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Geez, here we go again.... another op-ed piece

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  • Geez, here we go again.... another op-ed piece,2933,238139,00.html

    One Flu Over the Cuckoo's Nest

    Thursday , December 21, 2006

    By Steven Milloy

    Flu fearmongers must be quite depressed these days. Seasonal flu is late. Bird flu ? despite all the headlines ? hasn?t gained much traction among humans. And we haven?t had pandemic flu in 36 years.

    The good news is so good (for the rest of us, that is) that the flu lobby seems to be resorting to manufacturing fantasy flu statistics.

    A new study published this week in the medical journal The Lancet (Dec. 23/30) estimates that a global pandemic flu could result in 62 million deaths worldwide, mostly in poor nations. The researchers naturally conclude that ?prudence? requires ?focusing on practical and affordable strategies for low-income countries where the pandemic will have the biggest effect.?

    But the study is yet another example of how out-of-touch with the real world some public health researchers can be.

    First, the researchers? estimate of 62 million deaths has far more shock-value than credibility. It?s guesswork derived from other (cherry-picked) guesswork.

    The 62 million-death sound-bite is the product of statistical modeling that uses worst-case death rate estimates from the 1918-1920 pandemic influenza ? an epidemic that medical historians believe killed somewhere between 20 million to 100 million people.

    In addition to the obvious uncertainty surrounding the actual death toll from the 1918 flu pandemic, the researchers ignored several key (not to mention glaring) differences between 1918 and 2006.

    First, while there?s no sure-fire cure or preventative measure for the flu, modern medical care and public health practices have dramatically improved since 1918. So any flu epidemic is likely to be far less severe ? a point we?ll come back to in a moment.

    Next, a great proportion of the deaths in 1918 was probably due to secondary bacterial infections that followed the initial viral infections. Today, antibiotics would be used to treat bacterial infections.

    And let?s not forget that during 1918-1920, much of the world was still recovering from the strains of World War I. Poverty, hunger, unsanitary living conditions and stress likely made much of the global population ripe for a killer flu pandemic.

    None of these considerations were factored into the researchers? estimate of 62 million deaths.

    But perhaps the researchers? choice that most reveals their apparent desire to come up with a scary ? rather than a realistic ? death toll from pandemic flu is their decision to use the 1918 pandemic flu data in the first place. There were, after all, two other more recent and, in all likelihood, more relevant pandemic flu outbreaks in the 20th century.

    There was the 1957-58 Asian flu pandemic that killed somewhere between 1 million to 4 million people. The 1968-1969 Hong Kong flu killed an estimated 750,000 people.

    Now if one wanted to estimate a death toll from a hypothetical pandemic flu in today?s world, it seems as though data from the Asian and Hong Kong flu pandemics would be much better starting points than the far more uncertain data from a chaotic period almost 90 years ago. That presumes, of course, that one is interested in more realistic (albeit smaller) estimates that better reflect modern conditions as opposed to overblown numbers aimed at producing scary headlines.

    What this sort of study reveals is how public health researchers can put more stock in frightening the public than informing it. It?s as though they assume that we?re too stupid to work with facts and must be terrified into action.

    And then, what is the action that the researchers desire? In this case, they want more money allocated to pandemic flu preparedness. While this may sound reasonable at face value, let?s consider several key realities.

    First, pandemic flu is quite rare and we ought to be cautious not to over-allocate scarce public resources to events that seldom happen and that seem to be getting less severe when they do occur.

    Next, millions of people in the developing world die every year from preventable diseases, such as mosquito-borne malaria and diarrheal diseases caused by unsafe food and water. Why not spend available resources on saving people from those deadly diseases that are taking lives right now rather than on over-preparation for a hypothetical epidemic that is highly uncertain.

    Moreover, by tackling these other ongoing diseases, populations will be made less vulnerable to pandemic flu should it occur.

    Finally, pandemic flu frenzy is also a problem in the U.S. The federal government has already spent $600 million in local and state government preparedness planning for a pandemic flu that may or may not happen any time soon, according to a report this week in the Chicago Tribune. That ?preparedness? includes stockpiling vaccines ? a stockpile that could very well prove entirely useless since no one can be certain that the vaccines will be effective against a specific strain of flu virus from which pandemic flu might actually develop.

