Thoughtful responses to this H1N1 poster:

[Kuko 4000]

So, as the title suggests, I would appreciate thoughtful responses to this poster. It is usually linked by antivax people to show that the H1N1 does not demand vaccinations.

[Careyp74]

first thought, how many deaths would there be without the vaccine? The virus could spread rapidly, killing a lot of people in it's wake.

[temporalillusion]

Is death the only measuring stick that is appropriate?

[casebro]

Carey, what with the scarcity of the vaccine, it hasn't had much effect on the death rate yet. It will take a year's worth of data to show the benefit.

I think I have to say that I can understand the anti-faxers point.

What is the concept? QALY/cost ?

But I suppose my HMO will have some flu vax into me in a couple hours. I've got a muscle ting to see them about.

[Fiona]

http://en.wikipedia.org/wiki/1918_flu_pandemic

If governments did not act and there was a repeat of flu on anything like that scale they would be rightly accused of irresponsibility. It may or may not be that this flu is like that one: but a precautionary approach seems right to me

[ejk]

They seem to be saying that because more people die of other things, it's not worth the effort to save the 5000+ lives that have already been lost, and however many more will be in the coming months. That might be valid if resources put into this vaccine were taken away from efforts to combat other causes of death, but there's no indication of that.

Hard to be thoughtful in response to a poster that is trivializing the loss of almost six thousand lives.

[makaya325]

More people die from the common cold than H1N1 flu, yet why are people theorizing, almost to the point, that the government created this horrible "disease"? Those people probably believe that the common cold was also brought here by aliens!

[Ivor the Engineer]

How many of the 3,548,054 fatal respiratory infections were proceeded by the flu?

[fls]

Originally Posted by Kuko 4000

http://www.parentsplace.ca/wp-conten...ath-poster.jpg


So, as the title suggests, I would appreciate thoughtful responses to this poster. It is usually linked by antivax people to show that the H1N1 does not demand vaccinations.

"Hello Ms. Smith. I see that you have hepatitis. We do have an effective treatment for this, but since many more people die of cardiovascular disease than die of hepatitis, it doesn't make any sense for us to bother treating you."

I gotta say, this makes my job way easier.

Linda

[The Atheist]

Originally Posted by Kuko 4000

So, as the title suggests, I would appreciate thoughtful responses to this poster. It is usually linked by antivax people to show that the H1N1 does not demand vaccinations.

Can I sue them for plagiarism?

I use it to show that H1N1 is a relatively harmless disease, nothing to do with anti-vaxers, but I can see why they'd like it.

[vIQleS]

My understanding was that it wasn't so much about the deaths, but more about the loss of productivity - no one has an immunity to this yet, and so it could spread fast and take out a lot of people in a very short space of time...

Also - someone's mentioned this - that death rate is based on having and using the vaccine. How many would be dead without it?

[portlandatheist]

Wow, I guess the war in Iraq and Afghanistan are more trivial than I thought in comparison to all the "hype"

Not all deaths are created equal. It is much more traumatic to have a loved one die from violence(crime, war, etc) than say, something like heart disease in their old age. Along those same lines, it is much more traumatic on families to have flu deaths among the young as opposed to the old.
H1N1 is having a greater impact on society than seasonal flu for a number of reasons.

[Kuko 4000]

Originally Posted by vIQleS

My understanding was that it wasn't so much about the deaths, but more about the loss of productivity - no one has an immunity to this yet, and so it could spread fast and take out a lot of people in a very short space of time...

Afaik, some of the older population have immunity.

[vIQleS]

Originally Posted by Kuko 4000

Afaik, some of the older population have immunity.

"Almost no one"?

I should have known better - it's never OK to use absolutes... :-D

[Careyp74]

Originally Posted by makaya325

More people die from the common cold than H1N1 flu

How many people died from the common cold in the past 300 days?

[Skeptic Ginger]

Gee, we are wasting millions to prevent a mere 5,850+ deaths.

If I had the ability, in no particular order: I'd ban hand guns and mandate every motor vehicle safety option we had be used. I'd offer needle exchange programs and free clinics for STDs in every city in the world. Abortions would be safe free and legal, universal health care in every nation would be the norm, the entire world's population would have access to clean water, adequate nutrition and safe birth control as well as the best maternity care available. Men who threatened women would be jailed and depending on the severity of the threat, as long as for life in prison. The majority of the world's wealth would go into research aimed entirely at making human life better rather than into making the top 1% of the world's population richer. War would be replaced with economic development which makes war obsolete.

