Calibrating recollection with measured reality

A very interesting piece from James Lileks at The Bleat. I had been thinking about this earlier in the week. Why does Covid-19 sound different from Swine Flue, SARS, MERS and the other epidemics of the past couple of decades. I can't say that there is a difference, it just seems like it is being forced into a more excited and higher-pitched public conversation than in those earlier epidemics. Is it warranted? No idea. We are still too early in the cycle with insufficient information to be speaking with much confidence.

We can project based on past patterns of epidemics. We can estimate based on the early empirical data about infection rates, and mortality, and incubation, etc. But so far it is mostly guess work and things could go very bad or turn out to be much ado about nothing.

Just as with those earlier epidemics. Why does this one excite greater concern?

My recollection of the earlier cycles was that there were things that were in the headlines. We followed them. But it was all pretty dispassionate. Should we pay attention? Sure. Should take actions? Well, just be diligent about what is already common sense. Should we be alarmed? I don't think we ever got to that stage in the earlier incidents.

Am I just not remembering well? Quite possibly. I did not bother to research, but fortunately James Lileks did.

I suspect this will seem, in retrospect, as the last “normal” week. The one in which there was other news.

This doesn’t mean everything will be actually horrible. It means the news will be horrible, in that it gives a sense of a rapidly escalating catastrophe that produces mass unease and uncertainty.

A few weeks ago, I think, I mused about some previous pandemic about which I’d forgotten, except that I bought masks, and noted a run on rice at Costco, That was the Swine Flu pandemic, of course. It was declared by the WHO to be A Thing in June 2009. I decided to go back to the StarTribune archives to see how it played out. From what I recalled, there was concern, but nothing like we're seeing today. See if you recall any of this, or your local variant.

April 28: Front page Sunday story., "Is This the Big One, and Are We Ready Here?"

May: few stories, precautions relaxed.

June 9: the graduation ceremony for a local high school at Target Center was using fist bumps instead of handshakes. Front page story, written without alarm: just a sign of the times.

June 12: Front page lead story, with 30 cases reported per day.

It looks really bad:

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An epidemiologist quoted says it's not the Spanish Flu, "but we just don't know." Public health officials criticize the press for giving the flu too much attention earlier in the year, then soft-pedaling the story when the lethality appeared much less than advertised.

Article notes that half the people who died from the swine flu were "young and healthy."

Let's just imagine how the news would handle that fact with COVID19.

June 21: 10 kids get swine flu at Muscular Dystrophy Camp; national organization cancels all summer camps.

Aug 7 2009: Hennepin County “ramps up” for a swine-flu surge, after a summer hiatus; 252 people had been hospitalized for the flu; the hospitals were preparing for 30-40% absenteeism in hospital workers due to the flu.

Sept 17: Headline, in Metro: Flu Cases Rapidly increasing. Twenty-eight percent of students at Elementary school kept home with flu or flu-like illness! TWENTY-EIGHT PERCENT!

Oct 6: Healthy first-grader dies of the flu. Front page news.

Oct 29 four months after the declaration of the pandemic:

Click to enlarge.

This is the only result for "Obama Flu" in 2009, except for a story about the new CDC director, who was appointed in May.
The article notes in the third Graf that 46 states have been hit, and the national death toll is more than 1,000.

Nov 05: Local cases appear to have peaked, with 182 people hospitalized the previous week, as opposed to 225 the week before that.

Nov. 12: China’s “aggressive steps appear to be paying off,” with the flu, although it reported 5,000 new cases in the last three days.

December: flu vaccines recalled for ineffectiveness; third wave of H1N1 predicted.

Feb 2010: the only stories concern free shots, and the fact that the usual flu season had been quite mild.

Click to enlarge.
March 2010: It’s a joke on the weather page

April: three stories, one of which describes how mint leaves can loosen phlegm, another concerning some local basketball players who won’t be playing because of flu-like symptoms. A story on the 8th notes two more deaths, bringing the state total up to 70.

May: a story about Tiger Woods dropping out of a tournament, which he hadn’t done for a while; last time was years ago, when he had the flu.

The global death toll, by the time it was over, was estimated at over half a million people.

