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Crap journalism – swine flu, risk communication David Steven

April 29, 2009 | More on Influence and networks, UK | 3 comments

In the New York Times, think tanker, James Jay Carafano (areas of expertise: homeland security, defense, military affairs, affairs, post-conflict operations, and counterrorism) gets hot under the collar about “news stories [that] play fast and loose with terms like ‘outbreak,’ ‘epidemic,’ and ‘pandemic.’”

His advice: “We should all just wash our hands and go to the doctor if we have flu symptoms.” Er, wrong. According to the Centers for Disease Control and Prevention (area of expertise: public health):

If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

CDC is happy for people to contact their doctor if they need advice, but it only recommends adults seek emergency medical treatment if they have: (i) Difficulty breathing or shortness of breath; (ii) Pain or pressure in the chest or abdomen; (iii) Sudden dizziness; (iv) Confusion; (v) Severe or persistent vomiting. (The advice for children is similar – the list of warning symptoms different.)

In the UK, health authorities are even more explicit about the fact they don’t want people with flu sitting around in doctor’s waiting rooms. “If you have flu-like symptoms and have recently travelled to Mexico or been in contact with someone who has, stay at home and contact either your GP or NHS Direct on 0845 4647,” advises the NHS. Treating people without requiring face-to-face contact with healthcare professionals is at the heart of of the UK’s pandemic flu plan.

Carafano’s sins are minor compared with this preposterous Guardian article by Simon Jenkins (core expertise: frothing at the mouth).  According to Jenkins, swine flu is “a panic stoked in order to posture and spend” – with the public too moronic to resist having the wool pulled over its eyes:

We appear to have lost all ability to judge risk. The cause may lie in the national curriculum, the decline of “news” or the rise of blogs and concomitant, unmediated hysteria, but people seem helpless in navigating the gulf that separates public information from their daily round.

The government was “barking mad” to convene its emergency planning committee, Jenkins argues, while the World Health Organization is not really worried – it’s just making a pathetic bid to shore up its funding. Attention-whore doctors, health and safety hysterics, and rapacious drugs companies are all in on the plot, while ‘professional expertise’ (presumably from shrinking violent newspaper columnists) is being completely ignored.

BSE, SARs and avian flu, meanwhile, provide cast iron assurance that no pandemic is on the way.

What Carrafano, to his credit, understands, but Jenkins and his ilk refuse to accept, is that risks are risky, precisely because, for a long period, we simply don’t know how serious they are. This creates a huge quandary for governments. Anthony Giddens capture the tension well in his 1999 Reith Lecture:

There is a new moral climate of politics, marked by a push-and-pull between accusations of scaremongering on the one hand, and of cover-ups on the other. If anyone – government official, scientific expert or researcher – takes a given risk seriously, he or she must proclaim it. It must be widely publicised because people must be persuaded that the risk is real – a fuss must be made about it. Yet if a fuss is indeed created and the risk turns out to be minimal, those involved will be accused of scaremongering.

Suppose, on the other hand, that the authorities initially decide that the risk is not very great, as the British government did in the case of contaminated beef [early in the BSE scare]. In this instance, the government first of all said: we’ve got the backing of scientists here; there isn’t a significant risk, we can continue eating beef without any worries. In such situations, if events turn out otherwise – as in fact they did – the authorities will be accused of a cover-up – as indeed they were.

Being grown up about risk means planning in conditions of uncertainty – not allowing policy to be driven by Simon Jenkins and other petulant pub bores. His article may be one step up from the conspiracy theories I was tracking over the weekend – but that’s not saying very much…

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3 comments »


  1. Actually my comments are exactly the same as the CDC. I covered measures to keep from getting the flu. I went on to state that if you had the flu you should seek medical care. All this is laid out here http://www.heritage.org/Research/HomelandSecurity/wm2415.cfm

    Some day casual pundits will do research other than goggling a blog and get their facts straight…the good news is I can google the pundits and tell what jerks they are for not doing their homework.


  2. Thanks for popping by James. I didn’t “goggle [your] blog” at the Heritage Foundation, but read, and linked to, your opinion piece in the New York Times, entitled “not close to a pandemic.”

    In it you criticised the media for playing “fast and loose with the facts”, but made a mistake yourself. This you repeat on your blog, when you tell people that “at the onset of flu-like symptoms”, they should go straight to the doctor. Medical advice is not to go anywhere, but to stay at home and call for help if necessary.

    As I pointed out in my post, the UK has based its whole pandemic response on treating people remotely wherever possible, to avoid doctor’s waiting rooms becoming a major source of transmission (and to try and keep medical staff on their feet). The US position is similar though it appears to be less well planned – the UK has arrangements in place for couriering medical supplies to patients for example, and a phone line for giving advice. (A caveat: my knowledge of how the US will handle a serious pandemic is not extensive.)

    When you are ego-surfing (“the good news is I can google the pundits and tell what jerks they are for not doing their homework”), perhaps you should read any critique that you find before firing off an angry rejoinder. That said, my comment on your expertise was a cheap shot – sorry for that.

    And for the record, I agree with your arguments about not shutting borders and aiming for a proportionate response. I suspect the ill-advised headline for your NYT piece was added by an editor, not chosen by you. As I am sure you know, the consensus is that we probably are quite close to a pandemic, though how extensive and serious that pandemic will be cannot yet be determined.


  3. I am also not a fan of people rushing to medical facilities during pandemics for no good reason…but that does not mean that folks should not seek medical advice, many providers have medical and nurse hotlines. In many cases, they can call a local pharmacy or they can even do self-diagnose on line. Of course, there is also a difference if they need prescription medications. People also need some basic common knowledge and practical sense, if you have immune deficiency you are going to respond differently to a cold than some one with a healthy immune system.

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