But since I don't control the world, I'll at least promote vaccinations whenever possible. In the mean time, here's an interesting poll my son emailed me about just today:

Members of Congress who want health care reform should sneeze every time they talk about it.

Quote:

Last May, University of Michigan psychologists Spike W. S. Lee and Norbert Schwarz sent an experimenter out to shopping malls and downtown business areas to see if people would rather have the federal government spend $1.3 billion on the production of flu vaccines, or $1.3 billion to create "green" jobs. The experimenter got responses from about 50 people. In about half the cases, she coughed and sneezed once before handing over the questionnaire. In the other instances, she simply handed the form over.

The result: of the people who had just witnessed a sneeze up close and personal, 47.8% said that $1.3 billion should be spent on vaccine development. Of the people who had not been a party to the sneeze, 16.7% thought flu vaccines were the way to go.

[Skeptic Ginger]

Originally Posted by Careyp74

How many people died from the common cold in the past 300 days?

There is no single organism responsible for "the common cold". It's like saying how many people died today from the 200 known organisms that cause upper respiratory infections? The answer, a lot.

[Skeptic Ginger]

Originally Posted by The Atheist

Can I sue them for plagiarism?

I use it to show that H1N1 is a relatively harmless disease, nothing to do with anti-vaxers, but I can see why they'd like it.

The faces of 12 Canadians who've died from the 2009H1N1 influenza for which we have drugs and a vaccine that could have prevented these deaths had the drugs or vaccine been administered in time. So you know where you can stick it, TA.

[MetalSeagull]

Originally Posted by Ivor the Engineer

How many of the 3,548,054 fatal respiratory infections were proceeded by the flu?

That's just what I was wondering. Deaths from seasonal flu are conspicuously absent. How are these deaths being categorized, and how do they compare to H1N1?

[Skeptic Ginger]

Originally Posted by MetalSeagull

That's just what I was wondering. Deaths from seasonal flu are conspicuously absent. How are these deaths being categorized, and how do they compare to H1N1?

Currently in the US, seasonal flu is not circulating. Almost every influenza culture is coming back as 2009H1N1. Flu typically arrives in January, however. We have a number of months to go before we will know what this year's flu season has in store for the Northern hemisphere.

[Jorghnassen]

Originally Posted by skeptigirl

The faces of 12 Canadians who've died from the 2009H1N1 influenza for which we have drugs and a vaccine that could have prevented these deaths had the drugs or vaccine been administered in time. So you know where you can stick it, TA.

That list is missing chemist Keith Fagnou, since it predates his death. Some more info on the case and what makes this flu out of the ordinary.

[Skeptic Ginger]

Originally Posted by Jorghnassen

That list is missing chemist Keith Fagnou, since it predates his death. Some more info on the case and what makes this flu out of the ordinary.

The list is missing thousands of people. A local doctor here just died of H1N1. He was in his 80s, but that doesn't mean he was near death if it weren't for the flu.

I'm not in a good mood. I've been working for an entire month with only 2 days off since October 5th, literally, to get the H1N1 vaccine out to as many people as possible. I spent another couple hours today getting more vaccine after a simple zip code error threatened to delay my vaccine shipment by several days. The jerks at our county health department (whom I was defending until now) couldn't so much as give me the phone number of the state vaccine contact to try to resolve the matter before they shipped the vaccine back to the distributor. Thank goodness my genetics made me a fighter. I got the number on my own and got the vaccine after all.

[gtc]

Originally Posted by vIQleS

Also - someone's mentioned this - that death rate is based on having and using the vaccine. How many would be dead without it?

Isn't the vaccine fairly new? If so, most of those deaths predate the availability of the vaccine.

Originally Posted by skeptigirl

I'd ban hand guns

...

Abortions would be safe free and legal

...

Men who threatened women would be jailed and depending on the severity of the threat, as long as for life in prison.

If Mommy had a handgun she wouldn't need to be afraid of what Daddy would say when he finds out she killed their baby.

[Hydrogen Cyanide]

I don't have much to contribute, but I did find this special edition about the H1N1 pandemic of the Skeptics Guide to the Universe educational and entertaining: http://media.libsyn.com/media/skepti...2009-11-15.mp3

[RUR]

Assuming, for the sake of polite argument, that the numbers cited are valid and that the 300 days referenced means, more or less, the past 300 days, it strikes me that the poster is still a Big Lie. The clear implication is that all of these causes of death are comparable, dead is dead, after all, and H1N1 is a percent of a percent of the total and can/should/must be ignored. However, the causes listed are not comparable. There is a vaccine for H1N1; for most of the other causes listed, not. Nor was there a vigorous public debate six months ago about whether to spend the money developing an H1N1 vaccine or one for cancer or transportation accidents or war, because even stupid people aren't that stupid. The question was whether there was some likelihood of a worst case involving this particular virus that would justify the expense and effort of developing a vaccine, and the answer was yes. Whether the deciding point was a fair likelihood of a fairly bad worst case, or a small likelihood of a much worse case, or a much smaller likelihood of a national disaster I don't know or, much, care. Logically, the decision would make sense across a range of those possibilities.

