disease_fatalities_550Back in October, we discussed what I described as an over reaction to Swine flu: H1N1 Fatality Rates: Overreaction?

Many of the comments disagreed.

The WSJ reports today that 1 in 6 Americans were exposed to H1N1, and of those “47 million Americans who were sickened with swine flu from April to mid-November, 9,820 of them died.”

I am certainly not an immunologist or a medical doctor; rather, the point was to show how we all tend to over react to current news, and allow older  but valid (and often more accurate) data to be ignored.

For you students of investing psychology, this was another example of the Recency effect at work . . .

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Chart via Information is Beautiful

Category: Psychology, Science

Please use the comments to demonstrate your own ignorance, unfamiliarity with empirical data and lack of respect for scientific knowledge. Be sure to create straw men and argue against things I have neither said nor implied. If you could repeat previously discredited memes or steer the conversation into irrelevant, off topic discussions, it would be appreciated. Lastly, kindly forgo all civility in your discourse . . . you are, after all, anonymous.

30 Responses to “H1N1 Not So Deadly After All . . .”

  1. gordo365 says:

    Quick calculator work – 9,820/47m = 0.02%. WHO data in graphic shows fatality rate at 0.5% – which is 25 times higher than recent WSJ data.

    So technically speaking – fatality rate is either really low, or really really low – depending on which data source you believe.

    Gordo

  2. joro says:

    How much of the “over-reaction” caused people to take appropriate steps to keep this number relatively low?

    When my 15 month old got the swine flu, I immediately knew the warning signs to bring him to the doctor and sure enough, the beginning stages of pneumonia. Point being I am sure there is some cause and effect issues at work here.

  3. Dunno — but clearly not enough precautions to prevent 10s of millions of people from catching H1N1 tho . . .

  4. jake103 says:

    Joro… completely agree. Here was a risk matrix on that such topic from April:

    http://econompicdata.blogspot.com/2009/04/game-theory-why-swine-flu-panic-is-good.html

  5. Thatguy says:

    Jake and Joro,

    Thats similar to the same after the fact justification that I keep hearing about TARP and bailouts. How bad would it have been if we hadn’t stuffed the banksters (in this case Pharma’s) pockets with hundreds of billions (in this case “only” billions) of dollars????

    I heard on NPR this morning that the infection to death rate of H1N1 is about half that of the common flu. I find it dubious at best to attribute this significant a difference to people being better prepared. I’ll grant that it might have helped on the margins, but certainly can’t account for this wide a disparity.

  6. ilene says:

    I think it remains to be seen what’s going to happen with this because while the swine flu is generally mild in many, it hits some people very severely and it looks as though a genetic variation that makes it more aggressive is emerging in multiple places, the genetic variant called D225G (G meaning glycine in a critical spot for binding to cells). Here are a few articles I’ve written, with input from a flu researcher, Dr. Henry Niman:

    Swine Flu News: What is the significance of D225G?
    http://philsbackupsite.wordpress.com/2009/11/25/swine-flu-news-what%e2%80%99s-going-on/

    Flu News: D225G Follow-up
    http://philsbackupsite.wordpress.com/2009/11/30/flu-news-d225g-follow-up-2/

    What’s new with the flu?
    http://philsbackupsite.wordpress.com/2009/12/05/whats-new-with-the-flu/

    I’m hoping to update these articles this weekend with a new one. – Ilene

  7. jake103 says:

    Thatguy… I think we’re both right. It helped to “be scared” on the margin, but I’ll concede that the numbers do look significantly low (which is obviously a good thing).

    As someone who knows quite a few people who have had the swine flu (the power of Facebook), I’ll say most cases were just a “bad flu” and they were better 3-4 days later, but I also know two individuals that were in ICU for a week each and the reason things likely weren’t worse is they were checked for the disease VERY early in the cycle (whereas they would have just stayed home in past years).

  8. investorinpa says:

    Barry, I believe I posted earlier about it and said….swine flu is more contagious, less dangerous…meaning it is very communicable, but ultimately not deadly. For once, I’m glad I was right!

