Matt Yglesias

In Defense of Flu Vigilance

Now that the “swine flu” epidemic is maybe looking not-so-bad, there are signs in the air of a backlash against the speed with which the US government, the World Health Organization, and other government agencies worked to ring the alarm bell. I think that would be a big mistake. Part of the essence of the emergence of a new flu strain is that you can’t get a solid, statistically valid sense of how deadly it is until it’s already infected tons and tons of people. But by then it’s way too late to ring the alarm. You need to act, in the first instance, on the fact that a new flu strain could be extremely dangerous so it’s highly desirable to stop it from spreading widely.

Second, the way you stop a flu virus from spreading widely is that you’ve got to raise the level of public concern. There are several billion people living on the planet earth. If each of them becomes a bit more vigilant about washing their hands, a bit more vigilant about staying home from school or work from feeling ill, a bit more hesitant to travel to infection hotspots, a bit more careful about where they sneeze, etc., that all can ad up to a big reduction in the transmission rate. And if it works, you sit back and say “oh, well, I got all panicked over nothing.” But while it’s never good to panic, people haven’t been concerned over nothing—they’ve been concerned over the fact that unless people start acting more concerned, something bad could happen. But a prudent level of concern can solve the problem. That’s the system working, not a pointless gesture.

Mexico’s Quality Flu Response

Tyler Cowen observes that the Mexican government, which doesn’t always have the best performance, seems to have handled the swine flu episode quite well:

I hesitate to speak too soon but I’m actually somewhat impressed by how the Mexican government, at least at the national level, has responded. There have been many failures of Mexican health care systems at local levels but keep a few things in mind: a) some of the problems lie with citizens who won’t go see doctors, or who won’t go see non-shaman doctors, b) too many Mexicans self-administer antibiotics, and c) when there is so much air pollution it is harder to discover flu cases, especially in the midst of flu season there. Nonetheless Mexican reporting systems seem to have discovered an unusual flu fairly promptly.

Once the national government discovered what is going on, they acted decisively and without undue panic. There has been very little denial, a common feature in the early stages of health crises (how long was it until the U.S. government acknowledged AIDS?). No one is treating the Mexican federal government like a banana republic or a basket case or thinking that the Canadian government would have done so much better.

I think this is about right. Certainly in comparison with how the Chinese government handled SARS and the avian flu outbreak, the Mexicans seem to be acting responsibly and effectively.

Swine Flu and Industrial Agriculture

There’s been a great uptick in interest over the past couple of years in the environmental and ethical problems with the ways animals are conventionally raised in modern industrial agriculture settings. That, combined with the rise of swine flu, has naturally led to interest in the issue of whether or not the emergence and spread of the H1N1 virus is linked to pig Concentrated Animal Feeding Operations (CAFOs) in some damning way. Grist is hosting an interesting debate on the subject, with Tom Philpott making the case for links and Merritt Clifton pushing back and saying the evidence really isn’t in.

I’m not an expert, but my understanding of the general issue of animal-to-human flu strain “jumps” is that it is related to agriculture, but not necessarily to the CAFO question. The reason these transmission cases typical involve chickens (”avian flu”) or pigs (”swine flu”) is that these are the animals most commonly raised by man. And chicken and pig viruses are subject to animal-to-human transmission in part because it’s common for people and their animals to be living in extremely close quarters in the developed world. It’s true that strict adherence to humane treatment of free range animals would mitigate that risk. But the locus of the problem is less the state-of-the-art developed world CAFOs than it is developing world agricultural practices.

That’s in general. Of course in general these things also usually happen in Asia, where those practices are widespread. Since this particular flu arose in Mexico, where conditions are different, it’s not unreasonable to think that the circumstances of origin are different.

Biden and Airplanes

I guess I’ll just say that I’m a bit surprised it’s taken Joe Biden this long to say something dumb. The Vice President has a lot of virtues, but I would suggest not using him as a surrogate in circumstances where you need to walk a very fine line between expressing concern and not sparking panic.

America’s Employer-Friendly Labor Market Conditions Imperil Public Health

The Centers for Disease Control sensibly suggests that in these times of swine flu, if you get sick you should stay home rather than spread the disease to your coworkers:

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Which is nice for those people whose employers provide them with paid sick days. But as Pat Garofalo points out not that many people have employers who provide them with paid sick days:

Currently, nearly 50 percent of private-sector workers have no paid sick days. For low-income workers, the number jumps to 76 percent, and climbs to 86 percent for food service workers. These workers have to decide between the health of themselves and their co-workers, and the wages that they lose by staying home.

In other words, on any given day a large proportion of sick food service workers are going to find themselves unable to afford to take the day off, endangering the health of everyone else. This bill from Ted Kennedy and Rosa DeLauro would “guarantee workers up to seven paid sick days a year to recover from an illness or care for a sick family member.”