I suspect that there are people who would only accept the need for the effort if the outcome is a worst case, but for that to happen the effort would have to have failed.

With regard to the poster, the H1N1 figures given are so far. Clearly we are supposed to extrapolate these figures into the future, which probably works fine for highway deaths, but not so much for a virus. Past performance is no guarantee of future results. In addition, there is no date given for the data. (I'll ignore the lack of sources since I said we could accept the data as valid for the sake of argument.) There is no indication that the data should be or could be updated, nor how someone might find an update. So, even if the figures were perfectly accurate when the poster went to press and even if they are reasonably accurate today, they'll be a tad off when they're still circulating in 2017 or whenever the next swine flu hits. They'll also be a bit misleading a month or a year from now in a worst case, the worst case being that H1N1 takes off in a largely un-vaccinated population -- with some still slow to accept the danger because they're invested in the 300-days story.

To be reasonable, the worst case seems somewhat unlikely, given that H1N1 first appeared in my area (Memphis, TN) six months ago and has chugged along steadily and almost unremarkably since. Those I've known personally (who have been diagnosed by physicians; I discount self-diagnoses) haven't been terribly ill, almost all far less sick than I would expect from seasonal flu. In addition, devastating world-wide epidemics are just not the most likely outcome of any disease.

So am I going to get the vaccine now that it's finally available here? You betcha! This is something that might be very, very bad. Even if it isn't, in the best case flu is thoroughly unpleasant and I can easily, cheaply, and safely protect my family from it. Explain to me again why I shouldn't do that.

[Hydrogen Cyanide]

Hello RUR! You have blazed in, after belonging for a couple of years... hope you stay and contribute more!

[Puppycow]

Welcome RUR!

The poster seems to have a bit of a point. But it doesn't mean that all the effort and money spent on developing and rolling out the vaccine are wasted. This is a good drill if nothing else. And it will save some lives too. The next flu bug might be some orders of magnitude more deadly.

I'll just add that if you had a graph of the deaths, hospitalizations and adverse medical events due to H1N1 compared to a graph of the deaths, hospitalizations and adverse medical events due to the H1N1 vaccine, the former would dwarf the latter too.

[Ivor the Engineer]

Originally Posted by skeptigirl

Currently in the US, seasonal flu is not circulating. Almost every influenza culture is coming back as 2009H1N1. Flu typically arrives in January, however. We have a number of months to go before we will know what this year's flu season has in store for the Northern hemisphere.

Under which heading are the 36,000 whose deaths are related to seasonal flu in the US alone being tallied?

Extrapolating to the entire world population, that's about 700,000 deaths related to seasonal flu every year, or about 1.4% of the 50 million deaths on the poster.

Does 2009H1N1 appear to be protective against seasonal flu? Any data from the southern hemisphere which could be used to test this idea?

[SezMe]

Jeeze, RUR, it took you 2 1/2 years to post a thoughtful, to the point, rational response?







'Jes kidding. Welcome to the light.

[PixyMisa]

[PixyMisa]

Perspective.

[Careyp74]

Originally Posted by skeptigirl

There is no single organism responsible for "the common cold". It's like saying how many people died today from the 200 known organisms that cause upper respiratory infections? The answer, a lot.

So your answer is a lot of people died from the common cold? How many in the past 300 days?

[Ocelot]

Guy jumps off the Empire State Building, as he passes the 70th floor another guys yells out the window "how you doing" and gets the answer "so far so good!"

As he passes the 50th Floor a woman chucks him a parachute. Which he swiftly puts and deploys.

She meets him at the bottom. He hands her back the parachute saying, "turns out I'm fine so I didn't need it after all"

[whatthebutlersaw]

Originally Posted by RUR

...snip...a whole bunch of awesome...snip...

What the above was before I abbrevieated it.

Thank you. Since I am almost worn down by trolls, I will simply just agree with everything I see you (or Fiona) write from now on. Until I don't.

[Careyp74]

Originally Posted by Ocelot

Guy jumps off the Empire State Building, as he passes the 70th floor another guys yells out the window "how you doing" and gets the answer "so far so good!"

