Compared to what?

H1N1 overplayed by media, public health: MDs

Public health officials and journalists have overstated the importance of the swine flu, a former Ontario chief medical officer of health says.

Dr. Richard Schabas, chief medical officer of health for Hastings and Prince Edward Counties in eastern Ontario, said the H1N1 influenza outbreak needs to be put into proper perspective.

About 200,000 people die in Canada every year from all causes combined, including about 4,000 from seasonal flu.

“By the time all the dust has settled on H1N1, somewhere between 200 and 300 people will have died in this country,” Schabas said Thursday during a panel on media coverage of H1N1 on CBC-TV’s The National.

The panel also looked at the front-page coverage given to the death of Evan Frustaglio, a 13-year-old hockey player from Toronto. Evan died on the eve of the H1N1 vaccine becoming available, and demand for the vaccine jumped overnight, catching health officials by surprise.

A healthy child in Canada is about 20 times more likely to be killed by a car than by the H1N1 virus, Schabas said, but that isn’t going to make the national news…

So, a wildly over-played “crisis” to begin with. What of the other main media story-line, the allegedly incompetent handling of the crisis by public health authorities, notably the feds?

A great many commenters on this site seem quite certain they know how fast authorities “should have” responded, when vaccinations “should have” begun, etc. They are, of course, talking through their hats: they have no idea how long it takes to develop a vaccine, what sorts of consultations governments are obliged to engage in before deploying them, what sort of testing they have to undergo, etc.

Neither do I. But it seems to me the only sensible way to measure these things is in relative terms. Is 200 deaths a lot, or a little? Set beside the 4,000 who die every year of ordinary flu, it looks less terrifying. LIkewise, a plausible benchmark for how long something “should have” taken is how long it took in other countries. That’s not giving anybody a “pass.” You can still fail even if you’re graded on a bell curve.

I’ve already commented on the situation in the States, where at latest count they’ve delivered 38 million doses, or roughtly half as many, per capita, as in Canada. Stories of vaccine shortages are all over the US media. A quick sampler:

US faces swine flu vaccine shortage
NPR: Swine Flu Vaccine Shortage: Why? « Flu News Network
Swine flu vaccine supplies are growing, but flu is still spreading | Los Angeles Times
The Associated Press: Poll: One-third can find, get swine flu vaccine
Cornyn rips White House over H1N1 vaccine
White House Defends Its Response to H1N1 Outbreak
Minimal H1N1 vaccines leaves nation up in arms
The vaccine screw-up —

etc etc. Meanwhile, in Britain:

Swine flu vaccine jabs hit by delays

THE Scottish Government’s swine flu jab programme was condemned as “descending into chaos” yesterday, with vulnerable patients facing weeks of delays before they are vaccinated.

On the other hand, this story makes it out that there are no lineups in Europe — because they’re only vaccinating the high-risk cases. By invitation, no less. To vaccinate substantially all of the population by Christmas, as we are proposing to do, is hugely ambitious. China hopes to vaccinate five percent of its population in the same time frame.

Another reason the Europeans have avoided line-ups: mass indifference, similar to the situation here before Evan Frustaglio’s death. In France, for example, just 17% plan to get vaccinated; Germany, 13%.

Were we late getting started? Britain — though it ordered 90 million doses back in May — only began making them available October 21, two days before Canada. It initially shipped 5 million doses — fewer than Canada, which has just over half the population. France has thus far vaccinated only health care workers; it will start issuing “invitations” to high-risk groups next week.

Around the world, the WHO reports, only some 20-odd countries have launched vaccination programs of any kind, let alone on the scale attempted in Canada. This story reports vaccination programs “started in some European countries in recent weeks” but were “too late to halt the disease.” Meanwhille, public health experts in this country anticipate the epidemic could peak within days.

Worldwide, a recent poll indicates that “more than one-third of international physicians are anticipating a shortage of the H1N1 vaccine this fall in their country.”

In sum, other countries have been as slow or slower to roll out their own vaccination programs; where there have been shorter lineups, it is generally because the programs have been much less ambitious. The notion that our program has been especially incompetent is just not supportable.