PARMAGEDDON

April 29th, 2009 by Ben Goldacre in bad science, scare stories, uncertainty | 61 Comments »

This is possibly the most boring thing I’ve ever written in the Guardian, but I have been genuinely weirded out by the number of people inviting me to be a naysayer on the aporkalypse. I’m not, it’s a genuine risk. I ought to add that most of the people who rang, when I explained my position, invited me on anyway, but I’m a bit busy with other stuff, and more importantly (a) I’m not an infectious diseases epidemiologist, and (b) the world doesn’t need another arbitrary pundit to say “it’s a bit of a risk, yes”. [Oh incidentally comments on the site might take a while to appear since alexlomas has activated wp-cache after boingboing very excitingly linked the new Rath chapter.]

Ben Goldacre
guardian.co.uk
Wednesday 29 April 2009 18.30 BST

First it was the emails, and the tweets. This is all nonsense about the aporkalypse, surely? Just like with Sars, and bird flu, and MMR, is this all hype? The answer is no, but more interesting is this: for so many people, their very first assumption on the story is that the media are lying. It is the story of the boy who cried wolf.

We are poorly equipped to think around issues involving risk, and infectious diseases epidemiology is a tricky business: the error margins on the models are wide, and it’s extremely hard to make clear predictions.

Here’s an example. In Glasgow in the 1980s, less than 5% of injecting drug users were HIV positive. In Edinburgh at the same time, it was almost 50%, even though these two places are only an hour apart by train. Lots of people have got theories about why there should have been such a huge difference in the numbers of people infected, and there’s no doubt that it’s fun to try and come up with a plausible post hoc rationale. But you certainly wouldn’t have predicted it.

Maybe some bloke with HIV got off the train at Edinburgh station instead of Glasgow on a whim, some fateful day in the early 1980s.

Maybe there was a different culture among heroin users, or services.

Nobody really knows.

We face the same problem with swine flu. All people have done is raise the possibility of things really kicking off, and they are right to do so, but we don’t have brilliantly accurate information. Someone has said that up to 40% of the world could be infected. Is that scaremongering? Well it’s high, and I’m sure it’s a bit of a guess, but maybe up to 40% could be. Annoying, isn’t it, not to know.

Someone has said 120 million could die. Well I suppose they could: I’m sure it was done on the back of an envelope, by guessing how many would be infected, and what proportion would die, but I don’t think anyone’s pretending otherwise.

You could no more predict what will happen here than you could have predicted the enormous disparity in HIV prevalence between Glasgow and Edinburgh. Everyone is just saying: we don’t know, it could be bad, and the newspapers are reporting that. Sure there’s a bit of vaudeville in the headlines, but they’re not saying things that are wrong, and do you really know actual, real people, normally pretty solid, who are suddenly now panicking?

By Tuesday, pundit-seekers from the media were suddenly contacting me, a massive nobody, to say that swine flu is all nonsense and hype, like some kind of blind, automated naysaying device. “Will you come and talk about the media overhyping swine flu?” asked Case Notes on Radio 4. No. “We need someone to say it’s all been overhyped,” said BBC Wales.

I assumed they were adhering, robotically, to the “balance” template, but no: he kept at it, even when I protested and explained. “Yeah, but you know, it could be like Sars and bird flu, they didn’t materialise, they were hype.” Simon Jenkins suggested the same thing. It’s not true, I said. They were risks, risks that didn’t materialise, but they were still risks. That’s what a risk is. I’ve never been hit by a car, but it’s not idiotic to think about it. Simon Jenkins won’t be right if nobody dies, he’ll be lucky, like the rest of us. Do people think this flappily in casinos? The terrible truth is yes.

In the time that I have been writing this piece – no embellishment – I’ve had similar calls off This Week at the BBC (“Is the coverage misleading?”), Al-Jazeera English (“We wanted to talk to someone on the other side, you know, challenging the fear factor”), the Richard Bacon Show on Five Live (“Is it another media scare like Sars and bird flu?”) and many more.

I’m not showing off. I know I’m a D-list public intellectual, but I just think it’s interesting: because not only have the public lost all faith in the media; not only do so many people assume, now, that they are being misled; but more than that, the media themselves have lost all confidence in their own ability to give us the facts.


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61 Responses



  1. MarkThompson said,

    April 29, 2009 at 6:50 pm

    Interesting to hear this Ben.

    The media always seems to want extremes to report something. This can be seen in the way stories are introduced in the headlines. There was something on ITV News (or Shite TV News as I rather daringly call it) the other night about alcohol and it was trailed as “Alcohol, ‘Dangerous Timebomb’ or ‘Harmless Fun’?”. No room for any middle ground there. It must be either one or the other and they duly got people to speak from one or other of these polarised and completely unhelpful points of view.

    This is the same sort of thing. On the one hand we are being told “140 MILLION COULD DIE!” but they are also searching for someone to come along and say the opposite to as you say keep the balance of two polarised views.

    It seems that the media is incapable of reporting any issue in a balanced way.

