Is it me or is the Swine Flu waaay overrated? A case of the Availability Heuristic.

I think it's a bit like terrorism. It scares the shit out of you but there's next to zero chance it will actually happen to you. Seriously... you have a much much higher chance of choking on a twinky (even if you've never eaten one) than catching the swine flu and dying or being or even seeing a terrorist attack. Talk about a great case of the Availability Heuristic...

Here's a demo for you to try out (I use this to teach Psych 100). The correct answers are below the fold.

Which is the more common cause of death in the USA?

A) Asthma
B) Meningitis

A) Breast Cancer
B) Stomach Cancer

A) Lung Cancer
B) Motor Vehicle Accidents

A)Influenza (the flu)
B) Stomach Ulcer

The correct answers are...

6x as many die from Asthma than from Meningitis
3x more die from stomach cancer than breast
4x more die from lung cancer than car accident
2x more than all types of accidents combined!
2x more die from stomach ulcers than flu

How many did you get right? Let us know in the comments.

Also... just fyi
In the last three days Swine Flu has killed 1 baby while the Real Flu(tm) has killed nearly 300.

If you love the swine flu as much as I do you might like this t-shirt.


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I think your logic above is utterly warped. Using the same logic, you could argue that this "war" thing is waaaay overrated. Using comparable data to the figures you quote above, it would be easy to demonstrate that the number of Americans killed in wars is much less than the number dying from stomach ulcers (and not much different to the number dying of influenza).

So can you conclude that making a fuss about wars is misplaced, we should stop worrying about them? That they are not something that we should rationally fear?

Of course not. Because you have picked misleading statistics from one country (the US) in one year (2008) which doesn't even begin to illustrate the size of the threat. Wars have in the past killed huge numbers of people - just as influenza has. For example, the gigantic death toll of the Spanish flu was bigger than the bloodbath of the first world war. Many countries lost 5% of their population - that's a colossal human toll, with devastating consequences even for the survivors or people not directly exposed to the disease. Comparing the threat to choking on a twinkie utterly trivialises it.

People are scared of swine flu not because it has had spectacular effects so far (it hasn't), or because it has killed lots of people (it hasn't) but because past experience and our scientific knowledge tell us that new strains of flu can develop into devastating epidemics - particularly, if, as is entirely possible, they become resistant to the available drugs and vaccines.

Swine flu has only been around for a few months maximum. Give it a bit longer and I'm sure it will do its best to catch up with normal flu!

Yes, you are right about everything
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Michael Hjerth
psychologist, science junkie

Wow---I didn't do too well on your quiz.

How do stomach ulcers actually kill people? Why don't we have stomach ulcer or stomach cancer walks?

It is interesting how some diseases get more media attention than others...

Interestingly point of view there, but as a scientist you have left out the most significant variable here. Evolution.

Along with the fact that none of your aboved mentioned examples have currently capability of becoming pandemic, apart from 4A.

Your statements may be true at present, that does not mean they have validity in the future, unless there is no change.

I read a funny statement yesterday, "it is a bit like comparing apples and venereal disease"

Some times history does have lessons for us and although those lessons may not have the extent same context, we would be advised to learn from the past. However, often in our progress we fail to do that. Even in recent history, we have seen a very similar event involving H1N1, it seems to me that ignoring the possibility of the further adaptation of H1N1 in the southern hemisphere flu season could be ignoring a possible threat.

Whether H1N1 becomes more virulent or not, does not negate that fact that we should be aware and keep a respectful eye on evolution's most singular entity, the virus.

It concerns me that the number of reported cases is now 25,288.

That suggests a fairly successful transmission rate it would seem to me. One that could:

A) Stay the same
B) Become more effective
C) Become less effective

This holds true for the case-fatality ratio as well, it could:

A) Stay the same
B) Become more lethal
C) Become less lethal

This is not scaremongering, these are the possibilities, I do not think we could ever say what the probabilities are with any level of accruracy.

In this simplistic look at possible outcomes, we can determine that only 9 outcomes are possible.

1) 1A/2A
Bad outcome. In effect no outcome, the same possibilities for the virus to adapt and become a more virulent strain exist, at the same time the opposite could happen. But while we wait to find out which, people die and health systems are put under additional pressure.

2) 1A/2B
Bad outcome - transmission remains the same, but more people die. Outcome would result in us increasingly trying to stop the spread, increased pressure on health care resources, impact on economic movements.

3) 1A/2C
Good outcome - in the short term a good outcome, give us time to develop a vacine, but while it is in the wild, it has retains the ability to change.

