Swine H1N1 flu case fatality rate is edging higher worldwide

From Scott McPherson's Web Presence:

July 13, 2009

I don't know how many of you have caught this or done the math, but the case fatality rate (CFR) from swine flu has actually increased, at both global levels and within the United States.

The published global CFR in late June was plugging along at .002, while the US CFR was at .0045. Now, the US CFR is .0056, and the global CFR is at .0045. So the world has caught up with America in terms of its death rate, and the figure of .0045 places this pandemic squarely within the HHS Category Two pandemic status. But the threshold to Category 3 status is .0051. For the past two weeks, the US CFR has exceeded the Category 3 benchmark. Like the hurricane that spawned this HHS analogy, those winds -- and deaths -- have to be sustained. The next few weeks will tell us if we are seeing a drop in the CFR, or if the numbers are holding steady. That may also signal the waning of the pandemic's first wave.

These death numbers do not sound large until you look at large numbers. If the current CFR holds, by the end of the pandemic, we could be looking at over 400,000 dead in the United States alone. In Florida, for example, the final death toll could reach 30,000.

This is probably why the WHO has chosen its words very carefully when describing this pandemic as "moderate" and not as "mild."

How is this possible, you ask? Swine H1 is "mild," the public health authorities are telling us! You are even hearing the words "no worse than seasonal flu" mentioned!

I would answer this way: First, read Dr. Kawaoka's analysis of swine flu in today's/tomorrow's papers. Second, re-read my blog about totally botched risk communication, and Google/read Dr. Sandman's similar remarks about recent botched risk communication. Third, remember we are in the beginning stages of a global health crisis that will take at least eighteen months to finally play out.

Pandemics are not for institutions with ADD, nor are they for institutions who like quick resolutions at the end of a 60-minute show. Nor are they for institutions who demand happy endings, unless you count the conclusion itself as happy. They are slow, historic, and life-changing events. We should treat them and respect them as such.