The world is already sick of swine flu

By Eurasia Group analyst Scott Rosenstein

There are two common refrains we're hearing from flu experts: 1) "If someone tells you that a devastating pandemic is certain to happen or certain not to happen, stop talking to that person"; and 2) "Predicting the damage this swine flu virus will do, at this point, is like predicting the winner of the Indianapolis 500 after the first lap." This is sound advice. Unfortunately, it runs contrary to the way many media outlets provide information and how the public consumes it. Epidemiological and virological analysis in the coming weeks and months will not be simple or definitive. This will test the attention span of the public and challenge the media to move away from doomsday proclamations or Chicken Little accusations.

The mainstream media's 'round the clock swine flu coverage has already dwindled. There are still occasional stories about cases around the world (including new outbreaks in New York City), Mexico's slow return to normalcy, China's draconian treatment of Mexicans, and the possibility that this recent flu outbreak was actually the result of a lab accident.

But for the most part, swine flu fatigue is beginning to set in around the world. The prevailing sense among experts, markets, and laypeople is that this current outbreak is relatively mild. Many are adding this scare to the ranks of past pandemic scares, including H5N1 bird flu, SARS, and the Y2K bug (the computer pandemic that wasn't). This has raised the ire of many who see injustice in the seemingly disproportionate attention and resources being paid to an outbreak that pales in comparison to other severe health crises around the world. For a compelling graphical comparison of the deaths and media attention related to swine flu versus tuberculosis, watch this.

Meanwhile, governments, the WHO, and infectious disease experts are quick to point out that a celebration might be premature. After all, flu viruses are crafty: They mutate, come in waves, and mix with other viruses (possibly even the H5N1 bird flu virus, which is much deadlier in humans but also much harder to catch). So, some experts argue, the so-called swine flu virus might come back during the northern hemisphere's typical flu season and infect one-third of the human race if there is no vaccine by then. This might mean millions, or even tens of millions, of deaths -- far exceeding the yearly deaths from tuberculosis. It might be the destabilizing event that derails a tenuous global economic recovery. Or, it might just be like the seasonal flu, which kills on average 36,000 Americans a year and 500,000 people around the world. Or, it might just fade into oblivion. That's a whole lot of mights.

In the spirit of inter-blog backslapping that's all the rage with the kids these days, I'd like to direct you to some excellent analysis and debate underway in "flublogia." Blogs dedicated to potential doomsday scenarios are sometimes dismissed as the domain of hysterical crackpots. But these are the exception, often tempering the hysterical rhetoric of more traditional news outlets: Avian Flu Diary, Crof's H5N1, Flutrackers, and Effect Measure.

Flublogia was born in the age of bird flu and is now awash in minute-to-minute outbreak updates along with longer-term debates, featuring a variety of knowledgeable scientists and policymakers. Frequent topics of discussion include the serious risks and benefits associated with the production of an H1N1 pandemic vaccine, the utility and availability of anti-virals such as Tamiflu in a pandemic, public- and private-sector preparedness plans, and the relative pandemic vulnerability of countries with weak healthcare systems.

These discussions will continue-within governments, businesses, flublogia, the World Health Organization, and laboratories-for months. And during this time, there will likely be more claims of impending doom, which will inevitably produce a "sky is falling" backlash. In the fall, many countries will grapple with difficult seasonal and pandemic vaccination questions. Will the media and the public be engaged in the issue by then? Presuming the disease remains relatively mild, a recent poll suggests not so much. As a result, nervous parents and those with memories of the problematic 1976 swine flu vaccination program could strongly resist whatever vaccination strategy is implemented.

Moving forward, whether this flu virus changes the course of humanity or not, understanding complex, evolving epidemiological events in an environment that craves closure and certainty will remain a major challenge for policymakers, scientists, journalists, and the general public for the foreseeable future. That is, presuming we're not all dead.