  2. SteveGJ said,

    April 29, 2009 at 6:50 pm

    Simon Jenkins article was a classic contrarian column. I often suspect that they just pick a commonly held viewpoint and adopt the opposite as some form of intellectual exercise. Well in this case he just looks an idiot. First it was littered with such things as:-

    ‘The BBC calls it a “potentially terrible virus”, but any viral infection is potentially terrible.’

    Well I suppose that virus causing verrucas might mutate into a killing machine but, unlike the influenza virus it’s hardly got much of a history of doing so.

    Then he prattles on about the risk of SARS turning into a mass killer being overstated at 25% (of course nobody can know for sure what the chance was), but what he seems not to recognise is that the potential crisis was contained through rapid and effective action. Similarly BSE could have been a great deal worse without some firm actions. Being in the IT industry it’s a bit like everybody claimihg we’d been conned about the year 200 problem. In fact it wasn’t a problem because it was dealt with – but it would have been.

    Of course he may well be right – swine ‘flu might well not turn into a pandemic, and even if it does, then it could take a more restricted toll. But if the latter is the case it might owe rather a lot to better medical and infection control.

    I’d also like to say a (rare) word of praise about the BBC science coverage of this subject. Not necessarily in general, but on today’s excellent Case Study on Radio4. Perhaps it was because it was hosted by a doctor and had knowledgeable experts on the subject who didn’t go into alarmist talk and generalisations, yet didn’t underplay the issue.

    www.bbc.co.uk/programmes/b00jyyl4

    Indeed Radio 4 has another reliable science programme in the shape of Material World. Perhaps they could teach their TV chums to be a bit less tabloid.

  3. GrumpyRN said,

    April 29, 2009 at 7:16 pm

    Allegedly the disparity in HIV rates was caused by the way the police did their jobs in Edinburgh.
    In Edinburgh in the 80’s if you were caught with needles, syringes etc. the police destroyed them and charged you with possession. Everywhere else set up a needle exchange so addicts could have clean works. Addicts in Edinburgh were forced to share needles and syringes as they had no way of getting clean ones.

  4. sammartin said,

    April 29, 2009 at 7:33 pm

    If pig flu and bird flu meet up, what are we in for then? Flying pig flu?

    (Now I feel guilty).

  5. nswetenham said,

    April 29, 2009 at 7:43 pm

    Hi Ben,

    None of this false modesty please! You are an A-list public intellectual and the mainstream media have obviously have obvious decided you are ‘that health boffin who understands them numbers’. We may not need one more ‘random pundit’ but you are the only pundit who seems to understand said punditry and does it with honesty, humility, and media acumen.

    Use your powers for good.

  6. nix said,

    April 29, 2009 at 7:54 pm

    One wonders what the (media!) people who talk about the media ‘over-hyping’ infectious diseases are thinking. Do they think flu doesn’t spread? Do they think it doesn’t kill lots of people, that 1918 was a conspiracy or a lie? Or are they just thinking so hard about the *media coverage* of flu that they’ve forgotten that there’s an actual disease out there that is happy to infect you whether you’re an arts graduate or a molecular biologist?

  7. davetaylor1972 said,

    April 29, 2009 at 7:55 pm

    I sent you a message through Twitter asking for some truth therefore, I thank you for this post.

    I wonder if this isn’t about the media losing faith in themselves but more about not wanting to accept that they may not have the answers. Like you say, not knowing is annoying and it would take a brave editor to say, “Some people have it, some have died, some haven’t. We don’t know what will happen.”

    And maybe that’s hard for the public to accept as well.

  8. BrianA said,

    April 29, 2009 at 7:58 pm

    The – admittedly limited – evidence to date that I have seen is that the death rate from this event isn’t too dissimilar to that of flu outbreaks generally.

    Perhaps you need to explain the risk context.

    ‘Yes, the absolute risk on this occasion is probably small, but one of these days something will hit where the risk is massive and the consequences for the world potentially much more serious than you can imagine. Therefore we need to be ultra-vigilant and if that involves crying wolf sometimes, so be it.’

  9. liquidcow said,

    April 29, 2009 at 8:00 pm

    I think equally, people are skeptical about these things partly because of fear, in a way. We don’t actually want to believe that it might actually be a genuine risk, so we tell ourselves that it’s all media hype, and so people want to hear an expert say the same thing to reassure them.

    I do agree with the above poster who talks about polarized opinions on the BBC. Surely if they were to give a fair representation they would include all the more moderate and actually balanced opinions as well, but as it is, people who don’t have an extreme one-way-or-the-other opinion tend not to get heard.

  10. CDavis said,

    April 29, 2009 at 8:09 pm

    This is so depressing. After years of making molehills into mountains to sell papers, the media’s response to a real potential mountain is to see if making a molehill of it will sell papers.

    A virus on all their houses.

  11. muscleman said,

    April 29, 2009 at 9:01 pm

    It is of course an effect of the Culture Wars which has produced a generation of non Science graduates schooled in the idea that there is no single ‘truth’ and that all opinions and viewpoints are equally valid. Add to that a stricture that everything should have a ‘narrative’ and you get the necessity to set one up and people to argue from opposing viewpoints since there is no objective knowledge to have.