Not saying this is nothing; it's obviously serious. I also suspect the news will lack perspective, and we will get the sense that attempts to mitigate the spread are happening not because it could be bad for many, but because it already is horrible for most.

Just my impression.

That is interesting information.

There is also this from CNN's archives. H1N1 United States Fast Facts. That's the same epidemic Lileks was focused on.

(CNN)Here's a look at the H1N1 influenza virus, also known as swine flu. There was a pandemic outbreak across the globe which lasted from 2009 to 2010.

Human cases of H1N1 from April 2009-April 2010:
Fatalities in the United States - Estimated total is 12,469.

Fatalities Worldwide - A 2012 study estimated a range between 151,700 and 575,400 deaths.

Swine Flu:

Swine flu is a respiratory disease caused by type A influenza virus in pigs. Swine flu outbreaks are common in pig herds, but generally the disease causes few deaths in pigs.

Swine flu is transmitted between pigs through close contact and contact with contaminated objects. Flu spreads when someone touches an object coughed or sneezed on by an infected person and then touches his/her mouth or nose. However, swine flu cannot be passed from properly handled pork products to humans.

Swine flu outbreaks in pigs can occur at any time, but mostly occur during the late fall and winter months.
It is a constantly mutating virus. Pigs are susceptible to viruses from birds, humans and other swine. When different influenza viruses strike pigs, the genes can mutate and new viruses can develop.

In pigs, there are currently three common influenza A virus subtypes in the United States: H1N1, H1N2 and H3N2.

Swine Flu in Humans:
Swine flu occurs in people that are in contact with infected pigs. When this occurs, it is called a "variant influenza virus."

Symptoms are similar to that of regular human influenza and can include fever, lethargy, lack of appetite, coughing, runny nose, sore throat, nausea, vomiting and diarrhea.

Antiviral drugs that treat variant flu infections in humans are oseltamivir (Tamiflu), zanamivir (Relenza) and peramivir (Rapivab).

Timeline:
1930 - The swine flu virus (an influenza type A H1N1 virus) is first isolated from a pig.

1976 - Swine flu (Hsw1N1) breaks out among soldiers at Fort Dix in New Jersey. At least four soldiers are infected and one dies.

1976 - The United States begins a nationwide vaccination program against a type of swine flu known as Influenza A/New Jersey/76. However, the program is suspended after people who received shots develop a rare illness called Guillain-Barré syndrome.

September 1988 - A woman dies of the H1N1 flu virus days after visiting a county fair pig exhibition where there was widespread influenza-like illness among the swine.

December 2005-February 2009 - The Centers for Disease Control and Prevention reports 12 cases of swine flu among humans.

April 2009 - Swine influenza A (H1N1) virus is detected in a 10-year-old boy. CDC lab testing confirms the same virus in a second California child residing about 130 miles away from the first patient.

April 24, 2009 - The CDC issues an outbreak notice warning travelers of an increased health risk of swine flu in Central Mexico and Mexico City.

April 26, 2009 - The United States declares a public health emergency as cases of swine flu increase.

April 27, 2009 - World Health Organization (WHO) raises the influenza pandemic alert to a level 4, which means that there has been human-to-human transmission of the virus.

April 29, 2009 - WHO raises the influenza pandemic alert to a level 5, indicating sustained community-level outbreaks in two or more countries within the same region.

June 11, 2009 - WHO raises the influenza pandemic alert to a level 6. The outbreak is now being considered a global pandemic.

October 24, 2009 - US President Barack Obama declares the H1N1 outbreak a national emergency.

August 10, 2010 - WHO Director General Dr. Margaret Chan announces that the H1N1 outbreak has moved into the post-pandemic period.

June 26, 2012 - A study published in the Lancet Infectious Diseases journal estimates that the global death toll from the pandemic ranges between 151,700 and 575,400.

Net is that it feels like we were as equally aware of what turned out to be a serious but not especially damaging epidemic but that we had much less panic.

There are plenty of scenarios in which it will turn out to have been wise to take early and serious precautions.

But it also feels like there is a different communication dynamic going on today that is not similar to earlier outpbreaks.