Pandemic – OH MY! – A / H1N1 – Other strategies


The word “pandemic” raises great fear and trepidation due to the experience of the 1918 “flu pandemic”, “Spanish flu”,  that killed over 40 million people around the world, more than war killed. The average persons equates “pandemic” with a “deadly disease”.  Our government, the CDC, and the WHO have not adequately explained to the public and press that pandemic does NOT EQUAL deadly disease.

The 1918 flu pandemic was caused by the same family of virus A/H1N1 that is spreading around the globe this past month. There are hundreds of members of this family (strains) each which are unique but related. H1N1 was the family for the “seasonal flu” strains that infected people yearly from 1918 to 1957 when a new family emerged as the seasonal flu. Each year the dominant strain rearranged a bit causing a new strain to emerge in the same family of virus.

In 1977 the H1N1 family emerged again, but has not necessarily been the dominant family in the seasonal flu. There have been several families causing the yearly flu strain.  This means that most people born before 1957 have a partial resistance to the A/H1N1 family which might explain why mainly young adults are getting sick with the presently mild A/H1N1 family-new this year strain or “swine” or “Mexican” flu.  

So it is not the fact that it is an H1N1 family virus that scared the public health officials.  It is the fact that this year’s strain was emerging at an unusual time and was coming from the Americas, in addition to the fact that it contained both swine and bird genes, as well as the fact that it was spreading so very quickly from  person to person as well as tending to infect young healthy adults and causing deaths in a few of these people. Therefore it had some similarity to the pattern in the 1918 pandemic. As the scientists and the public health officials DO NOT UNDERSTAND what causes a flu to become really deadly and toxic this made the public health community very nervous.

In the U.S. influenza (the strain going around that year – called ‘seasonal’ flu for the kind of illness not the strain) infects about 30,000,000 people a year (10% of the population) and kills about 30,000 per year on the average. Generally the deaths are among the very old and very young who are already sick or fragile with chronic illness or congenital disease. Of note, the child that recently died in Texas was a chronically ill and fragile child.

Well, how do they pick what strains to make vaccine to every year. A new vaccine is needed every year because last year’s strain does not fully protect against the new strains that emerge each year as the virus has a tendency to rearrange  taking components from other strains each year. The public health authorities and experts meet every year in around February to March and look at the strains that were spread around the previous year and guess at which strains will be around this year. Then they instruct the manufacterers to make a virus to a mix of strains that they think will occur the next fall. The guess is usually pretty good, but 1 out of 3 years they guess wrong and the vaccine is not completely effective. This year they had not expected this new A/H1N1 family – new strain to emerge so it was not included in the list. They are racing to include it or in the alternative if it is too late to include in the “seasonal vaccine’, then to make a vaccine specifically to this new strain. The vaccine should be ready between September and December. The vaccine however is not a cure all and can have complications – dozens of cases of Guillain-Barre syndrom an illness that causes paralysis and puts you on a respirator in intensive care occurred after the last “swine flu” vaccine was distributed.

The 1918 flu was unusual because it emerged in the spring as a very mild illness and then re-emerged in August as an intensely deadly illness. My grandfather during 1918 had this flu but he was in his thirties and recovered. He described people dying suddenly on the street – literally falling on the street with blood foaming out of their mouths. He also described getting on a troop train and young 18 year old soldiers going into massive respiratory failure, foaming blood at the mouth and dying during the few hours it took the train to get to its destination. It was very rapid onset and deadly and death was often due to a rapid onset and toxic viral pneumonia instead of from bacterial complications that often cause deaths in seasonal flu among the fragile. There were so many bodies they were stacked like cord wood in morgues and hospitals and on military bases where up to 80 % of the troops died. Herses in some cities stretched for miles with continuous funerals for weeks. A study revealed that closing schools in 1918 may have slowed the spread of the pandemic. The goal in closing schools is not to prevent people from getting sick but to slow the spread of the disease so that public health officials have time to mobilize, such as to distribute Tamiflu and masks.  It is uncertain if masks are actually useful as most people don’t use them correctly and take them off frequently because they are uncomfortable.

It is my opinion that preventing the spread right now is foolish. I would encourage people to get exposed to this presently mild illness so as to build up herd immunity in the population while the illness is mild. You will also avoid the chance of complications from the vaccine in the fall and from medications. Then if per chance it should evolve and becoming deadly in the fall many people will at least be  partially immune and we can use the medication (Tamiflu and Relenza) for the very ill and use the vaccine that is being developed in a more targeted fashion.  Closing schools, businesses, and public events, when the illness is very mild, to me seems foolish and just deprives the kids of an education.  I would encourage the medically fragile, severe asthmatics, and elderly who are chronically ill to stay home or avoid crowds for at least a few more weeks.

The most important thing to do to protect yourself against catching the influenza virus, not just now, but every year, particularly in the winter, is to WASH YOUR HANDS frequently. Washing/sanitizing schools is a waste of money, except it will remove bacteria that can cause infections. Influenza virus is very fragile and dies after a few hours at most on any surface.  It is useful to sanitize things that people touch frequently like knobs on bathroom sinks and door handles several times a day during the flu season especially.

I do not see the present “pandemic” which just means it has spread across the continents any differently than I see the yearly seasonal strains at the moment. Pandemic does not tell you anything about the seriousness of the strain. It only tells you how widespread it has become. It is an epidemiologic term not a medical term that describes the toxicity or seriousness of the disease.

Excess use of Tamiflu will only cause the flu strain to become resistant sooner. I urge not using it for mild illness in the healthy. Also remember that Tamiflu has complications including delusions. People on it should be around a family member who can help them if they become confused and delusional and should consider not driving unless they know they don’t have this complication.

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