    This is of course bollocks. Normally we don’t notice, especially when they get politicians on and in current affairs stuff like Question Time. We do notice in something that is based on science or medicine.

  12. muscleman said,

    April 29, 2009 at 9:10 pm

    @BrianA

    One of things we don’t know is how virulent the virus is, time will tell. That is a different question from ‘how virulent was the virus’, which is one we may never now since it seems to have been circulating in rural Mexico for some time and testing has not been widespread.

    All that leads into another unknown: how virulent will it be? The worrying thing is that the 1918/19 pandemic flu started out as quite virulent, then became mild (enabling all those troop ships to get home with live carriers), before increasing in virulence again and causing those 20million deaths (estimated).

    So given all those unknowns we cannot say anything definite. Including that there is no general risk. We may be able to squash it fast enough so that we don’t have to know. That would be nice.

  13. SteveGJ said,

    April 29, 2009 at 9:32 pm

    @muscleman

    I don’t think we should confuse the idea that there is “no single truth” with the “all opinions and viewpoints are equally valid” line. The idea over whether there is a single, objective truth goes back to Plato and can ultimately not be determined. The belief in the existence of such a thing is maybe the nearest scientists have to a faith.

    However, what can be said with some considerable degree of certainty is that not all viewpoints are equal, if only by the measure of what is empirically the most successful. Science does at least strive for this ideal of objectivity with some means of measurement.

    I do not, by the way, believe that any proponents of the “all views are equal” philosophy actually believe it. I think it is more a means of undermining those with opposing views. It’s the ultimate get out clause…

  14. muscleman said,

    April 29, 2009 at 10:06 pm

    @SteveGJ
    “I do not, by the way, believe that any proponents of the “all views are equal” philosophy actually believe it. I think it is more a means of undermining those with opposing views. It’s the ultimate get out clause…”

    Of course, the last refuge of a scoundrel etc. just like those people who when losing an argument retreat into solipsism ‘we don’t know anything, we could just be brains in a vat’. Encountered a few of those in my time. Doesn’t stop them making definite statements though. Isn’t hypocrisy a wonderful thing?

  15. Dr Jim said,

    April 29, 2009 at 10:17 pm

    Playing ‘Cry Wolf’ is a bitch.

    It’s rather odd, isn’t it, how one week some people can be suckered along with the usual detritus flotsam stories, yet become out-and-out naysayers the next. Reading comments in various blogs on the subject this week, you see people with obviously no epidemiological background what so ever, quite firmly stating that it’s a storm in a tea cup, and it’ll wash away like all the other hypes.

    You’re right to suggest that it is a risk, and I think that the concept of a pandemic is so far beyond the human scale model (the ability of humans to conceptualise large distances, epochs of time and genocidal loss of human life) that they’d rather choose not to believe it.

    I’ve spent many years working in an epidemiological profession, and I have no bloody idea. Many of the control mechanisms to handle epidemics are rooted in evidence-based science, but are often conflicted with mindless governmental bureaucracy. There has always been the understanding that the most virulent of diseases are, due to precisely that virulence, self limiting. Incapacitate your host too quickly and you can’t spread; those serovars that survive to spread become the ‘agent’ we focus on.

    We get to have a tenuous grasp on the situation if we have control of patient zero, but seemingly this strain has been rumbling around in Mexico for some time prior to the world taking note. Once this is out of hand, we can have no more control than damage limitation.

    So it’s true, we don’t know, it’s still very much a subject of open study, so I will continue, akin to Ben, to neither hype, nor naysay.

  16. ossian said,

    April 29, 2009 at 11:24 pm

    This event that we are living through is proving a great IQ barometer for the general public and presenters. I have heard the following on the radio in the last 48 hours “it’s obvious how to avoid it don’t eat pork”, “don’t take the flu jab it gave me flu”, “don’t take the flu jab coz my GP wont tell me what’s in it, he just looked blank when I asked”, and a “holistic general practitioner” recommended taking soya sauce mixed with some other cooking ingredients (but when asked said it wouldn’t harm to take anti-virals too). Oh and I think it was this “holistic GP” who also seamed to think that this is H5N1.

    I am just off to go on twitter and suggest “Swine Flu Parties”.

  17. S said,

    April 30, 2009 at 12:16 am

    From what I remember, Case Notes ended up giving a fairly balanced view of it in the end – in that they stated risks, but not in a panicpanicpanic way, just in an informative way. Though I did hear some god-awful programme also on Radio 4 where they spent a good ten minutes talking to someone who…turned out just to have a bad cold. Yes, raise awareness, take appropriate action, be concerned, but don’t create a ‘case study’ just for the sake of having someone in the “I thought I had swine flu” corner – the ten minutes could’ve been better spent.

    This is terrifying: “the media themselves have lost all confidence in their own ability to give us the facts”

  18. james++ said,

    April 30, 2009 at 12:23 am

    If it fizzles out without thousands dying I expect the reaction will be akin to the post Y2K Bug media coverage which wondered what all the fuss was about, suggesting it was hysteria or a scam, and totally ignored that the risks were reduced and the problem contained because of the massive devotion of resources to fix the problem.

