One More Reason to Wonder About the CDC

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[The Centers for Disease Control and Prevention (CDC)] states that the historic 1968-9 "Hong Kong flu" pandemic killed 34,000 Americans. At the same time, CDC claims 36,000 Americans annually die from flu. What is going on?

That's what Harvard grad-student researcher Peter Doshi asks in the latest issue of BMJ. His answer is that CDC stats related to flu are "a mess" because the agency acknowledges

a difference between flu death and flu associated death yet uses the terms interchangeably. Additionally, there are significant statistical incompatibilities between official estimates and national vital statistics data. Compounding these problems is a marketing of fear–a CDC communications strategy in which medical experts "predict dire outcomes" during flu seasons.

Prior to 2003, CDC used to estimate about 20,000 flu-associated deaths a year. Then it started claiming 36,000 for unconvincing reasons. All while folks are losing interest in getting flu vaccine shots. The piece is an interesting window onto how lame many health stats are, even or especially when they have policy ramifications (such as the gov't pushing flu shots and reimbursing drug companies for unused stock). Whole thing here.

Other reasons to wonder about the CDC include this, this, and this.

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  1. I wonder if lobbyists are distorting CDC judgements in a non-scientific way. Maybe some more liability shields are in order so that any potential embarrassment to our important pharma co’s is eliminated. So they can focus on their lifesaving works which surely outweigh any foibles along the way.

  2. Like any scientist, I think numbers should be used and examined with great caution, and I will be curious to read Mr. Doshi’s article.

    I’ll let Dave W. explain what that says about me. Maybe it means that I want a gun that fires when bumped. Maybe it means that I guzzle corn syrup while shopping my resume to ADM executives. Maybe it means that I don’t care about racism in Mississippi.

  3. BTW, it’s a heavy job being the corporate apologist in one guy’s head and the liberal in another guy’s head.

    I think I know what I am in Mona’s head: A form letter reminding her that her subscription has lapsed, but if she renews now she’ll qualify for a special low rate!

  4. Numbers are nice, but if they lead to lawsuits then things have gotten clearly out of hand. There are important grants to be pursued and we would hate to see those funds get sidetracked into some kind of compensatory scheem for the biggest crybabies who happen to be able to afford a lawyer.

  5. Jesus Dave W., get a bloody life already.

  6. “BTW, it’s a heavy job being the corporate apologist in one guy’s head and the liberal in another guy’s head.”

    Thoreau…just lean back , take a deep breath back, relax….and stop hating amercia.

    🙂

  7. Conservatism is dead. Bush and DeLay killed it. So that takes care of your conservative foil NoCred (or AndyPanda or whatever her handle was). Dave W.’s way is now both the path of enlightenment and the path of least intellectual resistance. It is a good path, even if costs you a research grant here or there. We must be constantly vigilant about what businesses who have access say to government when we are not in a position to hear.

  8. I half-assedly reserched the issue of flu deaths last year when the gubmint+MSM were advertising flu shots (advertising disguised as news), and as near as I could figure only a few hundred people a year died from flu in recent years.

    FWIW, in their official mortality tables the CDC combines flu and pneumonia deaths into one category, and then refers to the total as flu deaths.

    And…apparently there’s little or no reason to believe that flu shots work, so save your money for health-giving liquor and ammunition.

  9. I haven’t said a word in favor of flu shots, and I don’t do anything even vaguely related to the flu (unless there’s a virologist who wants to enhance the resolution of his fluorescence microscopy experiments….) and I’m already accused of selling out to get a grant.

    For the record, I think that the dangers of bird flu will turn out to be over blown, although that’s just a hunch. As to more mundane flu, I haven’t paid as much attention to the matter. Mostly because the more mundane flu strains are only expected to kill a handful of people, while we’re told that bird flu will necessitate martial law.

    My failure to pay attention to flu vaccines means that I think black men shouldn’t get fair trials in Mississippi. And I want a gun that fires when bumped.

  10. Raymond Shaw is the kindest, bravest, warmest, most wonderful human being I’ve ever known in my life.

  11. What I am suggesting T. is that the pharma companies are influencing the government to have everybody spend on the flu than what is epidemiologically warranted. That scientists are turning the politicians into hand puppet pickpockets. I think that kind of thing should be investigated and, if true, stopped. Soon you will find yourself feeling the same. That is what separates you from the RCD’s.

