has actually physically received the vaccine yet...
The bottom line is they aren't spending nearly enough energy actually figuring out how to effectively distribute, administer and communicate the vaccines. A lot of people will get sick and some will die with vaccines sitting unused in central distribution facilities because of bureaucratic stupidity.
Must be Obama's fault.
Daily Beast: I am embarassed that you have chosen to give credability to this piece of poor reporting. At my last check in early October, 693 people in the U.S. had died from H1N1, with estimates for year-end at approximately 1000 to 1500. This with NO real vaccine availability as of yet. 1000 to 1500... out of 300 million. This disease essentially kills NO ONE, yet, we feel it is in our national interest to spend 2.5 BILLION on its development and CHARGE Americans approximately $30.00 apiece for it... genterating BILLIONS in profits for the vaccine industry. The desperate dream of the greedy industry is to instill fear in the public so that they will get the vaccine, then be unable to judge whether it was worth the investment.
China has NO real vaccine distribution system. Russia is worse. If our American vaccine is of any real value, death rates in these nations should be significantly higher than in our vaccinated nation... Check the numbers for yourself to find out if our vaccine and its associated hysteria is of any real value to the American public.
The Med-Heads have DUPED our president into declaring political support for a profit-hungry procedure that lacks any ability to prove its own value. Your author's self-serving, offensive remarks to the anti-vaccine groups are disgusting... particularly considering that visits to ALL medical doctors and emergency rooms are GOING THROUGH THE ROOF since they have done such an excellent job of sowing fear and panic in our population. Well-done to them for finding a move that both increases their control over our society, and boosts their profits at the same time.
I am sorry that this greedy, self-serving industry can count on you, Daily Beast, to spread their propoganda.
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genomegk: Thank you so much for responding! Regardless of your opinion, I thank you for taking the time to post a cogent response.
As to your point, there is NO study to date authorized by the National Institute of Health, or other similarly well respected entity that compares the health of non-vaccinated vs. vaccinated populations in our nation. The study you reference above DOES show that incidence of specific disease symptoms and their sequlae is reduced by vaccinations... but the overall burden to society of their overall cost, especially when compared to other places we could spend the money: such as REAL programs to encourage exercise, proper rest, and occasional checkups to prevent more expensive problems (such as an occasional dental or chiropractic checkup for dental or spinal problems), has yet to demonstrate its value. According to the World Health Organisation, we are 37th in terms of overall health for industrialized nations... OUT OF 37!!! Our nation is DEAD LAST in terms of lifespan, fitness levels, disease rates, and infant mortality when compared to other industrialized nations.. and we spend BILLIONS more on 'health' care. Our healthcare industry is an abysmal failure at producing REAL value in terms of human health... your study only demonstrates again how a greedy industry tries to justify HUGE expenditure for VERY LITTLE benefit. It would be FAR more valuable to let those elderly individuals in the study above get some good food an exercise than it is to dump another $30.00 worth of drugs in them every year... the more drugs we pump into them, the more complicated, expensive and SHORT their lives become overall. Don't believe me? Tell that to ALL other industrialized nations in the world who spend less on their drugs and their people LIVE LONGER.
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H1N1 fulfills the criteria for an epidemic and to spurn a vaccination program would be ludicrous. As of August 30th, 28 pregnant women have died, and as you have pointed out, hundreds of otherwise health people. The cost of vaccination is judged on number of life-years saved, and the calculation is not even close in favor of vaccination.
To say that vaccinations do not save lives is perhaps the least credible thing I've heard in along time (what type of dr are you drjonathan?) vaccination is not mandatory, so I'm not sure of your complaint. The average American spends more per month on their cell phone than the one-time $30 cost, so what's your beef? Penny wise and pound foolish, dontcha think.
As for the author of the article, I believe he needs to review the advantages and disadvantages of a president declaring a federal emergency. Resources are available and awareness is augmented. I'm not sure of the point of this article. Sure, folks are going to be scared-- but they're scared with or without a federal emergency declaration, and when thousands are dead by January, this same guy will be asking why Obama didn't anything more back in October.
Anybody remember the bird-flu??? That was supposed to be a pandemic.
Oh and daniel, regularly washing your hands is the number one way to prevent the spread of infectious diseases. So if you wash your hands regularly, it will serve you better than a vaccination.
bgeasyas123: Anybody remember the 1918 flu pandemic?
Between 20 an 50 million people died, worldwide.
Nobody knows in advance how a particular strain of flu virus will affect people, especially since it tends to mutate. Washing hands is good advice, but a vaccination is your best shot at avoiding the flu - and if you don't get it, you're not going to be giving it to others, either.
AlanD2: Of course YOU don't remember the 1918 flu pandemic. I highly doubt you were ALIVE then.