    It’s all a bit catch 22.

  19. jasondenys said,

    April 30, 2009 at 3:20 am

    No wonder Richard Bacon wants you to play down the risk.

  20. badrescher said,

    April 30, 2009 at 4:52 am

    Very nice piece.

    The media is probably so insecure because they are not accustomed to needing to report facts, but realize that it would be prudent in this case.

    We certainly don’t understand risk well, how knowledge can prevent predicted disaster, how complex systems work, etc. and many of us don’t understand why the experts don’t know what they would like them to know.

  21. briantist said,

    April 30, 2009 at 6:27 am

    I strongly agree with nswetenham’s comments. You might have terrible hair, but you have become acceptable to the media in their masochistic way.

    Yes, one minute it will be “Swine-Eleven” and the next “all-pigswill” with the general media, but these are the people who peddle the National Lottery as “you’ve got to be in it to win it” and other such hogwash.

    Thanks for you level head, Ben.

  22. pointybirds said,

    April 30, 2009 at 7:59 am

    Hi Ben,

    I think you were on track when you mentioned the “balance” line the media like to reel out, particularly with woo-related stories. They’ve obviously typecast you as the “unbelieving scientist who will get his comeuppance when the Shit Goes Down”, which is a bit annoying, but I guess that’s how they see the world: Public figures categorised according to probable soundbite.

    They need to generate more copy, more talking and more concern and confusion to get their content up; then their sponsors make more cash; calling it “balanced reporting” is the easiest way to do that. I wouldn’t look much further past it than that. Confusion can sell as well as fear, with the added benefit that after the shooting stops, you can draw whichever gerrymandered line around the target you wish in order to say, “See? We were right. We had Goldacre call this weeks ago.” Or alternatively, “That Goldacre told us we were fear-mongering, but now look at the death toll! You should believe us when we tell you it’s time to panic.”

    Good on you for — as ever — finding it “a bit more complicated than that”, and not taking a rest on the shiny Naysayer Throne the media have so lovingly built for you.

  23. Ghoti said,

    April 30, 2009 at 9:57 am

    Possibly the funniest thing about the Simon Jenkins piece is that he blames “the rise of blogs” for the public’s poor assessment of risk. I don’t need to tell anyone here that poor judgements of risk have a far longer and grander history than that. Many blogs are nowadays giving more accurate and complete information, with better risk assessments, than the “legacy media” – badscience.net is a prime example. Is Jenkins running scared?

  24. Robert Carnegie said,

    April 30, 2009 at 10:58 am

    Ben: people come to you for this particular angle because your special expertise is the media getting science facts wrong, especially when the result sounds like this does. But if you did participate then your time would be well spent, not only because you can say this time it isn’t a hoax or misunderstanding and it really could turn out that way, but because anyway you’d be an intelligent sane reasonable voice in a seat that otherwise would be occupied by, well, who knows. Maybe Andrew Wakefield, people have heard of him too. If you can’t do it yourself then send Chris Addison, no one will know. Or Mark Watson if he drops the fake accent.

    As I understand it, SARS didn’t stop by itself. “We” stopped it, by controlling the outbreak, imposing quarantines, in the case of Toronto making a movie about it which I think was on TV just recently. “We” are holding avian flu at bay in human populations. We need to stop this disease too so that people can survive to wonder what all the fuss was about.

    The other thing to say is that stopping pig and pork movements is irrelevant to human health but very advantageous to any country which has an excuse to ban imports, specifically advantageous to their domestic producers. And as it is, a couple of years ago they were saying that British pig welfare rules had put the price way above even countries following European Union policy on animal welfare. In [The Archers] some farms gave up on pigs altogether. So really it’s a free trade versus protectionism question, with an intellectual dishonesty garnish.

    I don’t think there’s huge traffic between Glasgow and Edinburgh, but the question would be movements of drug users. It is less than an hour on a fast train but could junkies afford the fare? Would that matter, though? But what would they go for, if they can get a fix at home?

  25. Robert Carnegie said,

    April 30, 2009 at 11:18 am

    …I hadn’t heard “swine-eleven”, has it caught on? Google… “Jews did swine eleven!” Oh, it has.

    I also have just seen “wine flu” which upon inquiry seems to be widespread. It’s been suggested that that’s what the Scottish victims had. And here’s one for “Doh The Humanity” if that’s still running: www.channel4.com/news/articles/science_technology/world+wakes+up+to+swine+flu/3112457
    “Microbiologist Professor Hugh Pennington talks to Krishnan Guru-Murthy about the potential spread of wine flu.”

  26. Andrew Clegg said,

    April 30, 2009 at 11:28 am

    Not to say that there isn’t a risk, but I can’t help thinking that media scares like this are, err, somewhat misplaced.

