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Could Swine Flu Panic Be Worse Than Outbreak Itself?
Date:9/22/2009

With infections typically causing only mild illness, experts point to exaggerated fears as the real threat

TUESDAY, Sept. 22 (HealthDay News) -- With all the warnings and preparations, dire predictions and hastily ordered vaccines, could the growing worry about H1N1 swine flu prove more disruptive than the actual outbreak?

That notion is weighing on the minds of more than a few infectious-disease experts as the fall and winter flu season looms.

Not only does societal panic not help during a public health situation, such as the current H1N1 flu pandemic, it can actually backfire, creating its own set of problems, the experts said.

"We have limited resources in the U.S. -- if this [swine flu] captures our negative imagination, it's going to hurt our health-care system," said Dr. Marc Siegel, associate professor of medicine at New York University School of Medicine in New York City. "Our emergency rooms will be flooded with worried people, doctors' phones will be hanging off the hook, everyone will be afraid of every sniffle and wanting to get tested for the flu."

Some examples of moves that many believe are stoking Americans' flu fears this season:

  • Numbers out of context. The U.S. Centers for Disease Control and Prevention reports that nearly 600 Americans have died from H1N1 swine flu, which now comprises 97 percent of new U.S. influenza infections. That sounds like a scary number, until you realize that the "regular" seasonal flu kills about 36,000 Americans each year.
  • Dramatic moves by public health officials. The widespread U.S. school closings ordered when H1N1 flu first surfaced in the spring can incite societal fear. While well-intentioned, this type of public health initiative tends to focus on a worst-case scenario and can be "alarmist" and "overly restrictive," according to a study on H1N1 panic appearing Sept. 3 in the British Medical Journal (BMJ).

Simplistic, emotional media headlines can also stoke outsized fears, creating "irrational behavior," said Joshua Klapow, associate professor at the University of Alabama at Birmingham School of Public Health and a member of the CDC-funded South Central Center for Public Health Preparedness.

Americans have been here before, the experts noted.

There were the post-9/11 anthrax attacks, fueling the public's fear that terrorists would unleash deadly smallpox germs on the population.

"People were stockpiling antibiotics. It didn't really result in a shortage, but it could have," said Dr. Dean Blumberg, associate professor of pediatric infectious diseases at the University of California, Davis Children's Hospital.

A rush for flu drugs has its own dangers, Blumberg said, because "people stockpiling Tamiflu or taking it inappropriately for the current swine flu might create [viral] resistance so the drug might not work well when we really need it."

Doomsday scenarios typically do not materialize, fortunately. Hysteria over the possible Y2K computer meltdown fizzled after the machines came through Jan. 1, 2000, relatively unscathed. And headlines over West Nile virus, SARS, Ebola virus and the bird flu have all faded, at least for now.

Often in a period of perceived crisis, people focus only on the benefit of certain precautionary measures, not the possible risks, Blumberg noted. The dangers of that approach were revealed in 1976 during the last H1N1 outbreak, when a federal government decision to vaccinate 43 million people against a different swine flu strain backfired.

Not only did the dreaded outbreak never materialize (illness never spread beyond 240 soldiers stationed at Fort Dix, N.J.) but some 500 Americans who did get vaccinated came down with a rare neurodegenerative condition called Guillain-Barre syndrome, which many experts believe was linked to the shot. Twenty-five of those 500 people died.

The current H1N1 outbreak remains far from a "worst-case scenario" with most illnesses still mild, even though they're widespread.

However, according to the BMJ article, medical laboratories are already straining under the sheer number of specimens they're being asked to test -- many from patients who ordinarily wouldn't have even considered a flu test before.

"Parents are calling pediatricians and demanding vaccine," added Dr. Geoffrey Weinberg, professor of pediatrics at the University of Rochester Medical Center in New York. "It's a burden on the offices because they're fielding so many phone calls."

The reality: "The [H1N1] infection to date has appeared to be mostly modest and has not caused a huge number of hospitalizations," Weinberg said.

More information

Get the facts on H1N1 flu at the U.S. Centers for Disease Control and Prevention.

Tips to Keep H1N1 Panic at Bay

Joshua Klapow, a disaster mental health specialist at the University of Alabama at Birmingham, said a few simple steps can help you keep your head in the time of swine flu:

  • Get a reality check. "Remind yourself to gain perspective," Klapow said. "The headlines of death, the headlines of serious, serious illness are only the headlines and they are not balanced by the fact that the vast majority are not dying and are not getting severely ill." Visit the CDC Web site, as well as that of your local health department for more complete information. "This will give you a much more accurate picture of swine flu as it affects you," Klapow said
  • Act sensibly to cut your risk. That's as simple as washing your hands frequently, keeping your hands out of your nose, ears and mouth, and staying away from people who are sick. "This is incredibly powerful preventive medicine," Klapow said. "The best way to be safe is with this sort of basic public health practice."
  • Remember that fear is unhealthy. "All that anxiety does is weaken your immune system, which puts you at greater risk for catching this virus or any other virus," Klapow said. "Getting a grip is critical -- not just so you feel better emotionally but it will increase the chance that you ward this off."



SOURCES: Dean Blumberg, M.D., associate professor, pediatric infectious diseases, UC Davis, Children's Hospital; Geoffrey Weinberg, M.D., professor, pediatrics, University of Rochester Medical Center; Marc Siegel, M.D., associate professor of medicine, New York University School of Medicine, New York City and author, Swine Flu: The New Pandemic; Joshua Klapow, Ph.D., certified disaster mental health specialist, associate professor, University of Alabama at Birmingham School of Public Health and faculty member, South Central Center for Public Health Preparedness; Sept. 3, 2009, British Medical Journal


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