More to the point: you have NO credible evidence to demostrate that a flu vaccine produces a reduction in infection or enhances public health in a way that justifies its cost. If I can produce a product that reduces infection by 1%, and costs 50 trillion dollars, is it worth it? I imagine the answer is most certainly YES, if you work for the vaccine industry. People die from all kinds of things: we have spent close to 3 billion in public dollars to develop this vaccine, and we will charge the American public many more billions to give it to them, do we spend proportionately as much on other lethal threats to our nation? About 1000 to 1500 people are expected to die this year in our nation from the swine flu: cigarette related deaths will be around 180,000. Is our nation ready to spend 180 times 3 billion, or 520 BILLION to get people to stop smoking?
Flu vaccines also carry significant risks of side effects, significant I say, especially since the risk of dying from the disease itself is so miniscule. You either have no clue of how to put your money towards the things that have the greatest financial need, or you are a very clever employee of the vaccine industry, or a medical doctor or doctor's employee who profits from the mass hysteria your industry has worked so hard to produce.
drjonathan: I wasn't alive in 1918, but unlike some posters here, I can read and take an interest in our history.
No credible evidence? Check out this report from the CDC at
http://www.cdc.gov/FLU/PROFESSIONALS/VACCINATION/effectivenessqa.htm
(Take out extra spaces if you copy and paste this link.)
"Overall, in years when the vaccine and circulating viruses are well-matched, influenza vaccines can be expected to reduce laboratory-confirmed influenza by approximately 70% to 90% in healthy adults < 65 years of age. Several studies have also found reductions in febrile illness, influenza-related work absenteeism, antibiotic use, and doctor visits."
As for deaths, we have about 36,000 each year from the usual flu. Swine flu may be less harmful than originally expected, but there are still deaths. Children seem to be particularly vulnerable. I doubt you would be so sanguine if a child of yours died.
The risk of dying from flu is much higher than the risk of dying from the vaccine. But nobody is making you get vaccinated, drjonathan. Go ahead and gamble.
Alan.
The CDC is purposely misinforming you and the public to sell the need for the vaccine.
It was revealed that many individuals on two key advisory committees had financial ties to pharmaceutical companies that manufacture vaccines. These individuals were even granted waivers allowing them to fully participate in discussions about vaccine licensing and recommendations for children, despite the fact that federal law states members of advisory committees are required to disclose such ties and recuse themselves from such discussions and decisions.
This year it is more important that you protect your children and loved ones from the flu vaccines than influenza itself. This article on Lew Rockwell discusses how:
1. The swine flu is simply another flu. It is not unusually deadly.
2. This is the first time both seasonal and pandemic flu vaccines will be administered. Both seasonal flu and swine flu vaccines will require two inoculations. This is because single inoculations have failed to produce sufficient antibodies. This is an admission that prior flu vaccines were virtually useless. Can you trust them this time?
3. Adjuvants are added to vaccines to boost production of antibodies but may trigger autoimmune reactions. Some adjuvants are mercury (thimerosal), aluminum and squalene. Why would you sign a consent form for your children to be injected with mercury, which is even more brain-toxic than lead?
4. This is the first year mock vaccines have been used to gain FDA approval. The vaccines that have been tested are not the same vaccines your children will be given.
5. Over-vaccination is a common practice now in America. American children are subjected to 29 vaccines by the age of two. Meanwhile, veterinarians have backed off of repeat vaccination in dogs because of observed side effects.
6. Modern medicine has no explanation for autism, despite its continued rise in prevalence. Yet autism is not reported among Amish children who go unvaccinated.
7. Researchers are warning that over-use of the flu vaccine and anti-flu drugs like Tamiflu and Relenza can apply genetic pressure on flu viruses and then they are more likely to mutate into a more deadly strain.
8. Most seasonal influenza A (H1N1) virus strains tested from the United States and other countries are now resistant to Tamiflu (oseltamivir). Tamiflu has become a nearly worthless drug against seasonal flu.
9. Public health officials are irresponsible in their omission of any ways to strengthen immunity against the flu. No options outside of problematic vaccines and anti-flu drugs are offered, despite the fact there is strong evidence that vitamins C and D activate the immune system and the trace mineral selenium prevents the worst form of the disease.
nb-moe, wow it's amazing how many things your post is wrong about. You need to branch out to more sources for your information and not get taken in by a few conspiracy articles.
@Alan, you're doing a good job responding to hysterical responses. Bravo.
I don't remember the 1918 flu but I asked my gram about it when she was still alive. She lived in Iowa and remembered an 'x' on doors where there was a flu death and carts instead of hearses used there were so many dead. Whole families died in her town. It was about the most somber I've ever seen her when I asked her about the epidemic.
A flu shot vs. conspiracy theories delivered with bully pulpit tactics here and on the radio? Easy.
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Thank you, Veronicaxy. I do my best... :-)
thanks nb-moe!! AlanD2:
I did not say vaccinations do not reduce infection, I said they do not reduce infection IN ANY WAY THAT JUSTIFIES THE COST. We are spending BILLIONS on this program, in the midst of a crisis of over-budgeted heathcare, and you can in no way demostrate that the lives saved with this much money are justified. Far MORE lives would be saved if we simply spent the money getting overweight adults to exercise, eat less processed food, and get an occasional checkup of their teeth by a dentist and their back by a chiropractor. Research is indisputable that as little as 10 minutes of exercise per day will reduce death rates... and that is FREE once we convince an adult to do it. The values of healthy food and occasional checkups are similarly powerful.