    From www.who.int/mediacentre/factsheets/2003/fs211/en/

    “In annual influenza epidemics 5-15% of the population are affected with upper respiratory tract infections. Hospitalization and deaths mainly occur in high-risk groups (elderly, chronically ill). Although difficult to assess, these annual epidemics are thought to result in between three and five million cases of severe illness and between 250 000 and 500 000 deaths every year around the world. Most deaths currently associated with influenza in industrialized countries occur among the elderly over 65 years of age.”

    That’s regular common-or-garden influenza, and a quarter to half a million deaths per year. Admittedly that’s in 2003, apparently that was the last time the WHO’s flu factsheet was updated. Maybe the reporters don’t care because, well, people over 65 are bound to die sooner or later aren’t they?

    It’s a bit like the way a massive storm is kicked up every time a toxic chemical is found in food, that might have made a couple of people sick, and yet people still go on dying from fags and leaky gas boilers at a much greater rate without the press screaming.

    PS @Robert Carnegie:

    “If you can’t do it yourself then send Chris Addison, no one will know.”

    Glad it wasn’t just me that thought that :-)

  27. martindeutsch said,

    April 30, 2009 at 12:52 pm

    At ‘Nine Carols…’, I was fairly sure that Ben was just Chris Addison with glasses and a different tie.

  28. mikewhit said,

    April 30, 2009 at 1:01 pm

    @james++:
    It’s all a bit catch 22 – no it’s not: check the original !
    ;-)

    But “well said” on the Y2k = “century bug” issue; would-be rubbishers, notably climate-change sceptics (yeah, right, CO2 doesn’t absorb infrared …?) seem to throw up Y2k as an “industry” rather than a risk that had to be addressed.

  29. Diversity said,

    April 30, 2009 at 4:04 pm

    If the BBC is approaching you as you say, this is serious. A key part of the BBC’s mission, and the greatest part of its authority, has been its’ ability to calmly and objectively convey the best information to be had when people are faced with a serious or potentially serious situation. That ability is relied upon in many parts of the world.

    If people at the BBC are checking with non-epidemiologists for views on the potential seriousness of this epidemic, they have lost the plot very badly indeed. If the BBC are seeking pundits of any kind just to say that a risk is overhyped (or underhyped) rather than to ask opinions on the substance of the matter, they are no longer serving any sort of public interest.

    You may care to use the standing you have earned to ask the Chairman of the Governors of the BBC what their staff are playing at?

  30. ljones0 said,

    April 30, 2009 at 5:30 pm

    Well I guess I’m one of those people who are taking a partial point of view in the opposite direction. Namely that the media has blown some of this story up out of proportion.

    For me, I’m not panicing over swine flu. I’ve seen this being reported on TV and it is intresting how frequently the numbers aren’t reported correctly in the news (some mass media outlets refer to ‘hundreds of deaths in mexico’ — the actual *confirmed* (note confirmed) cases of deaths in mexico [at the time of writing] is 7).

    I simply refuse to jump when the TV news tells me to. Why should I? How high do you want to jump?

    Another annoying problem is the emotive language used by the mass media. It cannot help matters when you see news headlines implying what amounts to almost the end of the world or big red and white text on news channels every few moments. It just reinforces the panic, generates conspiracy and causes people to do stuff that isn’t neccecary.

    On the Y2K bug, one other reason why it wasn’t so bad after all — many systems actually do not use the date at all!

    ljones

  31. SteveGJ said,

    April 30, 2009 at 5:36 pm

    @Andrew Clegg

    There is a saying to the effect that one death is a tragedy, but a million deaths are just a statistic. It’s certainly true that the media don’t have too much sense of perspective when it comes to numbers – they will print column-metres on individual deaths through very rare causes yet neglect the really big killers.

    However, on the subject of ‘flu, many of the annual victims of this will be the elderly, the frail and others who are vulnerable. Assuming that treatment and care has been appropriate and innoculations were given, it is individually sad, but in the big picture of things, ‘flu may be just the final straw. If it wasn’t ‘flu, then it could well have been something else.

    However, a pandemic strain that kills large number of healthy, fit people is a much more serious thing than seasonal ‘flu. There’s something particularly tragic about somebody who dies in the prime of life. Now we don’t know if this strain will work out like that, but certainly there have been young victims. So yes – I do think that deaths of 65 year olds are not the same as 25 year olds, and I am far, far closer in age to the former than the latter.

    It’s probably unfashionable, or thought to be very cold hearted, but rather than just counting lives saved, perhaps we ought to give some thought to lifetimes saved (or some fraction of them). Certainly everybody feels specially sensitive about childhood deaths, but it seems that once you get into adulthood by just a few years, then it’s considered somehow much less important. For that reason, the 1918 outbreak was particularly tragic; not just the numbers involved, – it devastated entire young families, not to mention some of those who had survived the carnage of 1914-1918.

  32. Andrew Clegg said,

    April 30, 2009 at 6:32 pm

    @SteveGJ:

    “It’s probably unfashionable, or thought to be very cold hearted, but rather than just counting lives saved, perhaps we ought to give some thought to lifetimes saved (or some fraction of them).”

    Yep, that’s Health Economics for you. Quality-Adjusted Life Years (QALYs) etc.

