Tuesday, June 9, 2009

Flu Pandemic or Aid Epidemic - Perspective

When is a Pandemic Nothing to Worry About?

There seems to be an increasing amount of press speculating that the WHO will soon pronounce the novel H1N1 to be a Level 6 and a true Pandemic.

I have been following the (almost) daily statistics that have been published by the WHO. They were publishing the “situation updates” daily, now new statistics come out every 2 or 3 days. Things have seemed to have become less worrisome, and at least here, in Toronto, there doesn't seem to be much concern about the flu anymore. None the less, I can’t help but remembering that the 1918 pandemic had a very mild first wave which started in March of that year. By August it had turned deadly.

Consequently, out of curiosity more than any real concern, I am watching those WHO situation updates and charting the % of new cases diagnosed (which may be less than half of the real numbers because not everyone has it gets diagnosed with it) and the % of deaths based on the overall number of cases.

The bottom line is that of late there have been about .5% of the total infected for which it is fatal and about 5-7% of the previous days number infected who are reported as new cases each day. So we have new cases being reported, but the number is not growing exponentially and the death rate is not really growing either. So far so good.

So whats this about the press saying that the WHO will be calling it a Pandemic? Well, there are an ever growing base of cases passing it on to about 7% of others on a daily bases. The actual numbers are growing. Yesterday there were over 1,100 new cases, June 1st there were just over 600 new cases. If it continues to grow that means a whole lot of people suffering from influenza in the coming months. So a lot of us are going to get sick. As long as the death rate does not start shooting up from the .07% we will probably come out of this not really much worse for wear.

When is a Pandemic Nothing to Worry About?

So dear readers, know that I am doing the plotting of the statistics and I will shout out if I start to see either the new cases or death rate start to rise a lot. Many people are watching the WHO statistics and Governments are spending a millions of dollars to ensure that we all get through this with a minimum of fuss…

The Real Worrisome Global Health Issue - AIDS

Now, for a moment let me contrast this to something else most of us don’t give much thought to on a daily basis – AIDS. I listened to an interview on CBC Radio on Saturday. The topic was AIDs in South Africa. The person who was being interviewed was a very intelligent and articulate man who is South Africa’s Supreme Court judge. His name is Edwin Cameron and he battles AIDS himself.

To listen to this CBC program you can get the podcast here

His message was simple. South Africa (and in fact the entire Sub Sahara subcontinent) has been experiencing a decade long AIDs epidemic. In my little tracking spreadsheet, I am tracking 1100 new cases of a “novel” flu virus with its supposedly mild flu symptoms. The H1N1 influenza virus has everyone around the globe in a flutter with its total of 139 deaths. However, there are over a thousand of AIDs deaths a day just in South Africa alone! The number of deaths in that country increased by 91% from 1997 to 2008 – 42% of all deaths are among those age 25-42 – all this attributed to the AIDs epidemic.

Comparing the Flu (almost) Pandemic with the AIDS Epidemic gives one a bit of perspective, I think. So lets continue looking at these numbers.

Contrast this to our Flu (almost) Pandemic where there have been just over 25,000 cases of flu diagnosed and all but 135 of those folks have recovered. There are 33 million cases of AIDS worldwide (22 million of them in the African subcontinent) and that those folks will never recover (there seems to be little hope for an outright cure) and that does not count the hundreds of millions who have died since AIDS first arrived. It is estimated that 10.8% of all South Africans over 2 years old were living with HIV in 2005. Among those between 15 and 49 years old, the estimated HIV prevalence was 16.2% in 2005. That is an awfully large proportion of the population.

However, in my view, that is not the worst of it. From listening to the CBC interview, the anti retro viral drugs are able to keep those infected with aids in reasonably good health – if they are able to get the drugs – expensive drugs. The issue, from the interview, seems that there are insufficient drugs to supply the 33 million people who have HIV/AIDS – 22 million of them in the African Subcontinent. No doubt this is a big issue, since without these drugs the deaths will continue the UNAIDS/WHO estimated rate of 350,000 lives estimated for 2007 - nearly 1,000 every day.

Think about it. If there continue to be millions of new cases of HIV annually (1.9 million new cases in 2007 in the African Subcontinent alone), and no one is ever cured, eventually there will be an overwhelming burden on the entire world - the developed world - to provide medication and continuing treatment and care for an growing percentage of the population. HIV, is imo the major global threat, not this pandemic in the making.

Go here for a discussion of the Issues Surrounding treatment for Millions of People with Aids

The bottom line is that our current fuss about the H1N1 needs to be kept in perspective. There are bigger health issues out there. The need for a vaccine for HIV/AIDs for a starter.

AIDS Statistics from Around the World

Advances in Immunology and AIDS Research


  1. Quite right. AIDS kills more people and so does cancer. Many thanks.

    Greetings from London.

  2. Oh Peggy, your comments about HIV/AIDS on the African continent and especially South Africa, came as a bit of a shock to me. Living in South Africa, I wrongly took it for granted that the rest of the world are as clued up on the prevalence and problems of HIV/AIDS as we are. I come into contact with HIV positive people and full-blown AIDS sufferers on a daily basis and I am not even nearly connected to the medical profession. I think I must do a post on it sometime, but I am afraid that it is such a huge issue and so wide ranging that one post will only be a drop in the ocean. However, thanks for opening my eyes to my own near sightedness and thanks for caring about the havoc that this deadly and debilitating disease is causing, especially in my part of the world.

  3. Thanks HKoH for your comments and sharing your reaction. I can't speak for anyone other than those around me, but I would say that there is a general lack of appreciation of the order of magnitude of problem that HIV/AIDs is, not only to the developing world, but also to our Global Economy as these people need financial support and will do for the rest of their lives.

    For the people that I know, if you asked them what the worst killer disease in the world would be, I suspect you might be told Cancer, not AIDS. The fact remains cancer can be beaten, HIV/AIDs cannot, and will not in my life time for sure.

    A blog (or series) from you on the topic would be most welcome as I am sure you could help us understand the real impact of HIV/AID on everyday people of South Africa.


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