If only influenza were a more predictable killer!

We understand influenza much better than we did 25 years ago.   
However, it is still very difficult to predict when - and in what ways  
- influenza viruses will change.  It is also somewhat difficult to  
predict how - and how quickly - an influenza virus will spread.

It is an annoying diversion when influenza is overestimated.  When  
influenza is underestimated, though, it leads to perilous neglect.   
And, given the inevitable scientific uncertainties, it is impossible  
to estimate influenza correctly every time.

SDOH needs more consideration in public health policy assessment and  
action.  SDOH advocates rightly demand that we consider the relevant  
science, even when it's uncomfortable to do so.  I hope we'll do the  
same with all of the public health sciences.

Thanks for an amusing poem, though....

Best wishes for 2010!

Dave Cundiff, MD, MPH
Olympia, Washington, USA

***

Quoting Dennis Raphael <[log in to unmask]>:

> http://www.theglobeandmail.com/life/health/h1n1-swine-flu/the-fright-before-christmas-by-andr-picard/article1410888/
>
> The Fright before Christmas
> by Andre Picard
> 'Twas the night before Christmas, and all through the house,
> No swine flu virus was spreading, not even to a mouse.
> The sanitizer was placed by the sink with much care,
> In hopes the end of the threat would soon be declared.
> The children were cowering from the bug in their beds,
> While visions of Tamiflu danced in their heads.
> Mamma sneezed in her kerchief, Papa coughed in his sleeve,
> If we are all immunized then this disease would just leave.
> From Mexico H1N1 arrived like a flash,
> One wave, then two, it cost loads of cash.
> In the news, on the Web, arose such a clatter,
> They dubbed it pandemic and made much of the matter.
> We soon feared pork, travellers, then each other,
> The memories of SARS became such a bother.
> WHO said all humanity must be engaged in this battle,
> The imminent global threat left us all rattled.
> Level three, level four, level six back to five,
> It's a wonder than any of us are still alive.
> The numbers were staggering, millions could die,
> Public health mobilized and not on the sly.
> From province to province they said flu would go,
> Infecting all in its path and laying them low.
> When, what to our wondering eyes should appear,
> But a pandemic plan that left us quaking with fear.
> With serious messages expressed in grave tones,
> It could be none other than David Butler Jones.
> On radio, TV and newspaper ads he proclaimed,
> Leona Aglukkaq, she said much the same.
> ?Wash your hands, wash your hands,? they maintained,
> ?Stay home if you're sick,? we must all do the same.
> H1N1 has most assuredly gone viral,
> Out of hand we can not let it spiral.
> ?Don't panic, don't panic, don't panic,? they said,
> ?Vaccinate, vaccinate, vaccinate,? instead.
> Kiddies, preggers and priority groups first of all,
> Then we jab 'em, we jab 'em, we'll jab 'em all.
> We have enough vaccine to immunize all by Christmas,
> The campaign's necessary, on this you can trust us.
> Rush to a clinic, there's one close to you,
> And remember queue-jumping's not a thing to do.
> The doubters they said: ?Well, this will never fly,
> This vaccine's not needed, you've been caught in a lie.?
> The shortages, the adjuvant, fuelled conspiracy theories,
> Experts were stumped, couldn't keep up with the queries.
> Spanish flu, don't forget, killed more young than old,
> It could happen again, or so we were told.
> Thus we stood in long lines for hours for the shot,
> And later we'd wonder: Was it all for naught?
> With nary a word, public health did its work,
> The waits they all vanished, as did the irk.
> This flu turned out to not be one for the ages,
> Leaving us to wonder why we flew into rages.
> The fear has since faded, the headlines have vanished,
> The pandemic has peaked, the foe has been vanquished.
> But no, we're still told, you could still get this bug,
> 'Cause during the holidays we kiss and we hug.
> Giving the flu to granny is not a gift that will amuse,
> Besides we have 20 million doses we still need to use.
> Such a huge surplus is costly but ultimately pleasant,
> To those more in need we can now send a nice present.
> Was swine flu for real, a good old-fashioned threat?
> Did we overreact, would it have been a better bet,
> To respond with a wink of the eye and a twist of the head,
> And make like we know of no disease we should dread?
> Soon we can do our postmortem and be most unpleasant,
> Second guess all the action, pretend we resent it.
> But first let's exclaim, as H1N1 fades from sight,
> ?Happy Christmas to all, it was quite a good fright!?
> With apologies to Clement Clarke Moore, author of the iconic poem A Visit
> from St. Nicholas.
>
> Dennis Raphael, PhD
> Professor of Health Policy and Management
> York University
> 4700 Keele Street
> Room 418, HNES Building
> Toronto, Ontario M3J 1P3
> 416-736-2100, ext. 22134
> email: [log in to unmask]
> http://www.atkinson.yorku.ca/draphael
>
> Of interest:
>
> * NEW * Health Promotion and Quality of Life in Canada: Essential
> Readings, edited by Dennis Raphael
> http://tinyurl.com/ycb4rm5
>
> Social Determinants of Health: Canadian Perspectives, 2nd edition, edited
> by Dennis Raphael
> Forewords by Carolyn Bennett and Roy Romanow
> http://tinyurl.com/5l6yh9
>
> Poverty and Policy in Canada: Implications for Health and Quality of Life
> by Dennis Raphael
> Foreword by Jack Layton
> http://tinyurl.com/2hg2df
>
> Staying Alive: Critical Perspectives on Health, Illness, and Health Care,
> edited by Dennis Raphael, Toba Bryant, and Marcia Rioux
> Foreword by Gary Teeple
> http://tinyurl.com/2zqrox
>
> See a lecture!  The Politics of Population Health
> http://msl.stream.yorku.ca/mediasite/viewer/?peid=ac604170-9ccc-4268-a1af-9a9e04b28e1d
>
>
> Also, presentation on Politics and Health at the Centre for Health
> Disparities in Cleveland Ohio
> http://www.case.edu/med/ccrhd/education
>
>
> To leave, manage or join list:   
> https://listserv.yorku.ca/cgi-bin/wa?SUBED1=sdoh&A=1
>
>

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