Concern for swine flu vaccination - from BMJ - (Aug/31/2009 )

I'll go you one better George. The health care/pandemic pimps are out for reputation and gov money - no more no less. If WHO and CDC could establish farting as pandemic, the news media would go bonkers seeing the end of the world for H2S poisoning, gov and UN funds would flow, pedantic worried faces would appear on network news in US, BBC and NPR and they'd all walk away the richer when a story broke about Madonna's fake breasts throwing farting to section E12 in the NY times.

You're ignoring one fact -- it *is* a pandemic. They must declare it, for the declaration triggers certain surveillance protocols and other means by which data is gathered to assess its significance as a threat and formulate methods to respond. In this regard, it's no different than the weather service issuing a tornado warning.

How the media reports it is not the concern of such organizations, they have a different job to do.

And they defined pandemic and let the media run wild with it. I don't buy for a second that they have no responsibility to ensure it's reported appropriately. They are only too eager to get in front of the camera.

On the other hand, I'm sure we've all heard of situations where a reasoned argument has been put up by an authority, only to have it cut to shreds and misrepresented by the media, who are often (always?) more interested in sensationalism and sales than accuracy.

It is what it is. Imagine what would happen to WHO/ CDC etc if swine flu did come out as a dangerous Spanish flu-type pandemic and they hadn't called it? They would all be (rightly) crucified. As it turns out, swine flu looks like it's a fairly mild flu that has nasty outcomes in a small section of the population.

Poor them - damned if they do and damned if they don't. Fact is - they've blown it for the last 4 decades - highlighting Bird flu, SARS, nvCJD and the original swine flu and missing AIDs. Worse - you'll find no review from these folks that attempts to understand why the former group did not meet projections.

eberthella -- you're the director of WHO or CDC (take your pick). You know there is a disease that has reached the level of a pandemic outbreak by the formal definition. What do you do?

I see you've managed very little in your career.

A leader doesn't go from predictable crisis to predictable crisis - managing each as a separate phenomenon - facing the same fait accompli, being held hostage to terms like "pandemic" that are always overblown by the press and that have lost significance to much of the public. I'd have established programs with the objectives:

1) better understand the previous failures of prediction - in a technical sense. Science is knowable and there's a reason, for example, why my dire predictions of H1N5 mutation did not happen (so far) and why the last swine flu predictions were so poor. Some relevant work has been published and even in CDC's emerging Disease journal by folks at Johns Hopkins, but nothing from or funded by WHO or CDC.

2) change information and terms with the objective of establishing the right public message based on the risk shown by data available at that time. The bird and swine flu announcements hyped by the press produced no functional change in citizen behaviours or practices. Tho it certainly did produce concern for increased CDC funding and that was probably part of the aim - for good (to get vaccine production started) and not so good (to grow my org).

If walked in into the office today and faced such a situation, the focus would be on the technical aspects of what we know, what milestones we're looking for that indicate increased risk and the scenarios projected. As for the press, I'd describe that we have another flu outbreak that appears to be more aggressive and has been reported from other countries as well and say what citizens can do at this time - as in nothing. I'd not use "pandemic" or other emotional terms i know will be misused by the press. to that point, I'd announce before the next crisis that the agency will not be using terms that can be overblown by the press.

eberthella on Sep 3 2009, 07:55 AM said:

That shows how very little you know about me. I'll stack my twenty-year career against yours and we'll see who comes out on top...

eberthella on Sep 3 2009, 07:55 AM said:

Ridiculous. Declaring a pandemic has nothing to do with predictions. The spread of a disease has either reached a pandemic level, or it hasn't.

eberthella on Sep 3 2009, 07:55 AM said:

Ridiculously Orwellian. You would change the definition of a pandemic based on the public's reaction to the word, and that definition would fluctuate over time based on risk? There is no risk metric or emotional quotient for a pandemic, it is a measure of how widespread a disease has become, and has nothing to do with how detrimental it is to human health.

Basically you're saying your actions in the face of a pandemic would be dictated by your assessment of how the press would report it and how the public would react to that reporting. Boy, am I glad you're not in charge of any public health organization...

No pandemic here in bioforum but just a tsunami ...whew...eberthella, you just won't stop eh, unless you meet someone your own size but definitely better..so my bet's on HomeBrew.....

anyways, my substanceless two cents....

Its classification as a pandemic is a regulatory policy based on criteria the WHO have established (and they like to have all these guidelines) i.e. there’s person to person transmission and it has crossed borders and barriers so it’s a pandemic. Actually they were even criticised for being too slow in upgrading its status bec of the political ramifications- they were concerned and rightly so for the wide spread fear and panic that can result. And changing the label is neither here nor there especially if we are bracing for a second wave this fall. With this classification comes heightened awareness and more pressure on our respective governments to institute action plans and enact health measures which would contain the virus. Besides, in the initial press realease by the WHO they pretty much defined the criteria and why it was being classified as a pandemic and what it is not. It was up to our govts’ health agencies and professionals to give the right information to the public.

As stated by one of our MPs “to be prudent, we must be prepared for the worst-case scenario”and I think this pretty much sums up succinctly the position of WHO and the government health agencies. Perhaps we don’t need to see this as a “damned if they do, damned if they don’t” situation but more like a twisted Pascal’s Wager : if we don’t get a second more deadly wave (and a mutated more virulent strain), their strategy worked and crisis is averted and everyone could have a collective sigh of relief. But if we do get hit, then hopefully, the vaccine and all the other measures in place will work out as planned.

The issue I’m more cynical about is that this massive vaccination campaign translates to a billion dollar boon for Big Pharma- and for these flu vaccines- there are about 5 or 6 of them. Here in Canada, it’s only Glaxo and this campaign alone costs us 400 M big ones. It’s also interesting to know that during epidemic/pandemic crises, they have lawsuit immunity (at least in the States and most probably here as well). Because of the fast-tracking of this vaccine, if they start cutting corners and doing something unethical because of the time crunch, they are still not liable unless they “willfully” released a defective or ineffective product. Then this could be worrisome...but we have assurances that it's the same technology that has always been working and the only thing new is the strain of virus so we have to trust them on that....

I think eberthella is not in fact a person, but an insult-generator.