Don’t Rely on Tamiflu to Save You

The swine flu’s turning out to be a bit of a bust so far – no vaccine, but on the other hand, not quite as deadly as regular flu. O’ course, the 1918 pandemic followed Aristotle’s great rule of drama, too, so we can’t get complacent just yet.

We also don’t need to riot in the streets if we run out of Tamiflu:

Look I don’t want to freak you out, since Tamiflu is the one thing which everyone believes will save us from Parmageddon, but I’ve been reading through the published trial data on the drug, and I’m not sure it’s all that great.The Cochrane Library is one of the greatest inventions of modern humankind. It’s all very well to do a trial, or lots of little trials, but one trial, simply by chance, might give a false negative, incorrectly missing a true benefit from an effective treatment; or one trial might falsely find a benefit from an ineffective treatment, either by chance, or because the study was designed so badly that it not longer represented a “fair test” of the intervention, against whatever you were comparing it to.

[snip]

Handily, there is a Cochrane review on Tamiflu, and a similar drug called Relenza.

There is indeed. You’ll have to go visit Ben Goldacre’s blog for the results, but the upshot is this: Tamiflu and Relenza will help you recover from the flu about 17 hours earlier than otherwise. They both do a pretty good job preventing symptomatic influenza. But they’re not magic bullets. So don’t hold your doc at gunpoint trying to get them. And don’t panic when some fear-mongering reporters start screaming “We’re out of Tamiflu! We’re all gonna diiiieeeee!!11!1!

Just wash your hands frequently, stay away from sneezy people, tell panicking pundits to go fuck themselves, and don’t go wallowing in pig pens, and you’ll be fine.

Pork Pushers Demand Name Change for Swine Flu

Funny. I don’t remember chicken farmers whining over avian flu being called avian flu. You’d think pork producers would be just as tough. Yet here they are, squealing like stuck pigs:

That’s right, people. It’s not just Obama refusing to call SWINE Flu by its real name – namely, SWINE Flu – but on The Takeaway this morning I actually heard the airheads transition from saying SWINE Flu to calling it the H18237FN10DSND027E – HIke! virus or something. And they even admitted they were doing that because the oh-so-tenderized sensibilities of the men who control the meat industry believe that calling SWINE Flu “SWINE Flu” is bad for business.

Fine. So what if it is? As Tristero so graphically points out, industrial pig farms are breeding grounds for disease and environmental disaster. Perfect places to breed a deadly flu virus. Call a spade a spade.

Of course, there’s more to it than that:

Several commenters have objected to my refusal to accede to the wishes of corporate pork production and euphemize swine flu by calling it something else. Their argument is that calling swine flu “swine flu” harms small, independent pork producers. Farm Girl, who has studied food issues closely and certainly cares deeply about small, independent farming, agrees with me:
…Mexico’s swine flu (and keep calling it that, no matter what the National Pork Producers say…)

In responding to the objections, I also posted several links to scientists’ discussion of swine flu that make the point that the term is accurate (go here, here, and here, for example. ) In comments to my previous post, Glen Tomkins writes:

Long-established practice in the field is to characterize strains of Influenza A first and foremost by which species it attacks. Thus we have avian (or bird) flu, swine flu, horse flu, dog flu and human flu.

There are other ways to characterize a given strain, such as by which type of the two antigenic glycoproteins it displays, and by this scheme, this swine flu is H1N1, and the avian flu of recent concern is H5N1.

But characterization by the animal of origin is the more basic and informative classification, and the HxNx name should be used as the primary name only if we’re talking about a strain of human flu. The animal vs human flu distinction is the most basic and informative because strains of flu adapted to animals other than humans tend to behave very differently in humans than strains adapted to us. The animal strains tend to cause more severe illness and death, because of some combination of our not being well-adapted to them, and their being not well-adapted to us. A microbe that uses us as its meal plan does not want to kill the goose that lays the golden eggs,and tends to do so only insofar as it hasn’t “learned” any better by long practice at adapting to us. But these animal strains also tend to not spread as readily among humans, presumably because that trick, much like not killing us, also requires adaptation to our peculiarities.

