Wednesday, August 5, 2009

Quick -- How Lethal is H1N1?

Headlines based on an update yesterday from the World Health Organization include "Global Swine Flu Deaths Top 1,100" (CNN), "WHO Says Swine Flu Death Surge to 1,154" (New York Times), and "Swine Flu Death Toll Climbs to 1,154" (Wall Street Journal). So, this is a quiz, how does the mortality rate of H1N1 compare to seasonal flu? How does it compare to the death rate of the 1918 flu pandemic? Don't feel bad if you don't know. No one seems to be bothering to tell you.

At this point, most of us have heard the statistic that 36,000 Americans die every year from seasonal flu. What we don't have is some point of comparison to how many people actually get seasonal flu. So I did some digging. And I came up fairly empty. The best information I came up with was from the CDC, which says that between 5% and 20% of the U.S. population gets the flu each year. That comes out to a mortality rate of somewhere between .06% and .2%. The new numbers from the WHO come out to a mortality rate of .7%, which is anywhere from 3 to 12 times more lethal than a typical seasonal flu is in the United States.

The problem, of course, is that we don't have accurate figures on how many people have had H1N1 so far, or on how many people get seasonal flu each year. That's because most people don't get tested. Think about it. Have you ever had the flu? Did you get tested?

By the way, if you're wondering about the "Spanish Flu" of 1918, it had a mortality rate estimated between 10% and 20%, which I think we can all agree is much worse than anything we're talking about here.

So H1N1 may well be worse than seasonal flu, and that is definitely worth reporting. It would just be nice if the media bothered to report it in some context where the numbers actually mean something. Reporting a raw death toll tells you that 1,154 people have died. And I am sorry to hear that. But it doesn't tell you anything about how dangerous this virus is, and I'm guessing that's what most people want to know. Worse yet, unless you think carefully about it, it's easy to think that you know how dangerous H1N1 is just based on the death toll, and that's what leads people to react based on gut instinct rather than facts. And that's the last thing we need.

(Related Quarterbacking here)


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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