Genuine public concern, or media-fuelled hype to sell more newspapers and/or medicines? Raphael Vassallo on all the swine flu fears that failed to materialise
Initial indications appear to confirm earlier prognostics that the dreaded A-H1N1 virus – a mutation of the swine flu virus, which has now spread via human-human contact from Mexico to the USA, and subsequently to the rest of the world – would be less dangerous than originally feared.
The so-called “intelligent” virus has turned out to be a good deal brainier than it is deadly. Admittedly, the mutation appears to have significantly improved its transmission speed – with statistics revealing that swine flu has taken just six weeks to spread across the world, where ordinary flu would have taken six months. But the most important statistic is mercifully another: the mortality rate, which latest data have fixed at around one fourth that of our annual bout of seasonal influenza.
In brief, swine flu seems to be a case of “much ado about (almost) nothing”. But still there seems to be some degree of panic regarding the spread of this disease... particularly in the UK, where the number of cases now exceeds 10,000.
Undue emphasis Part of the reason for the widespread panic is the fact that while the associated statistics appear impressive on paper, corresponding statistics for relatively familiar diseases are not made public each year.
For instance: updates by the European Centre for Disease Prevention and Control (ECDC) suggest a rate of infection for swine flu of one in every 1,000. For “ordinary” influenza, the corresponding statistic is four in every 1,000... but nobidy seems to know that, because the rate is never published.
Dr Julian Mamo, a doctor specialising in public health, believes the hype surrounding swine flu has been in part fuelled by the media... not necessarily out of any desire to thwart the facts surrounding the pandemic; but simply because the amount of information fed to news organisations was much higher than is usually the case for epidemics.
“Media coverage has never been so high for any infection so far,” Dr Mamo explains. “The World Health Organisation has utilised media coverage to enhance preparedness for this illness; but it turned out to have a lower case fatality rate even than the normal flu, as we had first reported in your paper several weeks back.”
Far from reassuring the public, however, it seems the sheer, unprecedented volume of information succeeded in achieving the very opposite effect: creating a backlash of genuine panic which has hindered, not helped, the medical profession in its attempts to treat new cases.
Part of this effect was guaranteed by the inevitable reporting of swine flu fatalities, which – although for the most part accurate in the details – failed to take into account the fact that other strains of influenza are just as deadly, if not substantially deadlier.
Dr Mamo is one of several medical experts to question the wisdom of such liberal supply of details, when the same sort of coverage is not accorded to other, more common diseases.
“The media coverage is such that we read reports about every single death – which we would not normally do for an influenza epidemic, when there are even more deaths,” he points out.
Nor is this the only anomaly associated with swine flu reportage to date.
“The fatalities that make the most noise are the deaths in cases which are not from any risk groups, and so remain unexplained. However, there are these ‘random’ type of deaths with normal influenza, too.”
Apart from an eagerness to inform, media houses appear to have also been driven by a desire to sell newspapers: and as any marketing mogul will confirm, “fear sells”.
“Unfortunately, the bad news makes the loudest news in our media as elsewhere,” Dr Mamo adds, with reference to (among others) extraordinarily alarmist headlines in certain UK newspapers. “The courageous journalist is the one who boldly headlines the fact that swine flu is probably the least harmful of all influenza types for some years...”
Second wave For all the good news concerning mortality rates, the fact remains that public health officials across the world are bracing themselves for the “second wave” – which Dr Mamo admits is expected around October. And while the prognostics remain essentiallly the same, the higher rate of incidence may well result in a few isolated fatalities.
“A second wave is expected after children return to school, when movements and frequency of contact among this age group increases dramatically,” he said. “We expect a second, higher peak then. As WHO and the Centres for Disease Control monitor the progress of reports, and we hopefully don’t discover any further changes in the structure and behaviour of the virus, a second peak may mean more cases and possibly, sadly, our first death/s, as we begin to get tens of thousands of cases...”
Dr Mamo is however confident that Malta’s public health specialists are well placed to deal with this pandemic.
“The family doctor remains the mainstay of care in the community, and is therefore the ideal person to deal with each case individually. The health of the Maltese owes much to the untiring efforts of our public health specialists and our family doctors, not only in difficult times like these. However, these are the times when we may become more aware of their tireless efforts even more...”
‘Stay at home’
Mamo’s view is shared by Malta’s director of health promotion Dr Charmaine Gauci, who outlined for MaltaToday the department’s preparations for the feared second wave.
“Currently, we are in line with all member states in monitoring the clinical picture of local cases, to see if the virus is changing in any way,” she said yesterday. “We are looking at the frequency of cases, and how the virus affects a sample of people outside the vulnerable groups...”
Gauci points out that Malta has had the “benefit” of being among the last European country to be hit by swine flu.
“We were lucky in Malta because we got the virus late, when we already knew a lot about it and had the experience of other countries to go on.”
Nonetheless, the job of health specialists is sometimes hampered by patients who bring an unnecessary dose of panic into the equation.
Dr John Cachia, director-general of healthcare services, reiterated the basic guidelines for persons who believe they may be infected by A-H1N1.
“It is vital that the public cooperate with our requests to avoid healthcare faciities if feeling ill and call their family or health centre doctor for assessment,” Dr Cachia said. “We are utilizing reception staff in hospitals and health centres and the staff responding through our helplines to re-inforce this message: those who are ill should remain at home and seek help at home.”
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