So it’s “swine flu”, not because we have it in for the porciculturists among us, or even because “swine flu” is a sexier phrase for CNN to use than “H1N1 flu”, but because that’s the way the nomenclature works, and works most effectively to convey important differences in expected disease behavior that calling it “H1N1″ would fail to convey.

Exactly.

It strikes me as exceedingly weird to insist that we describe the agent of a potential pandemic with a pretentious, and less accurate, euphemism. To do so at the insistence of powerful corporations because it might hurt their profits is simply outrageous.

I’m with Tristero. Fuck the pork producers’ feelings. And no, they can’t shelter themselves behind the small farmers they push out of business. Don’t let them try it.

And now for something completely different:

Swine Flu Swine

Way to bring on the stupid, Arizona. Are you proud of electing these assclowns now?

In the wake of the swine flu outbreak, we have the inevitable calls for closing the borders with Mexico (h/t):

“A spokesman for Rep. Trent Franks, R-Ariz., said Wednesday night that Franks believes the border should be closed right now except in critical cases or situations involving emergency personnel.

Sen. John McCain, R-Ariz., said all options should be considered to end the crisis involving swine flu, “including closing the border if it would prevent further transmission of the deadly virus.”

In a twitter message early Wednesday, McCain wrote “I said to Napolitano, ‘We need to be prepared to close the border with Mexico if the swine flu outbreak escalates further.'””

Regrettably, this idiocy seems to be bipartisan:

“Rep. Eric Massa (D-N.Y.) said the border should be closed until the threat is resolved.

“The public needs to be aware of the serious threat of swine flu, and we need to close our borders to Mexico immediately and completely until this is resolved,” Massa said in a statement.”

Hilzoy points out that, aside from the fact the disease is already here and happily spreading, border closures probably won’t do jack diddly shit, for the simple reason we can’t seal the damned border:

Unfortunately, the flu is infectious for about a day before people develop symptoms. That means that any attempt to screen people at the border will not work. (So much for those heat sensors.) You’d have to keep everyone out, period. We can’t do that even without an influenza epidemic; I have no idea why anyone thinks we would suddenly be able to do it now.

Earlier today, Ezra linked to a World Bank review of the literature on containing pandemic flu. It explains the pros and cons of various measures, and estimates of their likely effect, quite well (if a bit wonkily.) The discussion of travel restrictions starts on p. 30, though some of the terminology is defined earlier. The takeaway message is that even very effective border controls, including shutting down almost all air traffic, would have very little effect.

Franks, McCain and Massa’s ability to understand the simple reality of pandemics: epic fail. And unfortunately, they don’t lose their jobs for egregious stupidity.

But there is good news. The swine flu has claimed a deserving victim:

Conservative talker Jay Severin was suspended indefinitely today by Boston’s WTKK-FM after using the current swine flu outbreak to attack Mexicans and immigrants. On his radio show, Severin blamed the swine flu on what he called “some of the world’s lowest of primitives in poor Mexico”…

And that was the least of what he said. Hey, WTKK? Can we stretch that “indefinite” suspension out for, oh, say, the next 30 years?

I do so hope the swine flu continues to bring out the worst in right-wing radio hosts. It would be lovely to see a gaggle of racist gits swell the unemployment lines.

Swine Flu: The Terrarists Diddit

Newest wingnut theory: the swine flu is a terrorist attack:

Larry Klayman and the Worldnutdaily are a perfect match. If Michelle Bachmann is the prom queen at Wingnuttia High School, Klayman is her king. His latest bit of lunacy is in claiming that the outbreak of swine flu is an act of biological warfare. And the Worldnutdaily calls him an “anti-terrorism expert.” No, seriously.

