Disease Economics

The medical establishment has hurt its shoulder. It’s been patting itself on the back for its fine performance during what it calls the swine flu pandemic. In a New York Times article titled “U.S. Reaction to Swine Flu: Apt and Lucky,” the chairman of the Infectious Disease Society of America boasts that “we did a lot of things right” and the chairman of preventive medicine at Vanderbilt Medical School gave Federal officials “at least a B-plus.”

In the article, a good deal of space is devoted to what did and didn’t happen with the production and distribution of vaccines. Some space was also devoted to the light touch used in keeping the public informed and avoiding a panic.

No vaccine skeptic such as Tom Jefferson or Lisa Jackson is included in the article, someone to point out that whatever happened with vaccines and flu drugs was likely beside the point. Indeed, the Times article quotes conventional experts as taking great pride in their success at beating back the tide of resistance to vaccination and vaccine skepticism. No mention is made of what is actually known about this particular strain of influenza, information that points to what makes some people more vulnerable than others. No mention is made of the fact that what happened hardly qualifies as a pandemic. Nothing is mentioned regarding the guesswork used to estimate cases of swine flu—in fact, the official policy was that any case of flu or flu-like symptoms should be assumed to be swine flu.

The latest in this cavalcade of folly is the call last week by the CDC for everyone to get vaccinated. Why? Because there might be a second wave. What happened with the flu of 1957 is cited. No matter that even by the bloated official estimates, the swine flu affected one fifth the number of people compared to the 1957 episode. No matter that the best estimates for a second round are that it will be negligible. No matter that to date populations that have already experienced swine flu appear to be virtually immune with no significant recurrence.

The answer as to why the CDC is calling for everyone to get vaccinated is this: even though vaccine manufacturers failed utterly to have enough vaccines available this last fall when the swine flu hit, they’ve got tons of the stuff now. It’s the wrong solution, but they’ve got lots of it.

The CDC is encouraging people of all ages to get vaccinated, even though it’s well known that those at greatest risk are children 5 to 17. People over 50 are at virtually no risk. We also know deaths were due to acute lung injury and that the people who died tended to be infected with pneumonia, to have a chronic disease of inflammation such as heart disease, or to have a compromised immune system.

In a recent piece of research, three proteins of previously unknown function were identified as disrupting the replication of not only the flu virus but also other viruses such as West Nile and dengue fever. The three proteins are members of the interferon family, which is a part of innate immunity—meaning, they are part of the body’s first response to infection for which vaccines are irrelevant but for which overall health is very relevant. What’s one of the principal predictors of overall health? What’s called socioeconomic status, also known as the distribution of power and wealth.

It doesn’t take much imagination to know why the CDC isn’t promoting income equity as a preventive strategy. It also doesn’t take much imagination to figure out why the CDC is hawking vaccine doses. First, of course, they don’t seem to know anything else. But principally, the drug manufacturers with whom these officials are codependent have a boatload of inventory that they need to unload: someone’s got to pay for those 130 million doses of flu vaccine.

Risk taking is supposed to be the soul of capitalism, the justification for why businesses deserve whatever profits they make—because they can suffer losses by guessing wrong. So, in the spirit of preserving capitalism, why not let the drug companies eat the cost of those useless vaccine doses? Because it would then look like what it is: the doses weren’t needed. And we know that can’t possibly be true.

For more on these issues, see Too Much Medicine, Not Enough Health.