Home > Uncategorized > Earning trust vs. the myth of containment

Earning trust vs. the myth of containment

April 26, 2009

You may have heard of the Swine Flu epidemic, which has been found in Mexico, California (surprise) and New Zealand. It’s a nasty H1N1 virus that’s killing even young, healthy people.  Not quite bird flu (which fortunately hasn’t mutated to move from person-to-person yet) but bad enough.

Every time there’s an outbreak of disease, some wise person thinks of containment.  We found it in Mexico?  Don’t let anyone in from Mexico!  Yeah! It’s an age-old idea that you just snap the lid down on an area and (too bad for the people there) stop the disease in its tracks.

Except it didn’t work for plague in the 15th century, and it won’t work for swine flu from Mexico in the 21st century.  From the Effect Measure public health blog:

Add to this two additional cases in California, bringing the US total of lab confirmed cases to 11…

Now for the zombie idea (promoted to some extent by WHO) that we could ever bottle up an incipient flu pandemic by containing it at the source. As we have pointed out here too many times to count, that never was in the cards for a disease that hides itself in the background noise of prevalent respiratory disease, is difficult to diagnose, and for which there is little good surveillance in most countries. But because it was held out as a possibility, there is a faint whiff of recrimination in current news accounts…

All you have to do is look at the animation of world air traffic to know why: 

And that’s how it wound up in New Zealand! But there are other reasons as well, such as that in our transportation-rich world, people will move hell and high water to get out of a quarantine zone, all the while denying to themselves that their achy feeling and sniffles are the first two hours of swine flue.  For quarantine to work, a disease must have extremely short latency and be easy to diagnose.  That doesn’t work out to a lot of diseases. 

This is not to say we can’t improve the situation, but it’ll be a lot more complicated than just stopping people from traveling:

In the paper, “Modeling Targeted Layered Containment of an Influenza Pandemic in the USA,” members of the MIDAS Working Group on Modeling Pandemic Influenza concluded that a timely implementation of targeted household antiviral prevention measures and a reduction in contact between individuals could substantially lower the spread of the disease until a vaccine was available.

The groups coordinated efforts to each create individual-based, computer simulation models to examine the impact of the same set of intervention strategies used during a pandemic outbreak in a population similar in size to Chicago, which has about 8.6 million residents…

 

“…could substantially lower the spread of the disease until a vaccine becomes available.”  Not stop it, and if no vaccine is available, then the disease still ends up going wherever it wants to.  The simulations are hellishly complicated, including social network analysis, traffic, shipping, conventions, and probably the kitchen sink. 

There’s even a project to popularize the understanding of pandemics, all so the spread of the disease can be slowed.  To buy time.  That’s the game. Or part of it, anyway, because the vaccine must be created anew, manufactured in bulk, and distributed.  And people convinced to take it.  Which means the trust relationship with their governments must be carefully maintained in the off-season.  That means governments need to be competent and trustworthy.  Nepotism, cronyism, putting the “heckuva job” Michael D. Browns of the word in charge of federal agencies to pay off political debts… will end up killing people.  Maybe lots and lots of people.


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Categories: Uncategorized
  1. April 26, 2009 at 10:28 | #1

    My initial reaction to the blown out of proportion news stories is WTF! After reading only a couple articles passed around on Google Reader it became obvious just how ridiculous the TV news has been. Which I think it’s wrong to play up fears for ratings and such. Then again, when it comes to pandemics, is it okay for such actions to be taken? In other words, is it okay to play up the risks and outcomes to keep it in the back of people’s mind. So that if they start coughing, maybe they will go to a hospital.

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