With 40 confirmed cases of swine flu in the U.S., an anti-terrorism expert is questioning whether the outbreak is an act of biological warfare.

Freedom Watch, a public interest watchdog, believes that there is a very good possibility that the precipitous outbreak of the virus in Mexico, which has now spread to the United States and other western countries, is not the result of happenstance – but terrorism.

Anti-terrorism expert? Klayman knows as much about anti-terrorism as I know about the art of Origami. He’s a lawyer. A really bad lawyer who loves filing silly lawsuits. He’s what Larry Fafarman would be if he could get the dosages right. And you’re going to love his “evidence” that swine flu is spreading as an act of terrorism:

“What could be more clever than planting the seed in neighboring Mexico and allowing it to spread to the United States?” Freedom Watch asked.

This is the kind of shit that third-rate hack writers dream up, not terrorists. Guess what the Worldnut Daily’s made up of?

So’s the HuffPo’s “health” section. And the swine flu’s got the woo-meisters swarming like starving cockroaches on a dropped dinner:

Take “Dr” Wegmann at that execrable waste of bytes, the Huffington Post. This guy can’t even write a title without lying: 3 Sure-Fire Strategies to Prevent the Swine Flu.

Hey, fuck face: we don’t know enough about this thing yet to use the hack phrase “sure-fire”. Of course, that doesn’t really matter to you, you lying sack of excrement-filled kishkes. The lies pour out of you like pus from a diabetic foot wound (but less bonum et laudum). You actually go on to recommend fucking glorified massage therapy to prevent the fucking flu! That’s not even wrong! You reason that since chiropractic enhances the immune system (according to some dude–what, did you hear that at the bar?), that it is a “sure-fire” way to prevent the flu.

Now, ignoring (if that is humanly possible) the fact that rubbing someone’s back cannot prevent an infectious disease, and ignoring the vacuously meaningless statement of “boosting immunity”, even if we could “boost immunity”, who’s to say that’s a good thing? One theory for why the Spanish Flu pandemic of 1918 killed so many young people and spared the very young and elderly (unlike the usual flu) is that their relatively more robust immune systems killed them by over-reacting.

I love watching PalMD beat the woo-meisters to death. It’s awesome. And I’m sure plenty of beatings will follow.

Terrorist plots. Massage for swine flu. I can hardly wait to see what they come up with next.

Swine Flu Advice and Such

Hilzoy brings us a wonderful guest post by the Ruths Karron and Faden:

At this point, it is impossible to predict whether we are on the brink of an influenza pandemic. The threat is real, however, and governments across the globe are working hard to mitigate the potential impact of swine flu.

This is right and proper. Our government has an obligation to protect the public’s health, which it exercised responsibly by declaring a national public health emergency on Sunday. This declaration is the public face of countless actions that federal, state, and local health authorities are now undertaking on our behalf. But these are not the only actions that will be needed. There are also actions that we as citizens must undertake to minimize the swine flu threat that will help us protect ourselves and our families. These actions are not only prudent; they are a matter of moral and civic responsibility. Just as our government has an obligation to protect the public’s health, we too have an obligation to our country and to our fellow human beings to do our share to minimize the burdens of this influenza outbreak.

What can each of us do?

Their list is simple, sensible, and a perfect way to assuage any panic you might find creeping up on you and yelling “BOO!”

In other news, Michael Steele has shared his own infinite wisdom with us. I’m sorry, did I say wisdom? I meant whining:

Republican National Committee chair Michael Steele defended GOP opposition to pandemic preparedness funding in the stimulus bill in an interview with CNN Tuesday, saying the party had no way of knowing that such a threat might actually materialize. “Did we know this at the time of the vote?” Steele asked. “Don’t come back and make this link six months after the fact … we don’t know what tomorrow holds.”

Really, Michael? We had no way of knowing such a threat might materialize? Do you not know Google-fu?

Apparently not.