[Marxism] Pig Flu: 'There Will Be No Pandemic' -- Susil Gupta

[Paul Flewers]

Here's something that a friend of mine, Susil Gupta, wrote the other day on
the pig flu epidemic, which might cause some debate on the list.

Paul F

+++++++++++++++++++++++++++

Although the WHO has raised its pandemic alert level from 4 to 5 and claims
that 'All of humanity is under threat' a high-mortality pandemic is unlikely
-- at least not in the developed West.

First some terminology and useful conceptual distinctions which often get
confused under the general terms 'infectiousness' and 'virulence' -- even
among epidemiologists who should be more careful.

TRANSMISSIVITY is the easy with which a pathogen its transmitted between one
person and another. A pathogen may be very fast moving -- but harmless. So,
one need not be alarmed, though it is alarming, to hear that a disease is
very infectious. The common cold is extremely infectious but not very
'virulent'. 

INVASIVENESS is the ease with which the pathogen enters a person's system in
a way that produces harm. For example, legionella, the pathogen that causes
Legionnaire's Disease, is harmless if ingested but only becomes pathogenic
when inhaled -- usually in a micro-droplet produced by an air conditioning
system that uses a waterfall to cool and clean air. It also tends only to
affect a person with a weak immune system (old or ill people).

PATHOGENICITY or 'virulence' is the harm the pathogen does once it has
infected someone.

There is a great deal of debate among evolutionary biologists and
microbiologists about the relationship between the ease of transmission of a
pathogen and the harm that it does. It is generally postulated that the
higher the transmissivity and invasiveness of a pathogen, the lower its
pathogenicity, because otherwise the microbial world would have never
allowed higher animals to evolve! All pathogens are parasites that misuse
bodily functions for their own reproduction and dispersal (infection). So
microbes have vested interest in keeping its host alive and few require the
host. 

But one can also argue, that despite our apparent dominance of the natural
world, the microbial world has not allowed higher animals to evolve much. In
terms of species variation and sheer biomass, microbes dominate the world
many times over. Indeed, human beings and all higher animals together are
just a tiny spot on the face of the microbial world -- we are a tolerated,
insignificant minority of living things. There are also many examples of
pathogens that kill their hosts, against their theoretical interests. The
fact is that microbes, being so plentiful and resilient, don't need care
about being too virulent and wiping out the human race. 

So, in sum, there is -- or should be -- an inverse relationship between easy
transmission and the level of pathogenicity -- but it is a reasoned
proposition that beset by real-world problems. 

THE SINGLE BUG THEORY:

Simplified explanations of how infectious disease work rely heavily on the
one bug, one man, one disease schema. In reality, microbial and
epidemiological events are always population phenomena. There is no distinct
'swine flu' bug in the same way that lions and tigers are specific
creatures. Bacteria and viruses exist as hundreds of constantly evolving
genetic variations (antigenic drift) clustered around a core genetic
identity. When this genetic identity has migrated far enough (antigenic
shift) a new viral variant is established. Thus any particular type of virus
will have variants of greater and lesser invasiveness and pathogenicity.
Some microbes that are very stable needed only one lifetime vaccine to
confer immunity. Viruses are generally very fast-evolving, which is why a
yearly jab is necessary, and even then only covers 80%-90% of the
naturally-occurring variants. 

As a result of these processes, as a contagion develops, its pathogenicity
usually (but not always) becomes attenuated for two reasons:

1) The more pathogenic variants of the virus kill or disable their victims
faster and more severely -- thus making them less available (impaired or
interrupted social interaction) to transmit the infection to others. The
more benign versions of the pathogen live on in the 'walking and working
sick'. It pays to be nicer. 

2) Since viruses are not really living organisms but bits of portable DNA,
they require the DNA machinery of the human body to reproduce. Viruses that
are highly pathogenic tend to interfere with bodily functions, obstructing
their intra-cellular reproduction and extra-cellular transmission. Again,
the more benign ones tend to be successful. 

THE HOST THEORY OF INFECTION:

Because infectious disease phenomena are never random and always have social
or human characteristics, some biologists during the late 19 Century argued
that 'the microbe is nothing -- the terrain is everything". This was an
extreme position against the germ theory of disease which was at first
expressed in an extreme way against the old 'humours' or 'foul airs' theory
of disease. The truth is somewhere in the middle, and understanding an
epidemic is all about knowing what weight to give each factor. That is a
difficult judgement, and one that involves looking at the evidence and
analysing the situation - not something that comes easily in a panic, or
based on media views!

Take, for example Cholera. This is not an infectious disease
(person-to-person) in the usual sense but a transmissible one (milieu to
milieu). An infected person develops millions of cholera vibrio in his gut.
This provokes massive diarrhoea which flushes the incubated vibrio into the
sewage system. If sewage leaks into the water system (almost always the
cause of a cholera epidemic) then the process starts all over again, this
time with hundreds of infected people. The more pathogenic strains kill off
their hosts first, the less the pathogenic ones survive longer. Slowly,
immunity builds up in a population and the epidemic extinguishes itself.
Well fed people and alcoholics are more resistant to cholera. The
undernourished die like flies.

