This outbreak of swine flu is worth taking very seriously. Like the 1918 influenza outbreak, the early reports of local outbreaks have been split between mild disease or severe symptoms that kill unusual numbers of people in their prime. Just because the New York cases have been mild is no prediction that this won’t get much uglier in short order. Influenza virus have unusual genetics, allowing milder phenotypes to carry the genes for a severe form (and vice-versa), with rapid shifts between the two disease forms in a rapidly spreading epidemic.

Erica’s feature a couple of years ago on what an Avian influenza outbreak would be like is a good place to start. So is my post, courtesy of my public health nurse mom. The advice is about the same….

Unlike the typical annual influenza outbreak, deadly mostly for those very young or old, H5N1 kills people with the healthiest immune systems—people in their twenties. This virus, like the 1918 influenza, induces a panic response from our immune systems; for people in their twenties, it is your own immune system that does you in.

We have much better drugs to control the immune system, things like cortico-steroids….

The best plan is not getting infected. Here are some hints on how to that:

Avoid prolonged or close exposure to people who are infected.

Wash your hands. Start with the habit of washing every time you enter your home, and before every meal. For when soap and water isn’t available, carry some instant hand sanitizer—like Purell and with at least 60% alcohol—and use a dime-sized drop that will keep your hands wet for at least 10 seconds.

Use a surgical mask—available at drug or grocery stores—if you go out during the outbreak. It should be good enough to protect you from the virus-carrying droplets, provided you stay 3-6 feet away from someone coughing. And cover your own coughs.

Stock up on food and water.

The Federal Government’s pandemic flu website is pretty slammed right now. King County Public Health’s pandemic flu website is up and running, and one of the best put together sites.

Jonathan Golob is an actual doctor.

84 replies on “What To Do with Swine Flu”

  2. What ended up happening with avian flu? Oh yeah, not much. Remember SARS? I don’t even remember what year that was.

    Previous “OMG PANDEMIC” stories have made me think this is another cry-wolf story, I just don’t know which way to look at it.

  3. “The best plan is not avoid getting infected. Here are some hints on how to that:”

    I think you’ve got one too many nots, and one too few dos. Unless the best plan truly is not to avoid infection, sort of like those old chicken pox parties.

  4. Electra: Fixed it.

    @1, 2: I’m not saying ‘panic’. I’m saying wash your hands and have some drinking water and food (that you should probably have as earthquake preparation.)

    Part of the reason why avian flu or SARS weren’t severe is the hard work of excellent public health people worldwide. These are the same people who are calling a formal alarm right now. It might be wise to pay attention to them…

  5. Harvesting, torturing. killing, and consuming the corpses of animals already caused global warming and our public health disaster in America. There’s no doubt a pandemic is next.

  6. @4

    you may not be saying the word panic but your post sure does insinuate it.

    “These are the same people who are calling a formal alarm right now. It might be wise to pay attention to them…”

    the people you talk about have actually called for preparedness not ALARM. go read actual journalists who quote experts, not their mom.

    from the p.i. – “Napolitano called the emergency declaration standard operating procedure – one was declared recently for the inauguration and for flooding. She urged people to think of it as a “declaration of emergency preparedness.””

  7. @6: Awww, the old “actual journalist who quote experts” line. Shucks!

    What part of “buy some water and food” doesn’t translate to “preparedness”? When I start calling for ill-advised sex and looting, it counts as inciting panic.

    Thank you for reading!

  10. Do you know what else causes the immune system to go into shock? Fear.

    Thanks, Golob, now we’re all going to die of fear and not the Hamdemic(tm).

    And before you start, I’d prefer not to have aspersions cast upon my race for being so bacony and tasty.

  12. @11: BaconCAT.

    You can trust a cute little kitty.

    Hey, idea! You know what soothes fear? Vacations! I’ve got tickets for the entire Stranger staff to head down to Cancun! Cha cha cha!

  13. @7
    “When I start calling for ill-advised sex and looting, it counts as inciting panic.”

