Random thoughts and rumors

I'm sure all of us have been keeping up with the Swine Flu story as it circulates through the media cycle. As with any "crisis", whether "real" or "contrived", the news becomes confusing and difficult to follow. I'm not sure we know much more than we did over the weekend. Its still too early to know how this will play out. Random thoughts:

- The US cases continue to be relatively mild. The overall numbers at this point are quite unremarkable. Its hard to know the number of deaths in Mexico because different methods for determining an "official" death are in use. We have "suspected" deaths from the flu (based on the clinical course), we have "confirmed" deaths from this flu and getting a firm grip on the situation is VERY difficult at this point.

- The rhetoric from CDC and WHO is almost alarming. Based on the clinical data to date, it still seems unusual. What, on the surface appears as a "garden variety" flu is being treated as if thousands upon thousands have died at this point. My question, at this point is "why?". What do we NOT know about this? Is something being kept from the public? Is information being withheld in order to avoid public panic?

- Perhaps the "alarm" we see, is solely based on the early information coming from Mexico, which initially seemed worse than it is now. Once the process was started by the various medical groups (CDC, FDA, WHO, etc) it was hard to stop, and thus we find ourselves in the situation we're now in - responding as if it IS an emergency, although it is not (at this point).

- Perhaps this virus appropriately scared these groups because it has several features which appear similar to the "Spanish Flu" of 1918. If this is the case, the fear may be a mutation which takes this highly contageous virus into a more pathological form. This did happen with the Spanish Flu, so perhaps the fear is such a mutation - and the rhetoric we see daily is based on this possibility.

- Even considering the above possibilities - by viewing the alarming rhetoric as compared to the actual data - something still doesn't seem right. It is hard to determine; perhaps because there is a relative lack of information, and because it is still very early in the process.

There are many rumors, most of which are probably not true, but with a relative lack of information they may be worth exploring. There are some (unverified) reports from physicians that there are many many more cases which are not being reported - Emergency Rooms and medical clinics are being filled with these patients and many deaths will be seen soon. On the other hand, there are rumors that this is a "created crisis" and it will be used for other purposes.

Its still VERY early in this whole process. I still contend that we'll know a lot more in a matter of weeks. However, the caveat for this idea, is that a mutation in the virus could appear at almost any time over the coming months, changing the entire scenario very quickly. In that aspect, we could see this virus come back weeks later in a much more pathologic form, even after this story gets bumped from the front pages.

That puts us back to a "wait and see" approach. At this point, by simply looking at the cases in the U.S., which are all mild and self-limiting; this flu doesn't apppear to be a great concern. At this early stage however, things can change dramatically in a matter of days.

As far as prophecy, this is just one of many stories involving infectious disease. Another sign of the times.