    Useless preparation may be worse than no preparation because it means that precious public health resources, efforts and time have been wasted.

    If we can?t expect truthfulness and clear-thinking from public health researchers and officials in a time of relative calm, how much confidence can we have in them should a public health emergency develop?

    Steven Milloy publishes and He is a junk science expert , an advocate of free enterprise and an adjunct scholar at the Competitive Enterprise Institute .

  • #2
    and my response to him via email.

    Just a few counterpoints:

    The 1957 and 1968 pandemics were the result of a reassortant virus, meaning avian flu combined with human flu. In fact, the 1968 virus closely resembled the 1957 virus in its ability to reproduce, so 1957 victims had some immunity from 1968's strain.

    In contrast, genetic researchers have conclusively proven the 1918 pandemic strain was an avian virus that picked up some swine components via recombination and went directly to humans without combining with a human flu; thus, the high death toll. That is exactly why everyone is watching H5N1, because it is behaving in much the same way.

    "Moreover, by tackling these other ongoing diseases, populations will be made less vulnerable to pandemic flu should it occur".

    Pandemic influenza planning is different than planning for a mosquito-borne disease such as malaria or yellow fever (both enjoying a bit of a comeback, unfortunately). Malaria and yellow fever, as well as Rift Valley Fever (which is killing in Kenya as we speak), are controllable by better hygiene, protective clothing, quick diagnosis and treatment and, especially, spraying for mosquitoes. In the case of malaria, the WHO has requested the return of none other than DDT (!), because only DDT can reliably curtail the spread of the mosquitoes. Influenza is spread by birds, humans, and other animals by direct exposure to the virus via the respiratory tract (or entry into the eyes in the case of certain flus, such as H7N7 and H5N1). The only common ground is improved hygiene and awareness, which I agree is desperately needed.

    While science has gotten better on secondary infections, we now have a new class of "immuno-compromised" people such as cancer patients, HIV/AIDS patients (the "other" pandemic), TB, lupus, etc. These people are at extremely high risk from seasonal influenza, let alone a pandemic strain. And we have fewer staffed beds per capita now than we did in 1918, meaning we may have actually been better prepared for a pandemic's effects then than we are today.

    And the young may be especially susceptible. It has also been conclusively proven that the 1918 pandemic's virulence caused a reaction in young adults called the "cytokine storm," where the body's own immune system kills the patient. Medical studies have now conclusively proven that the same phenomenon is responsible for the huge death rate of people under 40 by H5N1. This is another distressing similarity between 1918's virus and H5N1. In 1918, the life expectancy of this nation dropped by an average of ten years -- ten years! -- due to the fact that 50% of the deaths were otherwise healthy people from eighteen to forty. Context is important here. Can you imagine the effects on the economy, on Social Security, on the future of this nation if we suffered similar losses among our young? In 1918, 675,000 died from H1N1. Half were eighteen to forty. That equates to roughly 900,000 young adults today. The long-term impact of the potential loss of nearly a million young, healthy, wage-earning, taxpaying adults is speculation that would cause many sleepless nights in state capitols and in Washington. The overwhelming majority of H5N1 deaths are people under 40, meaning the virus has a special affinity for them.

    Finally, since 1700, no fewer than ten pandemics have swept the planet, some with similar lethality to 1918's pandemic strain. They happen, on average, three times a century. Some, specifically the 1732 pandemic and the 1918 pandemic, are now believed to have started here in America. So we have now determined that influenza pandemics are as much a part of history as wars and hurricanes and terrorism. And we would be foolish not to prepare for those, so why question preparations for a pandemic? Flu is amazingly unpredictable. That is why, after nearly a hundred years of research, little is still known about why some flus just go pop! and create a new pandemic strain.

