Let's not get blue about swine flu

I had my graduation ceremony this past Tuesday at Georgian College. You can probably guess how much fun I had at a canned ceremony full of talking heads who had absolutely nothing to do with my program (so much for the school being “student-friendly”) telling us all the same clichés about all the potential we’d achieve (including some New Age crap about how some guy felt restricted by “having a finish line”...I guess he never got anything done, did he?), as well as having some “Convocation Marshalls” who were quite snippy. The only good news was that I saw most of my old classmates, which made the pain of the ceremony a little easier to take.

That wasn’t the worst part of the ceremony- the worst part was when one of the emcees of the ceremony announced that because of “fears of H1N1” the dignitaries who’d be giving me my diploma and make me feel special to share the stage with them would refuse to shake my hand- never mind that Brian Tamblyn, the president of Georgian, got his head really close to most of us in moving our sash from our arms to our shoulders, allowing us to momentarily share the same airspace face-to-face, which would be enough time with enough proximity to transmit a flu to Mr. Tamblyn anyway, even though he didn’t touch our evil hands. I have to say, it never felt so weird- or more wrong- to get congratulatory “fist pumps” from our teachers instead of a handshake. Hey guys, I’m not Matt Stairs after he hits a home run or that guy who turns everything he touches into Skittles- my hands aren’t evil.

The embarrassing ordeal did get me thinking about this apparent “swine flu” crisis that’s apparently starting to hit our shores as we speak, a fact that was underscored by the death of a 13-year-old male hockey player to H1N1 over the weekend. The player- Evan Frustaglio- apparently came down with the flu, seemingly recovered then unexpectedly collapsed. It was reported that Frustaglio had no prior medical condition, but both a doctor and his father did cite prior respiratory problems in his life, it’s not entirely unprecedented for athletes to experience untimely deaths (look up Sergei Zholtok and Alexei Cherprenov) and one shouldn’t be surprised that a hockey player- playing and sweating in freezing conditions- could get the flu. Frustaglio’s death is unfortunate, but let’s keep it in perspective.

What is the truth regarding H1N1, the stuff the sensationalist media (one Mr. Tamblyn and his staff at Georgian take a little too literally) is not telling you? Well, to begin, we have to start with the flu that the 2009 virus is being compared to and that’s the 1918-19 “Spanish influenza”, currently the deadliest flu outbreak in human history.

First of all, it’s technically incorrect to call it the “Spanish flu”, because it did not originate in- or even hit first- the country of Spain. The reason why it’s called the “Spanish flu” is because when the flu started to hit- in early 1918- World War I was still going on, and Spain was the only country affected by it and reporting on it that was neutral, so it was thought that Spanish authorities were the most trusted sources of information and were largely seen as the only ones really “doing anything about it”. The origin of the flu is not known, but it did hit North America before it hit Europe, and it hit in two waves- first in the summer then in the fall of 1918.

The first wave behaved like a normal flu, with extremely low mortality rates with deaths only in the so-called “expected” groups- infants, the elderly and any other kind of immunocompromised person. Then, in late August, the second wave- the one that would become the famous flu- hit, having a mortality rate between 10-20% of infected cases, with many of those deaths being young, healthy adults between the ages of 20-40. Some of the most famous deaths from the virus include Montreal Canadiens defenceman “Bad” Joe Hall (his death and the sickness of many players forced the cancellation of the 1918 Stanley Cup Final), the first South African Prime Minister Louis Botha and British diplomat and soldier Mark Sykes (whose body would be later exhumed for Spanish flu research). It’s estimated that of the population of people affected by the flu, 50% were infected, leading to the death of between 3-6% of the world’s total population, leading some historians to dub the flu as worse than the 1348 Black Death (that one got 25% of Europe (which was “the world”) which I think makes it worse than the 1918 epidemic but that’s a different debate).