    Actually, wasn’t that the Democratic Platform this election?

  15. Jonathan,
    Where does licking doorknobs in Iowa fit in to our Slog Office Protocol for Dealing with Swine Flu?
    I don’t have to stop, do I?
    Because, I am the boss, you know…

  17. I do know I should be concerned and I am, however I have this fascination regarding how this jumped from pigs to humans. The mutations must have been staggering in their number in order to infect humans or did it occur far more quickly? Did it sponteneously transition from pig to human or have “host” humans been carrying this infection until a point in time their was enough mutations to compromise their immune system and allow this to become infectious?

    This is indeed interesting. Has the public medical community been able to isolate and study this particular infection and understand its lineage?

  19. Harvesting, torturing. killing, and consuming the corpses of animals already caused global warming and our public health disaster in America.

    You mean our public health disaster wasn’t cause by national and local public health budgets being obliterated for the last 30 or so years? Well, I guess Ronald Reagan and the GOP are off the hook for that, then! And hey, we can tell the oil companies sorry, we didn’t mean to be so mean about that whole fossil fuels causing global warming thing!

  22. I think Jonathan has the right points. Practice good hygiene, stock up on food and water and essentials just as you would for an earthquake, and have masks on hand in case they’re needed if/when the flu arrives.

    But most importantly, if you’re sick, STAY HOME. DO NOT GO TO WORK. DO NOT GO TO THE CLUB. STAY HOME. STAYING OUT SICK WILL SAVE LIVES.

  24. I can’t identify the reasons for the flu outbreak, YET, but I’m 100% certain that they flatter my long-held opinions.

  25. Jonathan- thanks for your post. I’m now convinced a certain portion of the SLOG literati (if we can call them that) have some sort of internal defense mechanism that forces them to be literally blind to serious health risks. The “whistling past the graveyard” phenomenon?

    Whatever. Once again, in the hope that a few of the jokesters will maybe get it: AVIAN FLU (H5N1) DOESN’T PASS FROM PERSON TO PERSON. H1N1 READILY DOES.

    I will also mention that at *my* local Walgreens is already out of surgical masks. The Internets still have a few, though. It’s not inducing panic to suggest that getting a mask or two would be prudent. Consider it insurance- hope you’ll never need it.

  28. @5: Some pre-industrial cultures ate meat exclusively and were entirely free from the “diseases of civilization.” We Americans didn’t start dropping dead in huge numbers from diabetes and heart disease until we started scarfing white bread and guzzling “soft drinks.” Maybe that’s not a coincidence.

    But please feel free to keep looking down your nose at my ribeye if it makes that Tofurky® taste any better.

  29. I can appreciated Sven’s concern, and I went to the website, and learned what I can do (basically, wash my hands, don’t touch my face, wear a mask, stay away from people, and stay at home if things get bad) but other than that, there’s not much I can do to help.

    So, until and if anything happens here, I’m really not that that interested in hearing about it. Sure, it would truly suck if this becomes a pandemic, but nuclear war, asteroid collision, global warming and resurgence of the GOP would all suck also. There’s only so much time and energy you can devote to worrying.

    Do take care, darlings. I would hate for anyone to get sick.

  31. Don’t let fear rule your life, but use common sense when it comes to personal hygiene and staying home from work when you’re sick. This is true even if you simply have a common cold.

    And now if you’ll excuse me, I have to get back to reading Stephen King’s The Stand…

  32. @31, you know, I actually watched half of the miniseries on DVD last week and decided I needed to reread the book. Then I read about this and literally did a lovely facepalm.

  33. Should we stop answering our phones, too? You know, b/c Stephen King wrote a whole book about how that will give us a virus and kill us, too.

    HEY ALARMIST MEDIA! ENOUGH! Jesus Christ, if it’s not anthrax it’s Obama and if it’s not Obama it’s fucking pig flu. Wash your fucking hands you dirty assholes.

    I do have to say though, that reading your linked post made me happy that fnarf has been the voice of reason on slog for at least 2 years now.