    Finally, pandemic planning is such a small part of Gross Domestic Product that it is an absurdly small investment. The CBO has issued two papers which illustrate that even a mild (1957/68) pandemic would cost 1.5% of GDP. And a 1918-type event would drop GDP by a whopping 5%, a figure called too conservative by some economists. While medicine has gotten better, society has moved from an individualistic, agrarian culture to the global supply chain and huge interdependencies. It is precisely these global interdependencies that worry pandemic planners, because a severe pandemic (and even a mild one) will play havoc with the supply chain for food, for materials, and for finished goods. Even the seasonal flu costs American businesses billions in lost wages and lost productivity.

    So which threat is the more certain -- a terrorist attack or a pandemic? There is no correct answer save "both." So we must prepare for both. Junk science? You're bucking science and history both. While I hope you are right, we cannot afford for you to be wrong. We are watching a story unfold, nation by nation, case by case, and supplying science, preparation, commentary and (hopefully) common sense. I am sure if we could ask the decision-makers of 1918, from President Woodrow Wilson on down, if they would have preferred the news coverage that "bird flu" is getting to the sudden and unknown body blow of Spanish Flu, they would undeniably prefer the news and the debate.

    Thanks for the chance to respond.

    Scott McPherson
    Tallahassee, FL


    • #3
      Re: Geez, here we go again.... another op-ed piece
      Steven Milloy publishes and He is a junk science expert , an advocate of free enterprise and an adjunct scholar at the Competitive Enterprise Institute .

      Oy Veh!

      This persons entire argument is that the 1957 and 1968 pandemics didn't kill as many people as the 1918 pandemic, ergo the next pandemic wont kill as many people as the 1918 pandemic.

      This person over simplifies a complex problem into a simple but incorrect argument. The trend seems to be going in one direction ergo it will continue to go in that direction.

      Yeah, if that is the case then the stock market should only go in one direction too.

      There is a really simple way to completely destroy this argument.

      Take a look at what Chikungunya did over the past year.

      Chikungunya blew up across the Indian Ocean this year, out of nowhere.

      It ran through Indian Subcontinent unchecked, leaving misery and pain where ever it went.

      How effective was the modern medicine? Useless.
      Where was that rapid response? Nonexistant.
      What happened to public services in hard hit areas? They stopped or suffered greatly.
      How long did it take to get a vaccine? Still waiting.

      But we don't want to talk about that, nope, that would be to real.


      • #4
        well said, Jeremy.....

        I should have included Chikungunya in that list. Since it does not appear to be lethal, but is certainly debilitating, it also would cause some economic calamity, not to mention taxing the bejeesus out of the health care system.


        • #5
          Re: Geez, here we go again.... another op-ed piece

          Thank you, Scott, for taking the time to email Mr. Milloy. Please let us know if you receive a rebuttal. There are several other errors in this sensationalist op-ed piece. For example, the CFR is currently over 50%. If a pandemic strikes with its current virulence, the 62 million number will be dwarfed by the actual number that would succumb to a pandemic. That number would not include collateral deaths from infrastructure collapse.

          He states that modern health care and public health practices have dramatically improved since 1918. While that is true in general, it does not hold for a pandemic. We currently do not have an effective vaccine for H5N1 nor do we have the global capacity to produce and distribute such a vaccine to inoculate the world population within the time frame of an initial wave.

          While modern health care can address intensive care for "cytokine storm" for a small number of patients, the world medical community recognizes that it does not have any excess surge capacity for such care in the event of a pandemic. Families will be reduced to caring for sick family members and friends in the same fashion that family cared for sick friends and family in 1918. Why then would he expect the death toll to be any lower now than it was in 1918?

          I am afraid that this article was written to sell itself through syndication rather than present a fair and balanced view of the threat of a pandemic.


          • #6
            Re: Geez, here we go again.... another op-ed piece

            Free Enterprise Action Fund

            From Wikipedia, the free encyclopedia

            Jump to: navigation, search
            <!-- start content -->The Free Enterprise Action Fund is a mutual fund operated by Steven Milloy and Tom Borelli, with the aim of counterbalancing the activities ethical investment funds. Whereas 'ethical' funds avoid investments in firms that are accused of damaging the environment, or other unethical behaviour, the Free Enterprise Action Fund seeks out such investments, relying on Milloy;s arguments that such criticisms are typically based on political bias or junk science.