    But even in QALYs, swine flu still has a *looooonnnnng* way to go before it rivals good ol’-fashioned person flu (or its more debilitating strain, Man Flu) for impact on the human race.

  33. BenHemmens said,

    April 30, 2009 at 7:05 pm

    All very well, but what I was hoping for was that somebody would mention how many people die of bloody normal flu in a bloody normal winter. Thousands, I suppose in a large-ish country like the UK, and society as a whole does not pay the slightest attention. It’s not just the finer points of thinking about risks, there’s also the very simple effect of people who aren’t familiar with a phenomenon being shocked because they hear a number out of the blue, about something on whose frequency they have never wasted a thought before.

    Don’t get me onto traffic accident statistics, an area rich in numbers with good shock-horror potential. And in which the ones which we could do something about routinely get ignored.

  34. quietstorm said,

    April 30, 2009 at 7:08 pm

    Whilst I’m not surprised, I’m a little disappointed that the media are contacting you because they assume that you will oppose any media reporting of science – “the media always get it wrong”.

    Half of the panic of any new disease seems to be that many people are unsure as to how disease spreads, or could spread. Good for those news outlets and governments who are using this time to educate their audience/citizens.

  35. gazza said,

    April 30, 2009 at 7:33 pm

    Simon Jenkins has now posted yet another article on the issue, one day after his last ‘it’s all hype’ article;

    www.guardian.co.uk/commentisfree/2009/apr/30/swine-flu-media

    Now apparently focussing on the hype produced by journalists and scientists.

    He seems to have completely ignored Ben’s article. though for some reason he links to it via a line in his article – ‘… no limit to the hysteria that scientists and their allies are able to generate round a health scare….’.

    All a bit strange.

    He has plainly decided his position on the swine flu issue is that it’s all hype, thus taking the ‘sceptical’ extreme that Ben declined to take from media invitations.

    Incidentally I quite like The Daily Mash article;

    www.thedailymash.co.uk/news/health/-pandemic-obviously-not-what-you-thought-it-was-200904301734/

  36. SteveGJ said,

    April 30, 2009 at 8:09 pm

    @BenHemmen

    There’s nothing stopping you finding the stats – they are fairly freely available. Here’s one government document for a covering 2005 with links to Excel spreadsheets

    www.statistics.gov.uk/downloads/theme_health/Dh2_32/DH2_No32_2005.pdf

    Looking at the figures, it shows influenza & pneumonia combined as responsible for about 31,000 deaths that year, overwhelmingly in the 70+ age group with the 90-94 range having the highest incidence. That combination tells you a lot about the nature of those deaths – overwhelmingly the older, aged and infirm and very probably in combination with other ailments. That’s wildly different to the pattern in 1918 when the mortality was concentrated on young, fit adults and the number that died in the UK was of the order of 250,000 (from a smaller population). However, if you measure the effect by the number of years of potential life lost then it is many, many times worse than that.

    Transport (mostly road) accidents do, of course, kill both young an old (especially young men). You are far more liable to be killed on the road if male than female. Some of that will be due to greater exposure, but I think it a reasonable hypothesis that male, especially young male behaviour probably has a lot to do with it. The one thing that would instantly save a great number of lives on the road would be to ban motorbikes. Even with some displacement onto cars. The statistics are just horrendous.

    Incidentally, road accidents are only about one-third of total deaths due to accidents in the UK.

    What I might do is an analysis on this lot to show which causes are responsible for the greatest numbers of years of life expectancy cut short. It should be interesting, and I would suggest a much more rational way of setting health objectives than just counting deaths by cause.

    But back to ‘flu. Any comparison of normal seasonal ‘flu with what happened in the 1914-1918 pandemic is wildly off the mark. I rather suspect that if the current swine ‘flu does turn into a pandemic, we will cope with it better than those after the first world war (when medicine hardly qualified as a science-based discipline at all). It is surely right to think there is a risk that needs management, but I for one don’t see signs of public panic. Most people I know are playing a wait and see and it’s hardly an overreaction not to go on holiday to Mexico. Quite apart from the risk of infection, you are faced with a country where economic activity is grinding to a halt, where public venues are closed, and if the worst comes to the worst, it benefits nobody if you end up as a casualty in an over-loaded Mexican health system.

    I really can’t understand why some people (like Simon Jenkins) characterise measured, rational behaviour as that of mad men.

  37. BenHemmens said,

    April 30, 2009 at 8:41 pm

    What we are seeing in Mexico is possibly similar to what happened around the world in 1918.

    The real question is whether the tendency to kill “young fit people” asserts itself despite modern medical care. And/or indeed whether the health systems can respond in the volume and speed and with the level of organization of patients outside hospitals which may be demanded of them. If it spreads really fast, “modern medical care” in the sense that we think of it may not be available to everyone, even in countries with the most massive health systems- so we may not manage to do that experiment properly…

  38. pv said,

    April 30, 2009 at 9:22 pm

    Media eats itself! Changes meaning of “pandemic” to “we’re all going to die”, then asks someone who might know something about it to change the meaning again to “no-one’s going to die”. Makes you want to send them all off to Mexico City to do a bit of investigative journalism.
    If ever there was an example of media idiocy this is surely it.