4) 1B/2A
Bad outcome - more people die, more transmission, more evolution vectors, pressure on health care systems.

5) 1B/2B
Worst outcome.

6) 1B/2C
Bad outcome - less people die, but more people get infected, more evolution vectors, pressure on health care systems.

7) 1C/2A
Good outcome - slowly virus losses transmission success, less people die, less pressure on health care systems.

8) 1C/2B
Bad outcome/Good outcome - both as more people die, but less over time.

9) 1C/2C
Good outcome - less transmission, less people die, less pressure on health care systems.

So out of the 9 outcomes, we could only really classify 3 as good, 6 as bad.

It think that fact itself should give us a cause for some rational concern. Considering there will be in all probability, another pandemic event at some point in time and it is quite possible that our own developed world lifestyle may indeed contribute to the massive disruption of that event. Due to the fact that our modern just in time infrstructure in which all our services are interdependent and would take surprising little to disrupt, this seems to indicate perhaps we should indeed have very rational concerns about how effectively we could respond to a 1918 type pandemic.

Considering that case-fatality ratio in the 1918 pandemic was estimated at 3% to 6%. Let us consider the lower 3% in context of today. If we had a similar type of pandemic to 1918, 201 million people would be killed. Considering it is estimated that 25 million people died in the first 6 months (the conservation estimate), using the fatality estimates that translated to 50% or 25% of the total fatalites in 6 months.

What would that translate to with today's figures - that would be 50 million people dying in 6 months. That is a fairly frightening thought, how would our societies deal with that. It is not beyond the realms of feasibility that the infection rate, in our modern shared spaces societies, would be magnified and this would increase the case-fatality ratio.

These are just the fatalities, if we had a similar infection ratio as 1918, that would equate to 2.2 billion sick people.

I have tried vary hard to try and determine how our society would deal with that and I find it hard to believe, from the evidence we have from recent times of dramatic change, that we could respond to a pandemic event effectively, I hope I am wrong and I hope we do not find out any time soon. This is not to say that we would not make every effort, just that our efforts are not necessarily effective solely because we make them. In a global system, we have found that things can become much more complex and complicated.

It may be our complicated social systems that are the worst hit in a pandemic. I think it is fairly feasible to consider, if poeple stopped working and socialising, how long would it take our infrastructure services to fail and when one failed, the others would fail in a chain reaction. What would the people's of the modern world do if the electricity and water supplies failed, no food in the just in time delivered stores. Is it feasible that the failure of these systems may have a more profound affect on society than the pathogen itself.

We can hope for 1C/2C, but when one of the others does come along, we may find at the core of our being, survival is an incredibly powerful and cruel experience. I honestly hope that we figure these things out before they ever happen.

Eh? am I missing something?? Where are all the comments? Huh... Well... Either way, I gave all the correct answers.. But only because I had figured each was supposed to be an "I didn't think that would be the case" situation

The fear is more about the potential rather than the bodycount it allready has. If it stays the way it is not much will happen, but if it mutates to a more agressive form noone is protected due to prior infection and TADAAAA we have a catastophy...

By Spaceman_Spiff (not verified) on 15 Jun 2009 #permalink

Swine flu... I think everyone's already had it and barely felt it.

By John Adams (not verified) on 16 Jun 2009 #permalink

I think it is fairly feasible to consider, if poeple stopped working and socialising, how long would it take our infrastructure services to fail and when one failed, the others would fail in a chain reaction.

It's not the number of deaths that's important. It's the speed and ease at which the disease is transmitted.

I have asthma; you wouldn't catch it from me if you were in close contact with me. You might not want to hang around me if I had meningitis.

*Using comparable data to the figures you quote above, it would be easy to demonstrate that the number of Americans killed in wars is much less than the number dying from stomach ulcers (and not much different to the number dying of influenza).*

Apparently you miss the point. If the actual figures were part of the decision making process this *war thing* never would have happened. In the US 30,000 people die annually because of gunviolence. Isn't it odd this still is insufficient to warrant a debate on guncontrol. Yet 3,000 people once, years ago, is making people so afraid they fight wars at the cost of billions (wrecking the economy), they support destroying democracy (Patriot Act, Legalising torture, legalising violating FISA). All to protect against a threat that is to the average US citizen nothing more than a very, remote and utterly unlikely possibility.

We should avoid the myths we are being fed (anti-evolution, anti-vaccination, HIV-denialism, Black Helicopters, et cetera) and start looking at the facts. That is what this post is about.