            [edit] Controversy

            The Free Enterprise Action Fund has been criticised for taking ideological stances at the expense of its investors' interests . Daniel Gross, in Slate wrote that
            <DL><DD>FEAF's managers also don't appear to be very interested in making money. Assembling a portfolio of 392 teeny positions (111 shares of Federal Express, 60 shares of Tiffany, etc.) is an incredibly inefficient and costly way of trying to mimic the S&P 500. Asset managers get paid based on the assets they manage. At FEAF, the Adviser (Milloy plus Borelli) receives a fee equal to 1.25 percent of assets. Five million dollars in assets throws off about $62,000 in fees annually, which is nowhere near enough to pay the salary of a professional money manager. </DD></DL>
            <DL><DD>Page 17 of the annual report shows that the fund incurred total expenses of $302,117, a whopping 6 percent of assets. But the prospectus promises that fees won't eat up more than 2 percent of total assets each year. And so in 2005, the adviser (i.e., Borelli and Milloy) waived his entire $44,727 management fee. What's more, the adviser reimbursed some $185,616 in trading, administrative, and legal expenses to the fund. If the fund's assets rise sharply in the next few years, the adviser can theoretically recoup these waived payments and reimbursements. But in the short term, it looks like Borelli and Milloy are essentially paying the fund for the privilege of using it as a platform to broadcast their views on corporate governance, global warming, and a host of other issues.[1] </DD></DL>

            "Thank You for Investing

            A very curious right-wing mutual fund."

            By Daniel Gross
            Posted Thursday, May 4, 2006, at 1:07 PM ET
            Are you a right-wing, free-market type who believes that Fortune 500 CEOs have devolved into a gaggle of eco-friendly squishes? Do you like paying high expenses for stock market returns that lag the S&P 500? Would you trust a former tobacco executive and a critic of junk science to manage your money? Then have I got a mutual fund for you! The Free Enterprise Action Fund.....



            • #7
              Re: Geez, here we go again.... another op-ed piece

              Public health is not a political football.

              At the very least the networks should present these "opinions" from non-scientific persons in tandem with an opinion from a scientifically qualified author.
              Last edited by sharon sanders; December 22, 2006, 04:42 PM. Reason: edited myself - LOL


              • #8
                Please read these recent scientific opinions...

                Hat-tip to 4-Abba:

                "Last week South Korea announced two new outbreaks in poultry. And Dr. Timothy Uyeki of the U.S. Centers for Disease Control and Prevention said he's bracing for another surge in human infections. "When the temperature drops and the humidity drops, that's when you start seeing more poultry outbreaks. And when you see poultry outbreaks, that's when you see human cases."

                "It's still smoldering," said Dr. Anthony Fauci, who heads U.S. scientific efforts to combat bird flu. "What it hasn't done, much to our relief, is to become more virulent or better able to transmit from person to person."



                • #9
                  Michael Osterholm PhD - CIDRAP

                  Hat-tip 4-ABBA

                  Pandemic inevitable; local planning and leadership critical, health expert says

                  After listening all morning to the myriad manmade and natural risks facing the world in the 21st century, Michael Osterholm, an expert on public-health preparedness, offered a stark analysis of the threat of pandemic influenza

                  "All the events we've heard about today may or may not happen," Osterholm told 400 scholars, students, policymakers and diplomats attending the Freeman Spogli Institute for International Studies' conference, "A World at Risk," on Nov. 16. "This is going to happen." .

                  In a globalized, just-in-time economy with no surge capacity, local preparation and leadership will be critical to survival. "Community planning is not an option," he said.

                  Osterholm, who is director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said 10 influenza pandemics have taken place during the last 300 years. "They are recurring events," he said. The virulence of the 1918 Spanish flu, which killed an estimated 50 million to 100 million people, paled in comparison to one in 1516 that swept across Asia and Europe in just six weeks?in an age before modern transportation. In Rome, he said, 9,000 out of 81,000 residents died within one week, and many Spanish cities were left totally depopulated.

