Friday, May 01, 2009

Swine Flu

Is the swine flu already making us nuts? Consider the following, from Reuters:
:BOSTON — A flight from Munich, Germany to Washington has been diverted to Boston because a passenger complained of "flu-like symptoms."

Airport spokesman Phil Orlandella said United flight 903 was being diverted to Boston early Friday afternoon after a 53-year-old female passenger told flight attendants about her symptoms.

He said the flight had 245 passengers and 6 crew members. The flight had been scheduled to land at Washington Dulles International Airport later Friday.

It is not clear to me why, even if it were true that a swine-flu patient were on board the plane, it would be better to send it to Boston instead of Washington. But the larger question is whether swine flu is the sort of event that merits this kind of hysteria. Mark Steyn has also bought into it:

Well, you know, we’re, historically speaking, we’re overdue for one of these killer flues, not necessarily something on the scale of 1918, but certainly a big, global pandemic. And of course, what’s changed since 1918 is we’re now in the era of mass transportation, where people go from one end of the world to another. If you remember the SARS, the little SARS epidemic thing from five years ago, five or six years ago, that basically leapt across the planet very fast, from rural China, somebody went up and stayed in a fancy hotel in Hong Kong, infected everybody, I think, in the elevator and the bathroom, public bathrooms of that hotel, and they all then flew on, brought it to Toronto and killed a big, whole mass of people in Toronto. So I think if this thing does get around that fast, then we are looking at potentially something very serious.

The world, or at least that part of it excessively influenced by the media, appears to be in the grip of what we might call the mania of the epidemiologists. Epidemiologists study models of disease spread, and like many scientific models they are useful to point. But like all scientific models, at some point they cease to be useful. We appear to be rapidly reaching that point. Several years ago I wrote a post on the implications of globalization for the spread of new diseases. I argued that the rapidity with which a disease spreads, relative to our historical examples, is a function of forces promoting acceleration and forces promoting deceleration. Among the forces of acceleration are the intrinsic infectiousness of the new agent and the ease with which people can travel from one place to another. The former is essentially unpredictable (although perhaps it becomes more prominent than before due to changes in human society that make the generation of new lethal viruses easier, e.g. through the close proximity of humans and large factory farms). The latter, clearly, has become more powerful in recent years as transportation has become easier.

This is what promotes the doomsdayism of the Steyn sort. But there is more to it than that. The two deadly epidemics that "everyone" knows something about are the Spanish flu epidemic of 1918-1920 and the European Black Death. If acceleration is all you pay attention to, then enhanced propensity to spread, combined with unavoidable periodic generation of new lethal agents, equals disaster.

But the forces of deceleration are far more powerful than they were even 30 years ago. The world has a vast network of (dastardly) drug companies capable of ramping up production of new medicines, provided only that they are paid enough to cover the cost. There is now a vast medical-research apparatus that spans the globe -- in America, in Europe, and Japan, and increasingly elsewhere in East Asia. Our abilities to unravel the mysteries of any particular agent, and then to take advantage of the immense power of a decentralized global economy to distribute remedies, themselves generated much more rapidly than before by the global knowledge system, make addressing outbreaks far easier than before.

Monitoring too is far easier than before. Identifying the virus, figuring out who has it, and figuring out how it is likely to spread are made easier by the same medical-research infrastructure referred to above. But most critical of all is the fact that we are simply much wealthier now than we were in 1918, or in the Middle Ages. And wealth has both accidentally and intentionally inserted into society many breakwaters that slow the spread of the disease. Consider the typical airport public restroom. It is frequently operated on an entirely hands-free basis. Instead of having to push a door open, you walk in through an open gateway, make a turn to ensure the bathroom’s privacy, and then once inside find a bathroom where the toilets, the sinks, the soap dispensers, and the paper-towel dispenser do not require you to touch anything. No one had swine flu in mind when they designed this, but it will have the effect of slowing its spread just the same. Masks are much more available and very affordable, even if they are not 100% effective. Suburbs lower population density, meaning that one infected person is likely to get fewer people sick than he would have 100 years ago in an urban slum.

Dangerous new diseases will undoubtedly spring up from time to time. But epidemiological models, or at least the public perception of them, are badly amiss. There is no reason to shut down global travel because of some oversimplified model that says merely that one person is a vector that invariably infects n other people. Greater wealth means that all sorts of things that used to pose mortal threats to civilization don't anymore. Earthquakes do us less damage than when we were poor. So do pirates, telegenic though their barbarisms be. And so does the swine flu.


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