  12. To get back on topic, I’m not terribly shocked that numbers are reported dishonestly, but I’m also kind of stumped why the people who do it think it necessary. I get flu shots not because I think I’ll die of flu, but because I hate being sick. For a few years I had nasty recurring colds, getting it at least once per month. The doctors seem to have nailed down the problem and fixed it, but it truly sucked. So I got flu shots because the last thing I needed was one more illness.

    So I’m not surprised that people might be deceptive in reporting flu fatalities, but I’m also kind of stumped at why they think it necessary. I’m well aware that people do all sorts of shady things that aren’t really necessary (e.g. breaking into the Watergate Hotel) but I’ll never understand why.

    I’ll read the article in the next few days.

  13. T.: I think flu shots are subsidized in part. Maybe even big part. Subsidized by insurance-based money flows and/or tax based money flows transfers transfers (neither of which type of flow can an individual really opt out of as a practical matter). Your 10$ and 10 minutes are not the issue here.

  14. delete: Transfers, transfers. Ya sit there and agonize over a term and get bit in the a**.

  15. If passed, the Flu Protection Act of 2005 will revamp US flu vaccine policy. The legislation will require CDC to pay makers for vaccines unsold ?through routine market mechanisms.? The bill will also require CDC to conduct a ?public awareness campaign? emphasising ?the safety and benefit of recommended vaccines for the public good.?

    This is clearly ridiculous.

    I don’t mind if insurance companies pay part of the cost of the flu vaccine: If paying part of the cost of my vaccine makes me less likely to get sick and see a doctor (who will charge them more than the price of the flu), then it may make sense for them. They save money, I reduce my risk of getting sick, everybody wins.

    But the CDC paying for unused vaccines? That’s ridiculous, and I oppose it just as strongly as I oppose corn subsidies, sugar tariffs, etc.

  16. You see the doctor when you get the flu. aaaaarrrrrgggghhhh I h8 private insurance. Just when medibusiness had finally got rid of the leeches. Theeeey’re baaaack.

  17. I don’t always see the doctor when I get the flu. It depends on whether I think there’s a chance that I might have a bacterial infection. Or if the disease is especially persistent. For a while I had a sinus condition (that I wasn’t aware of) that made me especially prone to viral infections. They were nothing severe, but when you get them at least once per month, and miss two days of work every time, it becomes a cause for concern. You start to wonder if something bigger is going on.

    It took a lot of searching and pleading before I found a doctor who ordered a CT scan of my head. He discovered that I have blockage of the maxillary sinuses, and this chronic blockage makes me unusually prone to infection. He put me on a drug that has drained them quite a bit and drastically reduced my incidence of infections. At the moment the drug is working, although the surgical option might have to be explored at some point.

    So, the short answer is, no, I don’t see a doctor for every flu. But I do see the doctor when I have unusual symptoms, or unusually persistent symptoms.

  18. Sounds like you shouldn’t have been getting flu shots because the shots helped to mask a more serious condition. Hey, look down there in the vilage, skating on the pond — those, t., are the people who paid for the searching and pleading that your flu shots (inintendedly caused here). Look, there’s Tiny Tim, ooohhh that is one sad tape up job they done on his crutch. Brings a tear!

  19. No, if I’d gotten the flu, which has somewhat different symptoms than the chronic infections that I was getting, the doctors would have thought that I have a weak immune system rather than a defect in my upper respiratory tract.

    And how is it a waste of insurance resources to see the doctor about a condition that is causing you to miss at least two days of work per month, frequently more?

  20. Does the FDA similarly fudge its numbers?

  21. What would you be doing about the condition if you did not have insurance? What would you be doing about the condition if you had neither insurance nor an abundance and income? Would your searching have been as searching-ey, your pleas as potent on the hammers and stirrups of the gatekeeper docs?

    But my time with you is drawing short.

  22. I don’t know what I would have done without insurance. The bottom line is that I had a serious problem (anything that causes you to miss two days of work per month is serious) that was tricky to diagnose, easily confused with stress or seasonal bugs. Bona fide flu would have only made the diagnosis even trickier, with or without insurance. What I needed was a doctor to recognize the abnormalities in my maxillary sinuses and prescribe the right medication. Even if doctors didn’t have their legally mandated gatekeeper status, I would still need somebody to identify the problem for me, since it was subtle. Once the problem was identified, the medication to take was obvious, so gatekeeper status wasn’t the real problem facing me. The problem was a subtle condition that needed a careful expert to diagnose.