                  Osterholm delivered the luncheon address. Following opening remarks by former U.S. Secretaries of State Warren Christopher and George P. Shultz, and former U.S. Defense Secretary William J. Perry, attendees listened to a range of discussions by Stanford scholars on understanding and measuring risk, efforts to keep fissile materials out of terrorists' hands and whether the nuclear nonproliferation regime has collapsed.

                  Experts also focused on challenges posed by natural, national and international disasters; the neglect of critical infrastructure and terrorism; and energy shocks to the global system. Smaller breakout sessions included analyses of food security and the environment; the challenge of governance in failed and failing states; the rise of China and its implications for the world economy; and U.S. efforts at democracy promotion in Russia, Iraq and Iran. CNN terrorism analyst Peter Bergen delivered an evening address on the successes and failures of the war on terrorism since 9/11.

                  Despite the concrete dangers posed by such threats, Osterholm asserted that the unpredictable nature of pandemic influenza makes it particularly tricky to prepare for and combat. The last four pandemics have occurred in all four seasons, he said, and they have differed in mortality rates and phases of greatest virulence. For example, the second wave of the 1918 flu was the most deadly.

                  "If there is a silver lining to many of the terrorist events, when they happen we go into a recovery phase within minutes," Osterholm said. "They blow up and then they're done. That's a horrible thing, but it's tremendously advantageous. Imagine something that unfolds over a matter of months."

                  Osterholm explained that influenza pandemics occur when a unique, virulent strain of the disease emerges that is readily transmissible among humans. So far, the H5N1 virus, which is found mainly in birds (it can cause the illness referred to as "avian influenza," or "bird flu"), has resulted in 153 confirmed human deaths worldwide. "We don't have a clue," Osterholm said, about when and where the next pandemic might start. "The influenza virus is one of the most sloppy, promiscuous viruses we know."

                  According to a September report issued by the World Health Organization, the H5N1 virus has a 65 percent mortality rate, compared to 2.5 percent for the 1918 virus. In the event of a pandemic, however, "this [rate] will probably attenuate because you will die before you can pass it on," Osterholm said.

                  If a pandemic occurs in the near future, vaccines and antiviral medicines will have limited impact due to delays in developing effective drugs and limited manufacturing capacity. Steps such as quarantine and infection control also will have little effect, he said. "Stanford will never close?[because] every parent, every loved one, will take out their student before you have a chance," he said. "My concern is how do you open? When do you get people to come back?"

                  Despite the grim forecast, Osterholm said it is unacceptable for society to do nothing. Even if a 1918-like scenario unfolds, most of the world's population will survive. "If local was ever important, it's important now," he said. "What happens in Palo Alto is going to be more important than what happens in the Bay Area. Business continuity planning is not optional?as goes business, so goes our society. If we can't get food, heating oil and medicines to our population, we are in trouble. Hope and despair are not strategies?that's a common place to go. We'll get through it, but, ultimately, it's going to depend on how we prepare and the leadership during that time."

                  By Stanford University



                  <!-- / message -->


                  • #10
                    Re: Geez, here we go again.... another op-ed piece

                    Are we going to continue to let this go on or are we making progress with organising a coordinated continual submission of factual statements to the MSM outlets?

                    If we are then lets get cracking and start peppering these guys and the media outlets with 1,123( thats how many members at FT as of this morning) email requests to explain their misleading assertions.

                    Come on lets not be afraid to talk straight to people who are putting lives at risk, but lets do it en masse so that the sheer volume of response they receive forces them into either a) debate or b) awareness and admission that they are wrong.


                    • #11
                      Re: Geez, here we go again.... another op-ed piece

                      Jet - it is tough to get anything going until Tuesday here in the U.S at the earliest. Many have travel plans etc. If you want to start a draft, please do. PM me and I will give you my email.



                      • #12
                        Re: Geez, here we go again.... another op-ed piece

                        Will, do.

                        I'll put together a framework that addresses the most likely questions/responses we are likely to need to deal with.

                        I'll leave the actually detail to most of these to the people here who feel most knowledgeable and comfortable providing the meat of that particular response

                        You guys have a fun xmas/holiday