Swine flu follies: Don't test, we already know!


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CAN WE BLAME President Obama for the swine flu? Well, not exactly, unless someone comes up with pictures of him mutating viruses a year before he was elected.

But the way the U.S. government has been handling the new flu strain, technically named H1N1, has been less than reassuring and if the buck stops for anything at the Oval Office, it certainly should be for matters of public health.

We thought it odd when word came last summer that the federal government was advising states to stop testing for and tracking individual cases of the swine flu. The rationale given by the federal Centers for Disease Control? We already know this is going to be an epidemic, so don't waste your time and resources confirming what we know.

This don't-confuse-us-with-the-facts attitude piqued the curiosity of CBS News. Last week, it reported that the decision to stop testing is highly questionable in two important ways.

First, CBS went back and asked the individual states for the results of tests taken BEFORE the CDC no-test advisory. "The vast majority of cases were negative for H1N1 as well as seasonal flu," CBS reported, "despite the fact that many states were specifically testing patients deemed to be most likely to have H1N1, based on symptoms and risk factors, such as travel to Mexico."

So the size and scope of this flu epidemic may not have been as great as the government initially thought. But here comes the second questionable result of the no-test policy.

"Once you have H1N1 flu," CBS noted, "you're immune from future outbreaks of the same virus. Those who think they've had H1N1 flu -- but haven't -- might mistakenly presume they're immune. As a result, they might skip taking a vaccine that could help them, and expose themselves to others with H1N1 flu under the mistaken belief they won't catch it. Parents might not keep sick children home from school, mistakenly believing they've already had H1N1 flu."

Meanwhile, there have been problems with manufacturing sufficient quantities of vaccines for both seasonal and swine flu, in part because the drug companies switched over to the swine-flu vaccine production because of an epidemic that the government decided was coming, available evidence to the contrary notwithstanding. And now that epidemic is coming, although if we don't test for it, how will we know?

But at least we all know how to sneeze correctly and wash our hands because President Obama showed us.

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Without statisitics & supporting data, how can the federal government declare a Swine Flu "public health emergency"? Oh, I forgot, "Never let a good crisis go to waste"-Rahm Emmanuel.
- Mae, Plaistow

There are apparently two major problems with the test - sampling error (or not taking a sample correctly) and some technological problems with the test itself.

Apparently you have to be skilled at taking the proper specimens - it is not as easy as taking a throat culture.

This editorial was a political attack, IMHO.
- Bill Siroty, MD, Manchester

How can you interpret this editorial as an attack on Obama, Dr. Bill?
Maybe the last sentence is rather snide and could/should have been omitted, but the president's common sense reminders to us all is a point well taken, as very few people practice common sense nowadays. But I'm sure you know that only too well with all the patients you are seeing and have seen in your practice.
- Guy Plante, Manchester

Bill Siroty, MD

Why is H1N1 testing showing a 40% false negative rate? Do you think there is a problem with the testing? Is there enough difference between H1N1 testing and regular flu testing to figure out the difference? What is the false negative rate for regular flu?

What advice are you giving your patients dealing with H1N1?
- Ken Stremsky, Manchester, NH

You should examine the facts about H1N1 testing before you attack President Obama.

Studies have shown that the test for H1N1 infection has a 40% false negative rate - in other words 40% of patients who have H1N1 will have a incorrect negative result.

Thus testing for the purposes mentioned in this editorial are meaningless.

You are performing a disservice to your readers by attempting at a political attack before learning the facts about H1N1 testing.
- Bill Siroty, MD, Manchester


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