Wednesday, 22 July 2009

Swine flu: let's have some anti-hysteria hysteria! Yay!

The great thing about swine flu from a media point of view is that it provides great fodder for columnists as well as spectacular front pages. You can run front pages about how we're all going to die, and at the same time your delightfully world-weary old columnists can write "Pah! Swine flu? It's the new Milennium Bug, load of fuss about bugger-all! Have we all gone soft? During the war..." pieces for that section of the readership that bloody well hate experts and politicians and the nanny state and anything that seems to lack the correct level of British stiff upper lip.

Simon Jenkins in the Guardian isn't letting his notion that swine flu is a load of old bollocks go. Having written two such columns near the start of the outbreak, the fact that the whole bothersome business hasn't gone away yet has motivated him to drop his apparent wisdom on us again, inthe delightful Just two months of swine flu sniffles, and madness reigns.

It seems to follow the same basic format as his previous two, widely criticised, articles which asserted that everyone except a few wise sages like Jenkins had gone bonkers in the flippin' nut. The main problem with Jenkins' writing on this topic is that he seems to put any blame for the apparent hysteria squarely on the shoulders of Sir Liam Donaldson and unnamed 'public officials':

Last week the government's chief medical officer, Sir Liam Donaldson – never knowingly out-panicked – suffered an acute attack of headline deprivation. Nostalgic for the famous "750,000 could die" prediction for avian flu, he decided that "65,000 people might die" of swine flu. He later said the figure was an "upper estimate scenario for planning purposes". He added that his "lower limit" was 11,000 dead. Donaldson knows his media. This week he terrorised ministers gathered in Downing Street's Cobra bunker into conceding his dream, a 2,000-strong department for a "national pandemic flu service".
Brilliantly, the article he links to for the 65k figure points out in its very first line that 65k is a "worst case scenario". It's not clear where Jenkins gets his "lower limit" being "11,000" claim, since the very article he links to says;

The most optimistic scenario set out is based on only 5% of the population falling ill and 3,100 dying.
Jenkins continues with a tirade against Donaldson for having the temerity to qualify these apparent predictions;

Some spuriously exact statistic, such as 65,000 or 31% or 0.1, is dressed up with mights, coulds and other pseudo-qualifications.
It's not clear exactly what constitutes a "pseudo-qualification", because those all seem like actual qualifications to me. To Jenkins, Donaldson is a scaremonger, even when he says things like "We can't give an estimate of deaths from this virus yet. We don't know enough about it". Of course, Donaldson does nothing of the sort. He was at pains to point out that 65,000 is the absolute worse case scenario, and that the authorities had to plan for that. There's been a running theme throughout the swine flu coverage of government and WHO officials making fairly reasonable, even-handed statements about the potential risks, only for the media to splash the scariest-sounding bit in their headlines. It's understandable, but what bothers me is that people like Jenkins should know this. But no, it's easier to just pretend Donaldson et al are running round like Chicken Little telling us the sky is falling in.

I mean, why bother trying to write a sensible piece, when you could just write smarmy comebacks like this?

The head of the Royal College of General Practitioners announces that "at its worse [sic], the pandemic will hit 30% of the population, of whom 0.3% might die". I suppose they might, or perhaps might not.

Well, yes. They might or might not. That's the thing with risk assessment, it has to predict possible scenarios in the future by its very nature. The government and the health service know this, but they have a duty to plan for the worst. The media, on the other hand, really ought to have a duty to inform people about the risks in a measured way, but dang, that ain't no fun. Jenkins is having none of it though, and bravely argues that we should really stop worrying about the actual existing, unpredictable but clearly spreading swine flu, and instead ensure we're not diverting funds from preventing nuclear attacks from an unspecified source:

I would like to know how many people will die of heart attacks, meningitis, MRSA and delayed cancer treatment while health politicians play Whitehall games with flu. Many people might indeed die of flu, but they might also die of a nuclear attack, an asteroid strike or a dozen other diseases and accidents now receiving lower priority.
It'll be interesting to see how long Jenkins keeps this up. When no-one in Britain had died of swine flu, he shrugged off the inevitable headlines about swine flu's entry into Britain as "Two Britons are or were (not very) ill from flu", pointing out that "Nobody anywhere else in the world has died from this infection and only a handful have the new strain confirmed". Now that a number of people have died, he...oh wait, he's still shrugging it off;

And all this is over a condition correctly diagnosed by a Dulwich 12-year-old during the initial outburst of hysteria in May as "like a cold". Whitehall empire-building has been reduced to a nationalised sniffle
Yes, that 12-year-old got it mildly and didn't die. The vast majority of people who get it won't die. It's a bit more than a sniffle, but even Sir Liam Donaldson's gravest prediction had the mortality rate at an absolute worst-case 0.35%. Citing a single anecdote from two months ago while 30 other people in Britain have since died seems to miss the point just a tad.

The most baffling thing is that Jenkins doesn't seem to be getting the same coverage as me.

The information that 28 out of the 29 "killed so far by swine flu" had other potentially life-threatening conditions was rarely mentioned.
Again, the very article Jenkins linked to regarding the 65k figure indeed mentions "underlying health complications", a phrase that's been persistent throughout the media coverage since the beginning. Today's articles about the 30th British victim all say this, with the Guardian, the BBC, Reuters, the Mirror, the Sun, the Times and everyone else all quoting Scottish health secretary Nicola Sturgeon, who said:

"As we have seen in previous cases, this patient was suffering from underlying health conditions and her death should not cause alarm among the general population.

"Fortunately, for the vast majority of people who have H1N1, they will experience relatively mild symptoms and make a full recovery."
The scaremongering witch! This is pretty typical of the reporting though; the underlying health complications are always reported somewhere (since they're usually in the AP/Reuters articles everyone copies) and always stressed by spokespeople where appropriate. The reality is, though, that "underlying health complications" doesn't fit well with snappy headlines, whereas "65,000 deaths" does.

So who's really losing a sense of perspective here? For me it's people like Jenkins, desperate to downplay all risks, and hyping up the 65,000 figure by acting like it was Sir Donaldson's primary claim, when indeed he knows that the media focus is what made it stick out. Jenkins seems to have adopted a contrarian position here, when the bottom line is, we don't know how bad this is going to be. To take such a committed "bah, storm in a bloody teacup!" stance is just as daft as sticking the 65,000 deaths thing in your headline and panicking your readers. Combatting perceived nonsense with hyperbole of your own (for example, Jenkins' suggestion that Donaldson "terrorised" ministers), isn't fucking helping. It just contributes to a ludicrously unnecessary split between apparently fanatical swine flu believers on the one hand and eye-rolling naysayers on the other. What we need is more articles like Ben Goldacre's from around the time of Jenkins' first piece, which strike the right tone between the extremes. I won't be holding my breath, though. EVEN THOUGH NU LIEBORE WILL PROBABLY TELL US ALL TO START HOLDING OUR BREATH SOON SO WE DON'T BREATHE IN TEH DEADLY PIG FLU ZOMG


  1. This is the man who also wrote in the Times that HIV was not related to AIDS. You'd think he'd have learnt to keep his uninformed mouth shut by now.

  2. "Many of people might indeed die of flu, but they might also die of a nuclear attack, an asteroid strike or a dozen other diseases and accidents now receiving lower priority." It this guy nuts? With the level of health & safety trainings (you almost need a certificate to use a ladder at work today), he's reasoning is, that many people might die of other diseases or accidents, so why bother being prepared at all. A bit childish.