The extremely high infection and death rates, not to mention the population profile of the hardest-hit victims, are the most peculiar aspects of the virus. Many theories have been postulated as to why the virus struck as it did. The cause of death in many of the victims is something called a “cytokine storm”, or basically when the immune system’s response to a pathogen is so strong it starts to hurt the body itself. It is reasoned here that naturally, the immune systems of young adults are stronger than the immune systems of others and would be more susceptible to this kind of attack. However, the reasons why a cytokine storm occurs are not yet fully understood, and there are other reasons why the 1918 flu struck as it did, without having to sensationalize it.

First of all, it was wartime, and not just that but the end of what was a brutal, uncompromising war. Let us not forget that the powers that be in 1914 went to war believing that they’d only be fighting for a few months and weren’t prepared for a five-year war- so they dug trenches and went back and forth shooting at the pathetic attempts to run to the other trench to take it over, the running soldiers mere “moving targets”. You can only imagine what the close quarters of a trench would do, combined with obviously fatigued (and somewhat immunocompromised) soldiers- it’s a perfect powder keg for the emergence of a deadly flu. The other part of the equation is that doctors at the time did not know what they were dealing with, as they would not wear their masks properly (they may cover their mouths but not their noses) and would at times misdiagnose the pathogen altogether. Obviously, now we’re more knowledgeable at handling and identifying the flu (we even have a vaccine for the swine flu) so we’re better prepared for an outbreak. It is also worth noting that sanitary conditions in 1918 were nothing like they are now, to say nothing of the medical conditions. How many of those deaths could be prevented had those other factors been taken into consideration is an open debate, but I believe if the Spanish flu hit today, it wouldn’t be as devastating.

This brings us to the current outbreak. There was an initial frenzy after the flu was first reported in Mexico in late March, providing an additional scare since several deaths fit the profile of several of the deaths from 1918, but since the Mexican outbreak, the flu hasn’t been nearly as deadly, regressing to fit the behaviour pattern of a “normal” flu- i.e., one that affects the essentially immunocompromised. Why it struck Mexico particularly hard was baffling at first, though it bears mentioning that living conditions in Mexico City- the hardest hit area in Mexico- are still quite depressed (although it is improving) and that perhaps contributed to some deaths. New details have also emerged, suggesting that Mexico vastly underreported its cases and even misidentified some of the cases as “swine flu” when the affliction was another pathogen altogether. Finally, it’s worth noting that since Mexico had its initial outbreak, nothing else has come of it, as the Mexican policy of shutting down the entirety of its capital city for a weekend at the height of the outbreak appeared to curb it, as no new serious news has arisen from Mexico since the initial outbreak.

Since the scare, further research has shown that the flu poses no threat to gain in lethality. Scientists at the University of Maryland mixed swine flu with seasonal flu and concluded that both would not combine into something more lethal. The virus also only showed increased severity in Mexico- everywhere else it has been mild, and as stated before there is reason to believe it wasn’t that dangerous in Mexico at all. Finally, while previously healthy people have come down with severe complications from H1N1, they are the exceptions rather than the rule and in some cases they even had a prior history of medical problems (the 13-year-old boy who died in Toronto did have respiratory problems earlier in his life, for example).

This isn’t to say that we should ignore H1N1- far from it; since it’s new we ought to be cognizant of it. However, overreactions such as refusing to give a graduate a handshake are unnecessary- this isn’t an overtly serious virus and besides, living in fear is no way to combat a virus. I also believe if this virus ever does become more severe- which is doubtful at this stage- we’d all be quarantined and wouldn’t be allowed to interact like we already do; plus we have the capability to fight the flu better than we did in 1918, so any fears of a repeat are unfounded. The only frustrating part about the outbreak is the fact that the vaccination is delayed, but it still doesn’t change the fact this virus isn’t that dangerous.

It doesn’t change the fact that I’m still owed a handshake, so Mr. Tamblyn and my teachers...I’m waiting. Unless you’re worried I’m going to turn you into Skittles.

-DG