As he passes the 50th Floor a woman chucks him a parachute. Which he swiftly puts and deploys.

She meets him at the bottom. He hands her back the parachute saying, "turns out I'm fine so I didn't need it after all"

Reminds me of the fact that deaths from people jumping out of commercial airliners is very minimal, so we shouldn't spend the money on safety locks.

[Cuddles]

Originally Posted by RUR

There is a vaccine for H1N1; for most of the other causes listed, not.

This is more or less the point I was going to make. It's not just about vaccines, but about treatment and prevention in general. Every single cause of death listed there is something that we try to prevent killing people as much as possible. We have vaccines, public health programs, health and safety, and so on. They're applicable to a greater or lesser extent in different cases, but I can't think of a single cause of death where we say "It doesn't kill that many people, so let's not bother doing anything about it.". Except, apparently, flu. Which kills thousands of people, and will certainly kill thousands more even in the best case scenario.

Yes, swine flu isn't a big cause of death. And fortunately it seems that it's likely to be much milder than initially feared, even without any vaccination. But why is this supposed to be an excuse to dismiss it entirely? Predicting the future is not an exact science, especially when things like viruses and people are involved. Swine flu may not be a big deal, but on the other hand it still has the potential to be a very big deal indeed. Why is there such rabid opposition to the idea of making sure it doesn't become a big deal?

[Toke]

I believe most disease prevention is subject to diminished return, so it makes sense to spread the effort, also to stuff on the chart in the OP that does not affect that many people.

As for this virus, it makes good sense to be out early with vaccines.
The problem here is that the effort looks wasted if the vaccination program works as intended or H1N1 turn out to be less dangerous than feared.

[fls]

Originally Posted by Kuko 4000

So, as the title suggests, I would appreciate thoughtful responses to this poster. It is usually linked by antivax people to show that the H1N1 does not demand vaccinations.

Actually, quite appropriately, the effort put into preventing and treating H1N1 is miniscule compared to the prevention and treatment of heart disease or malaria. Compressing that effort into a tiny time period and the necessity of depending upon public appeals in order to disseminate information when speed is important, simply makes it temporarily more visible than the far vaster numbers of people working on cancer day after day and year after year.

Linda

[Jorghnassen]

Originally Posted by skeptigirl

The list is missing thousands of people. A local doctor here just died of H1N1. He was in his 80s, but that doesn't mean he was near death if it weren't for the flu.

I completely understand. I just wanted to add that if you're taking 12 examples of Canadian deaths (there aren't thousands of those, yet, and hopefully there won't be thousands), Keith Fagnou is one of the notable examples to show how A(H1N1) deaths differ from seasonal flu deaths. Seasonal flu affects the vulnerable: the very old, the chronically ill and the very young, but otherwise healthy individuals will not die of it and it is highly unlikely for them to be hospitalized for it. There's practically no way seasonal flu could kill a healthy 38 year old award winning researcher and father of 3. This H1N1 flu can kill otherwise perfectly healthy individuals frighteningly fast. Yes, deaths overall remain rare and (from crude estimates) still mostly strike those with "preexisitng conditions", to borrow American health insurance lingo. But there is a non-negligible risk of hospitalization and death for everyone. And that's why vaccinating everyone is so important compared to seasonal flu (where you can "get away" with vaccinating more targeted subpopulations).

[Kuko 4000]

Originally Posted by Jorghnassen

I completely understand. I just wanted to add that if you're taking 12 examples of Canadian deaths (there aren't thousands of those, yet, and hopefully there won't be thousands), Keith Fagnou is one of the notable examples to show how A(H1N1) deaths differ from seasonal flu deaths. Seasonal flu affects the vulnerable: the very old, the chronically ill and the very young, but otherwise healthy individuals will not die of it and it is highly unlikely for them to be hospitalized for it. There's practically no way seasonal flu could kill a healthy 38 year old award winning researcher and father of 3. This H1N1 flu can kill otherwise perfectly healthy individuals frighteningly fast. Yes, deaths overall remain rare and (from crude estimates) still mostly strike those with "preexisitng conditions", to borrow American health insurance lingo. But there is a non-negligible risk of hospitalization and death for everyone. And that's why vaccinating everyone is so important compared to seasonal flu (where you can "get away" with vaccinating more targeted subpopulations).

I'd like to see more data backing this up, the difference in behaviour between the A(H1N1)v and the seasonal flu, the best data as usual. It's a very interesting point, quite alarming too. Are there really no such examples from the usual seasonal influenza?