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Commentary
Excessive pH1N1 Deaths Escalate Pandemic Concerns Recombinomics
Commentary 17:24
April 5, 2010
The above comments, by a reporter at last week’s CDC press conference on Georgia, reflects a widely held belief that the current pandemic is “mild”. Although both numbers are generated by the CDC, they are calculated using very different methods, leading to major differences, which are artificial. In the past, seasonal flu deaths were based on excessive deaths in the Pneumonia and Influenza (P&I) data from 122 cities. The much cited 36,000 US flu deaths are an extrapolation from this data, which is why the number of deaths is always 36,000, even though there are year to year fluctuations. These numbers are based upon death cirtificates and clinical presentation, not lab confirmation.
The CDC calculation for pandemic deaths is based on an extrapolation from the lab confirmed data, using a large number of assumptions on exactly what the lab confirmed deaths represents. This leads to 12,000 deaths, even though the P&I deaths for the past year have been above baseline almost every week, which is highly unusual.
The P&I data from the past four years is updated each week. The P&I death rate is plotted against the seasonal baseline as well as epidemic threshold. In years prior to the pandmeic, the jump above baseline is concentrated over a short time period, when the rate spikes. In many seasons, the spike is negligible, but in seasons with large spikes, the rest of the year is largely below baseline.
However, for the pandemic period, which began a year ago, the rate immediately moved above baseline last spring, as seasonal flu was winding down. The rate briefly fell below baseline in the summer, but then spiked higher in early August, when school resumed in the south. That early spike was linked to the fall wave, but when the wave ended in December, the P&I rate only briefly touched the baseline and then again spiked higher, even though the number of lab confirmed deaths remained low. The P&I curve then remained above baseline and in the latest week, rose above the epidemic threshold.
Thus, the maintenance of the P&I rate above the baseline for the vast majority of the weeks in the past 12 months produces deaths that are markedly higher than the average for seasonal flu, but the CDC figure of 12,000 deaths are only 1/3 of the much quoted seasonal flu average of 36,000 deaths in the United States..
This failure to generate comparable data for pandemic flu has led to an abysmal vaccination rate in adults, which sets the stage for a spring spike that will further increase the number of flu deaths. Moreover, the failure to capture the consistently elevated number of deaths in weekly reports on lab confirmed cases represents a serious surveillance failure, which is likely replicated worldwide.
The inability of CDC and labs throughout the world to accurately measure and monitor pandemic H1N1 continues to be hazardous to the world’s health.
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