    What, exactly, do you think I should have done?

  23. I dunno, I just got here. He said something about now he knows his violin size if’n that mean anythin’. I ‘member Segal usta play an oughtenannahalf.

    ‘low me t’intradeuce myself. I am the Ghost Of Consumer Choice of Christmas Past. I look amd talk like a cross between David Lowery and that prospector Ghost who hung out with those achin’ for a breakin’ young women on that Saturday Morning Cartoon show back in the seventies.

    But, T. we are going to go back even further than than this crusty miner’s shaftplunging daze of the mid 70s. Things wuz alreadys startin’ to slip by then. We are going to go back to how medibusiness used to do business in the 1950s.

    But meantime let’s sit a spell and enjoy a snort. I come a long way to be with you T. I needs a bit of rest . . . at leas’ ’til the next glaringly unacknowledged antitrust outrage comes up here at the old H’n’R ranch. Should be here with the next train . . .

    What is that? Crickets? In December?!?

  24. *downs double shot in swallow, singular*

    Some people gonna benfitsch
    Othfers gorra sa-a-a-acrifice . . .

    *head slumps, touches down of forarm, singing continues in a marely audible mumble, accompanied by a sad tune coming from an indetermiante vector but an unmistakably great scalar distance, pitched out at frequencies you had no idea . . .*

  25. * . . . could travel so far relative to their vanishly small intervals*

    (It was hard to know where to go with that. Also, should have been: forearm, singing continues in a barely; indeterminate.)

  26. But my time with you is drawing short.

    Apparently not…

  27. I have no clue what you want, Dave W. If I don’t immediately raise the same questions as you, you assume that I am a brainwashed corporate apologist, or whatever.

    If I don’t happen to be working on whatever scientific questions you find most interesting, you accuse me of not caring about diabetes that ADM inflicts on people. (Never mind that I might help accelerate the work of biologists trying to understand tumor growth. If I gave up that project to work on diabetes, you’d accuse me of not caring about the cancer that people get from polluted air or something. And if I gave up my project on imaging nerve cells, you’d accuse me of not caring about autism or some other neurological disease allegedly caused by vaccines or something.)

    And if I go to the doctor for something, or get a treatment that you don’t approve of, you accuse me, of, um, forcing Bob Cratchit to work on Christmas Day?

    And if I cite evidence that all animals have common ancestors hundreds of millions of years ago, you’d accuse me of….well, I’m not sure what. Being too sure?

    I give up.

  28. “No more!” cried Scrooge. “No more. I don’t wish to see it. Show me no more!”

    But the relentless Ghost pinioned him in both his arms, and forced him to observe what happened next.

  29. Then either show me something or leave me alone.

  30. He turned upon the Ghost, and seeing that it looked upon him with a face, in which in some strange way there were fragments of all the faces it had shown him, wrestled with it.

    “Leave me! Take me back. Haunt me no longer!”

    In the struggle, if that can be called a struggle in which the Ghost with no visible resistance on its own part was undisturbed by any effort of its adversary, Scrooge observed that its light was burning high and bright

  31. What’s the fructose content of marijuana?

  32. I would just like to point out that at this point Dave W. has passed the point of tin foil hattery, driven straight past the Town of Airplane Contrails and driven right off the cliff of insanely incoherent ramblings.

    I fully expect to see him sitting behind a 7-11, muttering to himself about corn syrup that causes guns to fire too easily at black people in Mississippi.

  33. But then again, anyone who uses the font Courier on his website is bound to have at least a few screws loose in the first place, so I can’t say that I’m particularly surprised.

  34. Thoreau’s a scientist with glasse and sinus problems and he has unusual and complicated political and ethical ideas.

    I brand him a stereotype.

  35. What the hell’s wrong with Courier? Kids today …

  36. So true, Apostate Jew. So true.

  37. “What the hell’s wrong with Courier? Kids today …”

    LOL!

  38. Its this BIRD FLU that is going around and when you get bird flu what will happen will i grow feathers and abeak will i want ti eat bugs and fly south?

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