  9. dsawy says:

    Remember how AIDS was supposed to be the scourge of America? That didn’t go anywhere. Remember how Y2K was going to take down the whole of computerized civilization? Hmmm. It certainly pulled a lot of tech earnings forward into Q3 & Q4 1999, but there was no problem that ended computerized civilization.

    The business of the news media is to peddle the latest scare, to keep the people in a constant state of alarm. Doom sells.

  10. Patrick Neid says:

    Hysteria is big business as global warming is clearly proving.

  11. judyo says:

    In early September, 2009, during a routine check up, my own family doctor, an internist, told me she was very worried.
    I work for a county health department and the health professionals I associate with on a daily basis have been and continue to be concerned.
    Just sayin ….

  12. Tony61 says:

    Dude… it’s 5X more deadly than seasonal flu!!!!!!!!!!!!!!

    And those who die are young. Seasonal flu deaths are often older and debilitated patients who likely would have died within the next few years from other causes.

    The elderly are spared from H1N1 only because they have natural immunity (ie, they were exposed when they were young.)

    H1N1 costs MANY MANY more life-years.

    This is not considered a benign epidemiologic finding, and it’s somewhat irresponsible to imply otherwise. You posted this graph before and I laughed. I felt compelled to sign in and offer comment this time.

  13. Rikky says:

    “The business of the news media is to peddle the latest scare, to keep the people in a constant state of alarm. Doom sells.”

    dead on dsawy. i’ve been saying since day 1 of this ‘impending disaster’ that it was a bunch of hype after doing my own research. i find these ‘facts’ to be dubious at best. has anyone looked into the assumptions they’ve made and inputs into their models to arrive at such figures? i can tell you they’re quite suspect and almost negligent in their broad categorization. the proof is in the pudding in terms of their continual adjustments in arrears and an excuse being its untested in hogwash. they’ve been doing such studies for decades they know how to model it.

  14. KJMClark says:

    Um, Gordo, the US statistics are for the US, an OECD nation with a decent (certainly not one of the best, but not near the bottom either) health care system.

    The “World” Health Organization statistics are from all over the … world. For a communicable disease that, so far, responds in most cases to treatment, wouldn’t you expect a wealthy nation to have a lower mortality rate?

    My family “overreacted.” We spent about $100 buying lysol wipes, hand sanitizer, a box of surgical masks, and some extra boxes of tissues. When my two kids got it, we wiped most surfaces down several times per day, washed our hands and used hand sanitizer frequently, asked our kids to wear the masks when around the rest of the family, and otherwise treated them for flu. Result? Neither of us parents got the flu. That was good, since I have asthma problems when I get the flu. Since I managed to avoid getting it from my kids and co-workers, due to my panic I’m sure, I was able to get the shot before getting the flu.

    And the extra flu supplies? We donated them to our kids’ schools, the staff of which was happy to get them. Pretty scary how badly we all overreacted, huh?

  15. Transor Z says:

    David Singer might have to revise his TA on the H1N1 trend. :-)

    http://www.cdc.gov/flu/weekly/

    http://1.bp.blogspot.com/_r47sOI__h_M/SvwRrEeiLaI/AAAAAAAABjk/6n_2Oa2n6E4/s1600-h/Picture+6.png

    Don’t get too happy yet, folks. Scroll down to the Influenza-Associated Pediatric Mortality section of the weekly CDC influenza report. Total pediatric deaths due to flu/pneumonia are already almost double what they were for all of last year’s flu season, which runs until March.

  16. techy says:

    Hindsight?? i wonder if the same rule also needs to be applied to global warming….just ignore it till its really a big trouble??

    and its not over yet….but yes i agree it looks tame right now….but i am sure > 50 million have been vaccinated by now.

    i guess better be sorry than safe seems to be your motto.

  17. freejack says:

    How can I put this….