Thus it is possible to have a rich community living uphill with a clean
water supply and a down hill poor community that has a water supply
contaminated by the sewage of the uphill community and its own. The high
mortality rate of the down hill community is due to two non-pathogen
factors, the 'terrain', in addition to the pathogen: namely malnutrition and
contamination.

THE CURRENT SWINE FEVER EPIDEMIC:

My theory is this: A new strain of flu virus has erupted, possibly with some
connection to the food industry. To protect its important national exports,
the Mexican authorities have kept a lid on the ensuing minor epidemic until
it burst into public view -- giving the false impression of a major medical
emergency because, by then, the epidemic is well developed.

Thus we have two apparently dangerous ingredients

* The emergence of a new strain, where one would not expect to find it --
which is 'unusual' but no more threatening that any other flu outbreak. We
did have Haitian hog flu 30 years ago!

* An epidemic that appears to erupt like a thunderclap -- but only because
its initial stages have been concealed, not because it will now develop
exponentially.

What evidence or argument backs this up?

Much has been made of the intensive factory-rearing of pigs in their
thousands. This is not necessarily a problem. South East Asia is the locus
of constant flu incubation and development because of the close domestic
contact of a few pigs, a few ducks and a few human beings in thousands of
homes. Indeed, there are a dozen epidemics of bird-pig-human flu occurring
in South East Asia at any one time. This provides a source of a continual
infection-mutation-infection cycle between the three animals. This does not
occur in mass factory farming of pigs.

Five thousand people die in the UK of flu every year -- mostly the old, but
not exclusively so. With a population of 111 million, and a far poorer
health service and lower state of public health, we would expect to find
annual flu deaths in Mexico to be at least 10,000. In addition, these deaths
would not be so narrowly focused on more vulnerable populations, given that
poverty creates a larger and wider mortality-susceptible population.

Deaths from a brewing epidemic of a new strain of swine area easily
concealed in a larger population of normal annul flu deaths. However,
because the disease surveillance community is international, the news
eventually filters out. Now, in the general panic, the reverse can happen: a
large number of normal flu deaths are attributed to the new-strain, because
the whole of the political, administrative and public health effort is now
mobilised in that direction. Everyone needs to be seen erring on the side of
caution, which means not being cautious about alarming and worst-case
scenarios. 

A massive epidemic has been created where only a small one exists because
what we have in reality is an administrative manipulation that has come
apart. This has led to the media exaggeration of otherwise minor phenomena.
So far only 12 of the 176 deaths in Mexico have been confirmed as
attributable to the new strain.

We should also note that:

* This is what happened in the Aids epidemic. I was virtually the only
person in the UK to predict there would be no generalised epidemic outside
specific risk groups.

* This is what happened in the CJD 'epidemic'. 100,000 cases were predicted
by the Government's Chief Medical Officer. Again I was the only person in
the UK to predict there would be no generalised epidemic (and still am).
There have been no more than 200 cases after 25 years!

If the Mexican authorities did cover up the eruption of a new-strain flu for
economic reasons, they would be in very, very serious trouble with the world
health authorities and with their trading partners. So it is in their
interests to present the epidemic as a tsunami they were not expecting.
Again, this fosters the sense of something ominous and beyond their control.

So far, the Mexican authorities have not provided any account of the
epidemic. Flu is a very easy epidemic to follow, because it conforms very
well to mathematical modelling and has an uncomplicated and well-understood
uniform transmission and disease process. With 176 claimed deaths, the
Mexican authorities must have a good idea about the nature the specific
outbreak by now -- but we are not being told!

This smells very fishy. Of course, if new-strain cases are mixed up with
normal-strain cases in the process of administrative obfuscation then it is
impossible to develop a specific epidemiological picture.

The great puzzling aspect of the epidemic is the very high mortality in
Mexico and the low mortality everywhere else. This is where the initial
cover-up comes apart. It is true that malnutrition impairs the immune system
and can cause what appears to be a mortal epidemic which would be non-fatal
in a healthy population. But most people in Mexico City are not
undernourished to the degree that would make such a difference. And given
the close relationship between Mexico and some Southern US States, there
would have been a much bigger spill-over by now. This suggests that the
evidence of the number of deaths is a false count.

My conclusion: there will be no pandemic.

Susil Gupta

+++++++++

POSTSCRIPT: The Pandemic Disappearing Act

Sunday, 03 May 2009

When I wrote the piece on Mexican flu I expected that it would take several
weeks for the truth to emerge. I was even advised to avoid being a hostage
to fortune by not declaring a non-event so early. Well, 24 hours later the
pandemic story is already falling apart, and in a way that I suggested. An
initial down-grading of the new-strain cases in an attempt to cover-up the
eruption then led to its opposite -- an over estimation of new-strain
figures.

According to today's El Pais, the Mexican authorities have downgraded the
fatalities from 160 to 16 confirmed cases. Other sources are reported by the
BBC along similar lines. The pathogenicity of the new-strain does not appear
to be greater than 'normal' flu. 

By any standards of flu phenomena this is not a pandemic, not even an
epidemic -- just an outbreak. In a normal winter in the UK 100,000 people
are infected with flu in a week.