  34. @ 17 — Evidence points to a race of half-pig, half-human hybrids that have been breeding in the backwaters of global society for decades … probably forced into more frequent human contact in recent months by the pruning of the hedge funds, etc.

  36. I was still attending school in Toronto when the SARS epidemic broke out. TO had one of the largest outbreaks in North America (some 200-400 cases, if I recall) — the CDC and Toronto Health people went out of their way to mitigate the spread at every turn.

    For example, you couldn’t enter a hospital if you weren’t in need of care (ie, visiting hours were shut down completely). The U of T medical school shut down for weeks, too — they didn’t want students passing it to each other after doing rounds at various hospitals…and then passing it on to other students on campus. The height of the outbreak was during exam period, and all students were explicitly barred from taking their exams if they were at all sniffly (and this was in April, when everyone catches a spring cold).

    All in all, I was impressed at the public response to SARS. It could have been much, much worse.

  37. From Matt Yglesias:

    “I have no opinions on [swine flu] beyond the observation that it would be nice to live in a country where, if you fell seriously ill due to viral infection, your access to effective medical remedies was not determined by your wealth, income, or employment status.”

    Indeed.

  38. There is no reason to panic. In fact, if you think about it logically, you might be more inclined to do the few easy things that are being suggested… get a week’s worth of food and water, some hand sanitizer, and some face masks. These are the same things that would help in the event of an earthquake, and you would be glad to have the masks if Rainier ever goes while the wind is blowing your direction.

    By the way, it’s not a flimsy fabric or paper face mask you want. It’s N95 respirators. They are currently the number one sales item in Health on Amazon.

    The reason for getting a reasonable amount of extra food, water, and some masks now is because if an outbreak occurs, people will be probably be asked to stay home as much as possible. If it were me, I’d want to go straight there, and not into a crowd of panicked people to get infected in an empty supermarket.

    ps: Don’t rub your eyes with your hands.

  40. If this is the pandemic they’ve been warning us is coming for years, the upside will be watching all these “don’t panic” trolls contract it and die because they refused to take basic precautions.

  43. why not compare this outbreak with the 1976 outbreak, instead of bringing up 1918? you may have as well compared it to the plague.

    shoddy, jonathan.

  44. I’m just asking that the media stop ignoring the most basic fact: swine flu, bird flu, and other pandemics only kill people and are a major global threat because of the people that choose to eat meat. These meat eaters’ unfortunate choices endanger everyone’s lives.

    Meat eaters: will you please stop eating meat so we can stop worrying about hundreds of millions of people dying in a pandemic?

  45. #44: Havent you heard of the “Great Soy Flu” of 1979? Yep, killed more than 150 million people in China alone. All of it was caused by Soy beans transferring a flu contagion amongst themselves then the virus mutating stronger and able to transfer to humans. Eventually, humans were able to spread the flu amongst each other, then the devastation kicked in. Health food eateries were ravaged: corpses were everywhere. Hippies were unable to tend for themselves and eventually died. it was a terrible time, and proof that non-veg sources spread flu viruses as well as meat eaters.

  47. Short version:

    Don’t go to church or raves.

    Use hot water and soap and wash your hands frequently.

    And if you get sick stay home.

  48. @44– Do you really want to leave hundreds of millions of pigs unemployed in a recession?

    My own meat-eating has given a lifetime of employment to some 2000 chickens.

  49. Jonathan, what’s your take on grist.org‘s reporting from the field, literally, in Mexico where many have pointed out a possible source of the outbreak from water pollution from a pig slaughterhouse in Perote, Mexico owned by Smithfield Foods?

  50. #44: Havent you heard of the “Great Kung Fu” of 1975? Yep, killed more than 150 million people in China alone. It was fast as lightning. And it was real exciting. Eventually, humans were able to spread the Fu amongst each other, then the devastation kicked in! Towns were ravaged: corpses were everywhere. Hippies were unable to tend for themselves (of course they never could anyway, filthy animals-) and eventually died. It was a terrible time. (except for the hippies)

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