  39. fontwell said,

    April 30, 2009 at 10:26 pm

    Ben: I have to say that although I had formed my own tentative opinions about the risk of a pandemic and the severity it might have, it wasn’t until you wrote a few tweets and this piece that I felt I had been informed by a reliable source, infectious diseases epidemiologist status not withstanding.

  40. wolfekeeper said,

    April 30, 2009 at 10:39 pm

    You should have done the show and then used it as an opportunity to criticise the media in general and that show in particular for always picking pro-con positions on things that should be done from a balanced, neutral point of view.

    Doing pro-con inherently over-represents extreme minority views.

  41. NileH said,

    May 1, 2009 at 1:15 am

    I have posted a suggestion that we could collectively raise the human ‘herd immunity’ if we all rush out and kiss a pig.

    This is not quite a serious suggestion. But it becomes a little worrying when I consider that a targeted promotional campaign, with all the ‘homeopathic’ and ‘100% natural’ and ‘organic’ buzzwords, would probably get a fair number of celebrities onside; the mass media would be sure to follow and I’d end up doing as much harm as any quack with a warehouse full of vitamin pills.

    What’s more than a little worrying is that a humorous vignette with glaring factual inaccuracies is probably a net positive contribution to the scientific literacy of the Swine Flu coverage in the media to date.

    Meanwhile, our host Dr. Goldacre is in for a hefty dose of malicious misrepresentation and vicious ad-hominem attacks; he’s getting some backand now, just for being moderate and refusing to offer a soundbite that the press-pack can sensationalise. Being moderate and being right will provoke the hacks to hatred if we get a three-figure body-count. They do not take kindly to criticism!

  42. Filias Cupio said,

    May 1, 2009 at 6:47 am

    The way I look at it, predicting pandemics is like predicting hurricanes: most of the time, the hurricane changes course or weakens before landfall, and it isn’t a big deal. Other times it changes the average building height of a town to 1 metre.

    Despite the fact that most of the time it will be a non-event, you can’t afford not to issue hurricane warnings, or to ignore the warnings that are issued. Nor can you afford to wait until you’re sure the hurricane will hit before making the warning.

    Incidentally, 6 billion x 40% infected x 5% mortality = 120 million.

  43. woodchopper said,

    May 1, 2009 at 7:45 am

    Worth noting that ‘Parmageddon’ is currently the third most read article on the Guardian’s web site.

    The readers obviously appreciate it (though not as much as ‘Couple caught having sex on Queen’s lawn’).

  44. gazza said,

    May 1, 2009 at 8:06 am

    And now Simon Jenkins has popped up on Radio 4’s Today programme, up against Professor Oxford. Jenkins put his newspaper points (emphasising publicity seeking scientists hyping up the issue for research funds!).

    Unfortunately Prof Oxford didn’t come across too well, in my view. Too concillatory and too restrained, letting Simon Jenkins come across as sensibly rejectionist of all ‘flu scares’. Jenkins even managed to get a jibe in about ‘aren’t scientists meant to use statistics sensibly’?.

    While Prof Oxford accepted that this specific swine flu probably wouldn’t do much he made the point that the longer term danger was Bird Flu. But didn’t get the chance to expand on this.

  45. TriathNanEilean said,

    May 1, 2009 at 1:44 pm

    The last time Tamiflu was in the news, I remember Ben doing an article about the wonderful “What Doctors Dont Tell You” organization (do a search for ‘Asian Flu’ on Badscience). So I thought I’d have a look to see what they make of Hamageddon/Parmageddon/The Aporkalypse at www.wddty.com/

    The answer is that this scare is a way for governments to get rid of the huge stocks of Tamiflu they ordered three years ago and didn’t need for the Avian Flu scare. The shelf life of Tamiflu is apparently three years, so unless it all gets used now it will have to be chucked away. Three years = three years; no coincidence there I’m sure you’ll agree.

    Great stuff.

  46. TriathNanEilean said,

    May 1, 2009 at 1:46 pm

    Typo, sigh. That should be “Avian Flu” above, not Asian Flu.

  47. mikewi said,

    May 1, 2009 at 7:23 pm

    The editorial in my New Scientist this morning suggests that the 1918 pandemic death rate translates to 170 million today, and claims that there are nearly 7 billion people in the world. So, even if there were another pandemic as deadly as that one, it would only kill 1 in 40 of the world population, leaving a human breeding population of around 6.825 billion. Not such a big deal, after all?

  48. SteveGJ said,

    May 1, 2009 at 8:39 pm

    @mikewi

    Bring back the Black Death – 40% mortality, and the world population will still be about what it was when I was 10 years old. I wonder what the human equivalent of myxomatosis would look like? That might be a bit more effective. Jolly good for getting the CO2 footprint down.

    nb. a breeding population of 6,825 million rather overestimates the fertility of those past the menopause…

  49. Dr Ed said,

    May 2, 2009 at 7:52 am

    Ben, thanks for a reliably measured perspective. Just because we don’t agree with the “We’re all going to die” headlines doesn’t mean we shouldn’t take precautions. It’s absolutely right that hospitals are rolling out their pandemic flu plans just in case (although ours has gone a bit Top Gun – apparently I’m known as “Bronze Command” for the weekend).

