Scott McPherson's Web Presence

A recent blog, where I predicted that several hundred thousand Americans could perish from a fall/winter resurgence of pandemic H1N1, caused more than a little angst at home and abroad. Several times, I was called upon (and called out) to defend my numbers and my methodology.

Hopefully, I have accomplished that, and I thank my readers who jumped to my aid with their own corroborating sets of data.  Most of their work shamed my own, and this speaks to the power of the Internet to connect persons who in any other time would have had great difficulty getting their voices and comments heard.

The most recent confirmation came from the British government itself.  The headlines (picked up by the Drudge Report) speak of 65,000 dead Britons at the pandemic's conclusion.  Read my previous blog on that topic for more information.

Two recent news stories help to make my argument that the current case fatality rate, or CFR, from swine H1N1v influenza is sufficient to use for calculating mortality.

The first story would seemingly refute my contention. From BBC News (my edits):

The government must map the spread of swine flu more accurately in order to predict the number of people who are likely to die from it, scientists say.

Researchers at Imperial College say data is vital to ensure the country is "best prepared to fight the pandemic". They predict that one in 200 people who get swine flu badly enough to need medical help could go on to die. (bold mine)

But the government's chief medical adviser said there was "no reason" to focus on establishing a single figure. Meanwhile, the BBC understands that vaccines may not be ready until later than the government had predicted. (bold mine)

Medical correspondent Fergus Walsh said World Health Organisation officials expected the first stocks to be available in September or October, not August as ministers had said. In any event, it will be the end of the year at least (bold mine) before there are sufficient quantities to immunise half of the UK population.

Chief medical officer Liam Donaldson also told the BBC that to cope with "the height of the pandemic", the government was considering changing the rules to speed up the death certification process for swine flu victims.

"We want to try and reduce as much as possible the burden of work on doctors and we are considering all sorts of things which will help will that," he said. "That's one of the options that's being looked at."

Margin of error

Accurate predictions about the number of deaths likely to occur from swine flu are not yet available. Current estimates suggest it is about as virulent as some types of seasonal flu, but far less deadly than some previous flu pandemics.

Any estimates about swine flu are subject to a wide margin of error, not least because not everyone who catches it develops symptoms. But despite the difficulties, the Imperial College scientists - who are advising the government on its swine flu strategy - say more accurate mapping of the spread of the virus must be carried out if it is to be effectively managed.

Their work is published in the British Medical Journal.

Dr Tini Garske said: "If we fail to get an accurate prediction of severity, we will not be providing healthcare planners, doctors and nurses, with the information that they need to ensure they are best prepared to fight the pandemic as we head into the flu season this autumn."

She said data must be collected "according to well designed study protocols and analysed in a more sophisticated way than is frequently being performed at present".

'Only an estimate'

Not everyone who is infected with swine flu will become ill enough to report their case to a doctor. Of the proportion who do, scientists predict that 0.5% of them - one in 200 - could go on to die. (bold mine)

Health Secretary Andy Burnham has said in the worst case there could be 100,000 new cases of swine flu a day later in the year, although many of these may not fall seriously ill.

The BBC story mentions that Imperial College scientists forecast a case fatality rate of .005, or .5% of those infected.  That is a rate comparable to the current US CFR, and 175% larger than the just-released, official UK government estimate of overall dead at this pandemic's conclusion (see my last blog).  So while casting aspersions upon the practice of using what public health practitioners consider to be too small numbers, they are nonetheless validating the math in their own estimates.  Curious.

This is the second official British source that is predicting a major viral event for that nation this fall and winter.

The second article (I promised you two) deals with the mysterious case of the British family doctor who tested positive for swine flu, died, and his death was ruled "natural causes!"  The best critique of this comes from Revere of Effect Measure.   How the local authorities could arrive at this conclusion is both mystifying and troubling.  It serves to validate my blog of a couple weeks ago where I said the actual number of deaths in this country from swine H1 was/is much higher than is being reported.  Mistakes (or apparent mistakes) such as what happened in England with this General Practitioner, or GP, are easily duplicated here.

What makes the British episode so unfathomable is that it happened in the media equivalent of scorchingly broad daylight.  The British press is possibly the best-tuned toward swine flu coverage anywhere in the world right now, and the proclamation that this hapless GP died of "natural causes" when at least three of the symptoms he had could have been exacerbated by influenza, is unbelievable. Those symptoms -- heart disease (flu can cause heart attacks and strokes), viral pneumonia (DUH!) and pulminary embolisms (blood clots in lungs) are all known secondary medical issues exploited by influenza.  So are MRSA infections, bacterial pneumonia, encephalitis, and deaths from COPD.  So is diabetes.  So is HIV/AIDS.

Now how many persons in this country alone might have been misdiagnosed as heart attack patients, stroke patients, MRSA patients, and the like?  You tell me.