Swine Flu: The New Pandemic
By Marc Siegel
()
About this ebook
Introduction
1. Pandemic Basics
2. 1918 versus 1976
3. The Swine Flu Timeline
4. All You Need to Know
Bibliography
Index
Marc Siegel
Dr. Siegel is a prolific writer, a Clinical Professor of Medicine at New York University School of Medicine, a Medical Director of Doctor Radio at NYU and SiriusXM, a Fox News Medical Correspondent, a frequent columnist for the Los Angeles Times, the New York Post, Slate, FoxNews.com, National Review Online and Forbes Online, and a member of the board of contributors at USA Today.
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Swine Flu - Marc Siegel
Table of Contents
Title Page
Copyright Page
Dedication
Introduction
Chapter 1 - Pandemic Basics
The Spanish Flu
Flu Origins
Other Twentieth Century Pandemics
The H5N1 Bird Flu
Chapter 2 - 1918 versus 1976
The Blue Death
1976 Swine Flu
The Swine Flu Never Came
Guillain-Barré Syndrome
Then and Now
Chapter 3 - The Swine Flu Timeline
April 2009: The Worried Bus Driver
May 2009: Boots on the Ground and Press Conferences
June 2009: The First Wave?
July 2009
August 2009
Late August 2009: The President’s Council of Advisors
September 2009
Chapter 4 - All You Need to Know
Essential Questions and Answers
Bibliography
Index
001Copyright © 2009 by Marc Siegel. All rights reserved
Published by John Wiley & Sons, Inc., Hoboken, New Jersey
Published simultaneously in Canada
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eISBN : 978-0-470-59268-7
To my beloved son Samuel Benjamin Siegel
Introduction
Contagions are not new. They have existed throughout history, and one might say the perception that your neighbor will one day infect you has interfered with social intercourse throughout time. Infectors are perceived as dirty, unkempt, secret germ factories. They are not people we love easily. Whenever I see a patient in my office who says he has been exposed to scabies or bedbugs, I can’t get out of there fast enough or wash my hands frequently enough. And keep in mind that I am a physician who has written about overblown perception of risk; I can only imagine how a person on the subway feels sitting next to one of these patients.
Since the microscopic culprits of infections are themselves unseen, they are perceived by potential victims as mysterious, imagined as deadly, and subject to immediate exaggeration and distortion. With the contagions throughout history, there always have been two problems: the contagion itself, as well as the sense that the outbreak or epidemic is far worse than it actually is. This is the prime reason why regional quarantine, or roping off a region, doesn’t work to contain an emerging bacteria or virus. People who are afraid tend to take fewer precautions, as the powerful emotional brain interferes with the ability to reason. Not only that, but as occurred during the massive Black Death in fourteenth century Europe, when more than a third of the population became infected over a three-year period, regional quarantine was ineffective; those who were restrained tended to panic and attempt to escape. That sense of terror has been transmitted down through the centuries to today even though, with the aid of modern medicine, we have less reason to be afraid.
As I will describe in chapter 2, fear of another 1918 not only fueled the vast overreaction to a potential pandemic in 1976, but it also influences how we react and overreact to the real and emerging pandemic now. The powerful mental gates of heavy emotion cause us to alternatively overestimate and then underestimate a problem. And it isn’t only flu. The human response to contagions always has been out of proportion to the risk. In this book I cover both the real and the imagined concerns about influenza, the way that history both informs the debate but also sets us up for a hair trigger response. After all, conditions have changed drastically since 1918, and we have all these ways to combat contagions that we lacked back then. Plus, the deadly virus that evolved via likely mutation and returned with a vengeance that fall represented an extremely unlikely historical occurrence.
Still, we are informed by our emotions at least as much as we are by the facts. It is not surprising that among my most flu-literate patients is Arnold, a ninety three-year old whose grandmother died of the Spanish flu when he was an infant. But it isn’t this man who is most worried; he says that though his grandmother died, she died of pneumonia after recovering from the flu. Arnold also points out that several other family members had milder cases and survived. Arnold is not really afraid of the flu; he sees it in perspective, based on his personal experience. But everyone else in his family, his children as well as his grandchildren, are worried, and they call me every week to find out when the H1N1 swine flu vaccine will become available. Their negative imaginations are fueled by Arnold’s story from his infancy; they imagine the dark rooms and the brooding, downtrodden faces far more than he does. Responses to an emerging contagion are fueled as much by worries and rumors as by facts. A study from England warns that the antiviral drug Tamiflu may be poorly tolerated and ineffective in children, and this quickly becomes dogma despite a mass of evidence (including my own) to the contrary. I lose an important medical arrow from my quiver. Next, fears are stoked that the new vaccine could cause ascending paralysis (Guillain Barré syndrome), just as the last swine flu vaccine appears to have done in one in one hundred thousand patients. But even if that worst case scenario turns out to be true, there is an important difference between today and the 1976 swine flu scare. This time there is a real pandemic virus, infecting many millions. We need the vaccine.
Contagions throughout history have been characterized by intense emotions that accompany killer pathogens. These emotions are understandable. Our primitive fear of death is tied to the unknown, connected by our lifeblood to an invisible microbe.
1
Pandemic Basics
In 1997,