    I’m not sure that you were asked to comment in order to provide “balance”, more likely in order to provide “conflict”. It’s much more interesting from a media perspective to have two diametrically opposed views arguing as heatedly as possible – a dispassionate and considered view of the facts doesn’t attract viewers.

    And as far as comedy names go, I quite like The Daily Show’s “Snoutbreak”.

  50. Robert Carnegie said,

    May 2, 2009 at 11:36 pm

    Bronze Command: be prepared for a training exercise where you are told halfway through the senior surviving administrator (in the whole country?)

    Make sure it -is- an exercise before sending someone to get the Crown Jewels…

  51. jodyaberdein said,

    May 3, 2009 at 7:45 am

    “Red Leader, This is Gold Leader. We’re starting our attack run.”

  52. CampFreddie said,

    May 5, 2009 at 1:03 pm

    “Stay on target”

  53. AntibodyBoy said,

    May 5, 2009 at 6:43 pm

    Wow, small world, I went to school with Alex Lomas! Didn’t know he’d got married; I’m fairly sure I know his husband, I’d swear he demonstrated on my undergrad at IC 10 years ago…

  54. AntibodyBoy said,

    May 5, 2009 at 7:51 pm

    …hmmm, come to think of it, I also fairly sure you used to work for arms dealers (BAE systems) didn’t you? Is doing BS your atonement? ;)

  55. DeeTee said,

    May 5, 2009 at 11:34 pm

    @Ben: “Maybe some bloke with HIV got off the train at Edinburgh station instead of Glasgow on a whim, some fateful day in the early 1980s.
    Maybe there was a different culture among heroin users, or services.
    Nobody really knows [why HIV was more prevalent in Edinburgh].”

    Yes, people do know, or at least have workable, plausible hypotheses with considerable evidence that explains why.

    In Glasgow, drug users tended to inhabit a subculture where citric acid (jif) was used to dissolve the heroin preinjection. This has been shown to inactivate HIV in vitro. Edinburgh drug users never really caught onto this technique.

    One thing Edinburgh drug users did was to frequent “shooting galleries”, sites where they could go to to obtain drugs and inject them at the same time on site. Reason was the Lothian and Borders Police in the early 1980s used to interpret the drug legislation in a particular way – if you were caught in posesion of drug paraphernalia you could be charged. (This never happened in Glasgow). To overcome this inconvenience, they would go along to a shooting gallery site, obtain their smack, borrow the equipment from the dealer, inject, then go away. No drugs or equipment in their possesion; no chance of the Polis coming down on them. Result: Multiple shared injecting equipment, high prevalence of blood borne viruses like HIV, Hep B and C.

  56. DeeTee said,

    May 5, 2009 at 11:39 pm

    Oh, and another thing… HIV prevalence was not 50% in Edinburgh drug users. This figure was obtained from screening of drug users in the Muirhouse estate who had presented to their GP with Hepatitis B.

    This is a bit like saying because 20% patients with chlamydia also have HPV infection, 20% of the general population do.
    Massive selection bias issue here, Ben.
    True seroprevalence was more like 15% in Edinburgh drug users, if I recall.

  57. DeeTee said,

    May 5, 2009 at 11:43 pm

    So you had a call from Richard Bacon? Can I claim a Bacon number of 2 then?

  58. shane said,

    June 4, 2009 at 7:01 am

    Great post and very useful information to share with the readers,What’s more than a little worrying is that a humorous vignette with glaring factual inaccuracies is probably a net positive contribution to the scientific literacy of the Swine Flu coverage in the media to date.get more information from here:
    lahealthandrejuvenation.com/

  59. pb said,

    October 20, 2009 at 11:59 pm

    Ben,

    I’m hoping this will be a bit like calling International Rescue. Just leave a message and hope you’ll receive it.

    I’ve tried to send the following link via email but have snags a my end.

    This is doing the rounds of service websites and is provoking much comment.

    My own comments are under the screen name Peebs.

    www.romft.co.uk/smf1/index.php?topic=10538.0

    I would be grateful if you would have a look and comment.

    Apologies for the sometimes profane language and obscure naval slang.

    Peebs

  60. damat101 said,

    December 2, 2009 at 11:12 am

    Hi Ben and thanks for the good job.

    To avoid play the “naysayr” of apocalypse for the media but could you please any insights on the proccedure that Novartis -if I’m right- followed during the assesment of their swine flue vaccine? Or maybe resources on other reliable analyses in order to make an informed desision?

    Thanks.

  61. stevedav said,

    January 20, 2011 at 10:30 am

    that a funny vignette with glaring factual inaccuracies is likely a snare affirmative assistance to the technical literacy of the Swine Flu treatment in the newspapers to date.
    www.lalookandrejuvenation.com/