We’re all going to die – but probably not of swine flu

IF THERE is one thing that has spread far faster than swine flu in recent weeks, it is fear of swine flu. The newspapers are full of it, governments are working themselves into a frenzy over it and Mexico’s tourist industry is collapsing under the strain. Meanwhile, people are dying – but not nearly as many as you might think.

Last week, craving a dose of the entertaining bombast of American TV news reporting, I tuned in to CNN’s Situation Room politics show. I wasn’t disappointed. Greeting me on the screen was a bloodcurdling banner proclaiming the “breaking news” of the moment: “Humanity under threat”. CNN’s team of political commentators, quite clearly out of their depths, were doing their best to mask their ignorance while offering sombre platitudes about the seriousness of humankind’s predicament.

At that stage, just one American had died of the disease.

Lack of knowledge breeds fear. When new diseases arise – which happens more often than you might think – we inevitably prepare for the worst because we don’t know what to expect. It’s not an irrational reaction – AIDS, which appeared, to all intents and purposes, out of nowhere, spread like wildfire and killed millions. SARS, the pneumonia-like disease which emerged in China in 2003, came perilously close to spreading uncontrollably across the world – although it eventually petered out after causing about 800 deaths.

However, new diseases, or new strains of existing diseases, are not necessarily all that serious even if they do infect many people. The word “pandemic” is widely misunderstood, perhaps because of its associations with HIV and with the 1918 Spanish flu. But the word is not an expression of how deadly a disease is, but of how widespread it is – the World Health Organisation’s definition is merely that there is sustained person-to-person infection of a particular strain in more than one country. It is actually quite possible for a flu pandemic to cause fewer deaths than the normal seasonal flu that hits every winter.

Whether this outbreak of flu will be a bad one is, to quote Donald Rumsfeld, a known unknown. We don’t yet know enough about the behaviour of the virus or its spread to make a proper assessment. For a disease that has only been on the radar for a few weeks, this is hardly surprising – we should be surprised that we know so much about it, not that we know so little. But what we can predict is that the outlook, at least for citizens of rich countries in the northern hemisphere, is not a cause for serious concern. This is down to a little good planning and a great deal of luck.

In terms of government responses, Britain’s has been, whisper it, not too bad. While there has unquestionably been some degree of overreaction, the basics of British Government policy towards swine flu are sound: to prevent the spread of the disease by closing down affected schools and institutions, warning against travel to affected areas, and using anti-viral drugs like Tamiflu where they are needed. Contingency measures – such as planning for A-levels to be awarded based on coursework in the case of widespread school closures – have been mostly just a matter of common sense forward planning.

In terms of sheer luck, Britain hasn’t done too badly either. Our stocks of Tamiflu are high not because Department of Health mandarins predicted the outbreak and acted accordingly, but because of previous scares about Asian bird flu that came to nothing. And we have plenty of time to prepare for the winter flu season simply because of the time of year at which the virus emerged (the southern hemisphere, now at the start of winter, is not so lucky). With a bit more good fortune, we should have time to prepare vaccines in time for the northern hemisphere winter.

On top of all this we have a well functioning health service with no barriers to access due to doctors’ fees or scarce facilities. Mexico’s health system has struggled to respond to the epidemic and has undoubtedly worsened the disease’s impact as a result.

Besides, the early signs are that the disease is not particularly virulent, and outside of Mexico, only two people have died. Even in Mexico, which is struggling to cope with the outbreak, an estimated 99 per cent of people infected have survived. The accounts of British survivors – or at least those who haven’t sold their stories to Max Clifford – suggest that for many patients, it’s not much worse than a cold.

All of this suggests that, even if the strain is more virulent than we expect, fears of a 1918-style catastrophe are wide of the mark. We are far better prepared than our forebears were and it would take a great deal of bad luck for this to cause more than a moderate spike in deaths in Britain. If tens of millions die like they did 90 years ago – assuming I am not among them – I will eat this page. And I will never again mock CNN.