    July, 2007
    WASHINGTON (MarketWatch) — Federal Reserve Chairman Ben Bernanke said Thursday that there will be “significant losses” associated with subprime mortgages but that these losses should be regarded as “bumps” along the road of market innovation. “We’ll see how this works out,” Bernanke said.
    The Fed chief repeated that the problems in the subprime-mortgage market haven’t caused a systemwide credit crunch.
    http://www.marketwatch.com/story/subprime-losses-are-bumps-in-road-of-innovation-bernanke

    “Black Swan Theory” refers only to unexpected events of large magnitude and consequence and their dominant role in history. Such events are considered extreme outliers.
    http://en.wikipedia.org/wiki/Black_swan_theory.

    Hope to hell this post isn’t the healthcare equivalent of a contrary indicator.

  18. Chtulu says:

    I’d wait until after April, 2010, to say we’ve dodged a bullet with this particular flavor of H1N1.

    The pandemic models for H1N1 (1918 and [I think] 1954) show an initial appearance (Spring – Early Summer), followed by the Second Wave (Fall-Winter), and a Third wave in spring of the following year. The initial wave of the 1918 H1N1 was mild; the Second and Third waves were the worst.

    The alarm shown by the medical and research community is well-founded: Influenza’s greatest danger is its unpredictability — it’s an organism, and its biological imperative is to spread to survive. It might do that inefficiently (like Ebola, which spreads like wildfire and can kill its hosts quickly), or more efficiently (like HIV), but it’s motto is Evolve Or Die.

    Potential changes in this H1N1′s genetic makeup that would make it more transmissible and more deadly don’t seem to have occurred in this second wave. Hindsight being what it is, it’s easy to say that individuals and health agencies overreacted unnecessarily. But it could have gone the other way, and it still could — or not, and that ‘maybe/maybe not’ is the problem for people in the street and for the CDC and WHO. Unlike individuals, public health bodies have to make decisions that take the science into account — and the science says we just don’t know what this bug will do.

    There have been clusters of cases in Ukraine and Norway that show some really frightening potential for this H1N1 to become much worse – but so far there’s no real proof those cases show proof of efficent transmission between humans.

    And that’s good news. For now.

  19. Struggling Man says:

    Ilene,

    Can you answer me this???

    I get vacinated against H1N1, and I am spared getting the H1N1 flu. Down the road, the bug mutates (as it apparently has). Will the the vacination protect me against the mutated version of the bug??

    Or, second scenario. I don’t get a vacination, and do contract H1N1, and live through it. Will having had H1N1 make me resistant to the new mutated bug??

    Not playing devils advocate here, just wondering.

    Thanks, H

  20. foxorrabbit says:

    You run into two problems here:
    (1) the math of infinites — anything times infinite is infinite, so if there’s a 0.0000001% chance of a devastating pandemic, and that would be infinitely unpleasant, then the expected value is infinite unpleasantness. Therefore, everyone should freak out about every possible catastrophic event.
    (2) the boy who cried wolf — if the CDC creates panic enough times, people will stop taking them seriously. The CDC should manage its decisions on when to create panics.

    As for #1, an interesting question is whether it really would be infinitely bad, or more precisely: whether it would be inifinitely bad to the person or organization assessing how bad it would be. A 0.0000001% chance times 1,000,000 “badness” points is only an expected badness of -1, not -infinite. A “small” but determinative difference.

    On a semi-related note… I find it hilarious (or tragic?) how little information is shared about these panics (though, admitedly, the point is not to share information, but to create fear). Can’t ONE national news organization give 30 seconds of airtime to sharing the incidence rate, mortality rate, and breakbown of mortality between children, adults, and elderly? Someday soon the Long Tail will get long enough that there will be economic room for a news organization that actually reports news. Yet another spot on the long tail you are filling BR. You are a pioneer.

  21. CaptiousNut says:

    Both of my small children had swine flu, and both are asthmatic….

    But we did not even take them to the doctor or do anything different than we would have for normal illness.

    The docile folk who worship *experts* and can’t think for themselves are truly slaves – mind slaves.