Imagine the reduction in death rates if President Obama would simply ask Americans to go to McDonalds once less per week. Or if he would just advocate a basic exercise regimen that all Amercians were encouraged to participate in ... these rediculous studies attempting to 'prove' the value of billions of dollars of expense in pumping Americans even MORE full of durgs would be far overshadowed by the simple truth of health.
drjonathan: Do you have any sources for your claim that vaccines are not cost effective?
I agree that there are many things Americans could do to improve their health. However, being in good health does not guarantee you will survive any disease, although it does improve your odds.
For those that air on the side of pessimism, do you have children? I know someone whose children were diagnosed with H1N1 and it was a very scary ordeal. I myself have a son and, as a parent, I would rather be proactive about treatment than even risk his health. I, for one, am glad that the president hightened the awareness of the virus by declaring it a national emergency. For those that spend their time being critical of the political angles they can only ASSUME the White House is taking, take a minute and thimk about the lives that are being saved by the heightened awareness.
Good for you, KofTX1. Too many parents have been paralyzed by the fear-mongering about vaccines. I fear that at least a few of these parents will be devastated by the eventual outcomes of their inaction.
Well, if the president did nothing--people would be What part of the government does not make the shots don't people get. Blame the drug companies for their overestimates of how many vaccines they could produce. It is the drug companies making and shipping the vaccines. We are lucky they could even make it this quickly.
All of a sudden, people are running to the government--I thought you did not want the government doing anything for you. You want everything private--call your drug company, located overseas, and see how far you get.
With the declaration of emergency, the president is being pro-active. That is the opposite of doing nothing even after the hurricane hits--get it. Every single person here has access to the information he or she needs. Quit your bitchen and look it up. And if you think that the whole thing is a conspiracy, then you need to go to your local library. A librarian will teach you how to source the information you are reading. Just because it is in print--does not make it true.
And if you think that everything the government does is bad, or is trying to kill you--good luck. The information is out there---you can take it or leave it. The government wants to keep you alive--they need the money.
Read more at: http://www.huffingtonpost.com/social/blue53?action=comments&display=news&so rt=newestscreaming.
One of the key concepts behind vaccination is "vaccinating the herd."
If most of the healthy people around at-risk people are vaccinated, then there is a much lower chance that the at-risk person will become exposed and get sick.
Getting most of a population vaccinated reduces the risk of fatalities from the disease as well as increasing overall productivity of the economy because fewer people are at home sick.
I'm angry that our country is not prepared to deal with this.I had a doctor appt. for something else , I thought I might as well get the regular flu vaccine. My doctor said they had been out for sometime.If we really do have a pandemic, how can we feel safe that we can get enough vaccine when the regular one is in short supply?
As far as vaccine safety...... would you not take the polio vaccine ?
There is no such thing as public health in this country anymore -- just "my" health.
I grew up when polio was rampant, killing and disabling thousands of people (mostly children) every year. When a vaccine was finally developed it was welcomed as a miracle. And there was no question as to the need for the public (the whole public) to get immunized. The idea was not simply to obtain individual immunity, but to eliminate hosts of any kind for all time. And, to a large extent, we did.
Was the vaccine safe by current standards? Probably not. But its universal usage traded a small risk of bad outcomes for a larger risk of horrible outcomes.
Today it is about "me". We don't care about transmitting diseases as long as we are safe. H1N1 may not be a particularly big risk. Maybe it is OK to forego something approaching universal vaccination. But a pathogen will come along which will be truly terrible.
Polio is a dim memory for most of us today because people understood that sometimes "we" is more important than "me".
If only we had a magic crystal ball to tell us where the next big flu is coming from, we'd all be better off. Great reporting! And please do look up the reasons WHY Obama declared an emergency now. Maybe you should go ask a journalist?
To those opposed to vaccines, I suggest reading "Plagues and People" and "Bring Out Your Dead" for a glimpse at life before public health and vaccines (check you local library). And the link between vaccines and autism is yet to be established; many believe it has more to do with industrial pollution.
C'mon. Stop this blame it on Obama crap already. If anything is a health issue it is all this bull dung being thrown around to taint the Pres.
Um... with record unemployment, scores of businesses in bankruptcy and lots of empty factories around the country, I wonder why The U.S. Government cannot train a core of virus producers and have them on call for emergencies such as this.
Kind of like The National Guard.
This way production could be ramped up as necessary, folks would have a part time J.O.B. when needed, and surely there is a manufacturing facility that could be re-purposed for the emerging infections that we are told are just around the corner.
Maybe we should call Modell's Times Square? They seemed to have the Yankees ALCS shirts ready the split second the Yankees won!!!
Go Yankees!!!!!
Thousands die from the flu every year. The only difference this year is the shift from the very young and old being the most susecptible. Was part of the white house back door deal to hype H1N1 to boost vaccine sales?
Thank you.
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