  22. freejack says:

    “Both of my small children had swine flu…”

    How did you rule out seasonal flu as the cause?

  23. V says:

    @Struggling Man

    It will depend on the degree of mutation, within H1N1 there are itself varying strains – some of which are resistant to effective anti-viral drugs (Tamiflu).

    Personally I think neither scenario may protect you from a mutant strain that has undergone significant mutation to render it immune to your current H1N1 antibody titre.

  24. Pat G. says:

    In a country that spends the most for medical services of any other on this planet, I am appalled that even 1 person died from H1N1 let alone 9800!! Think of it as 9800 stones being tossed into 9800 small ponds than you get the idea of the “ripple” effect of those deaths on the lives they left behind. Better, I’d like to know the other countries who lost as many or more to it and what they pay for medical services.

  25. I heard part way into the flu season they stopped testing for swine flu altogether and just assumed it was swine flu.

    Also, The most dangerous part of swine flu is the associated pneumonia and if people were to get a once in a lifetime vaccination for that instead they would be much safer. This is what I’ve heard. You might want to confirm it with your doctor

  26. DeDude says:

    The initial data from Mexico raised some serious concerns, and I began following the CDC/WHO data daily. By the time we hit 1000 reported cases in the US it was clear that we were not facing anything that was orders of magnitude worse than the seasonal flue. Yet the media were still in “we are all going to die” mode. I guess that for the media it is not about information, its about sensation and creating panic – that is how they make money. If you want information go to the internet and learn how to sort things, if you want to know how many mistresses Tiger have had, turn on the “news”.

  27. Darkness says:

    How can this blog discuss this without chart porn? Weekly CDC Influenza Report What is most interesting is that still, knee deep in flu season, 99% of tested influenza is still H1N1 or it’s newest variant Seasonal H1N1. Like a monopolist, H1N1 is crowding out competitors. Maybe people are finally taking seriously advice to avoid spreading illness.

    If you want to know why health professionals panicked, you need only to look at

    http://www.cdc.gov/flu/weekly/weeklyarchives2009-2010/images/IPD48_small.gif

    this chart. Notice the blue bars, in the middle of summer, mimicking the normal pattern of deaths from winter
    influenza. This was the pattern from the Spanish Flu, too. The alternative to feeding anything to the threat mongers in the media is saying nothing at all to them. They are children, and will react exactly the same way every time, with stupid graphics, teasers aimed at 60 points of IQ, and scary music. Quality, intelligent news media is something we badly need from many perspectives, but we don’t have it, and probably won’t ever. But insisting the national health services should say nothing leading up to an apparent crisis isn’t a policy solution either. Those whining need to actual suggest something reasonable or you are nothing more than part of a different problem.

  28. bobby says:

    ummmm—since they rarely if ever test if in fact it IS swine flu, how can any numbers have validity?

  29. ilene says:

    Rsponding to:

    Can you answer me this???

    I get vacinated against H1N1, and I am spared getting the H1N1 flu. Down the road, the bug mutates (as it apparently has). Will the the vacination protect me against the mutated version of the bug??

    It’s relatively in that partial immunity should provide some protection but how much is unknown – its not all or none.

    The current vaccine that is in the injectible form does not appear to be very effective against the sub-strain that has the D225G change – it was not developed against it. The testing to make this statement was limited, as far as I know, only one test result showed a lack of sufficient activity. Maybe further testing has been done since. The Flu Mist should provide some protection because the S225G marker was present in the mix of viruses that were used in developing the Flu Mist vaccine.

    Or, second scenario. I don’t get a vacination, and do contract H1N1, and live through it. Will having had H1N1 make me resistant to the new mutated bug??

    That should provide you some degree of protection against a new mutated virus that is similar to the one you already contacted, but again the degree of protection is unknown.

    Hope that helps and sorry I didn’t check back sooner. My new article is here: http://philsbackupsite.wordpress.com/2009/12/14/evolution-of-the-swine-flu-virus/

    Ilene

  30. ilene says:

    that’s D225G not S225G.