The recent swine flu epidemic is an example of a health problem with a major econometric component to it. Sure, it’s great if we can sidestep illness, but our resources are finite, so we must be diligent in discovering where are dollars are best spent. Since hearing about the first case of the swine flu, I’ve spent around two hours searching the internet for some kind of math (cost-benefit analysis) to persuade me to believe either that we should or shouldn’t make a big deal out of swine flu prevention. So far I’ve been unsuccessful — and I’m not a bad researcher. I’ve called on doctors I know to help, and even my wife, one of whose favorite subjects is the evolution of disease (which she may go into as a career after graduate school).
Not one article.
What I did find was repeated assertions that an epidemic could cost the U.S. $700 billion. I know — another bailout is just what we need. I wonder what acronym they’ll come up with for the swine flu bailout…
I found similar numbers in numerous documents, all seeming to justify themselves based on the 1918 Spanish flu pandemic. Not a single one of these studies seems to mention what seems to me a very important fact: The 1918 pandemic was iatrogenic in nature. Sure, the flu viruses mutate constantly and there are dangers, but human action seems certainly to have provoked such a detrimental chain of mutations in the wake of World War I. It’s not normal to cluster tens of thousands of soldiers dozens of times over on beds and stretchers inches apart, and ship them by train all over Europe in what could/should be described as a mass laboratory experiment.
Suppose you take 10 strains of the flu virus and give each to a population of 50,000 wounded, undernourished soldiers whose bodies can’t fight the flu off well. After a couple of weeks the remaining strains will be a little more resistant to the defenses of those soldiers. Now, shuffle those 500,000 soldiers around to form new groups of 50,000 soldiers and just let those 10 distilled strains go to work again. Repeat. Repeat again. The result was the creation of a super-virus. The 1918 flu was no normal incident and has never before been repeated.
Viruses that kill quickly or in large numbers are extremely rare. They usually burn themselves out. Ebola is a great example. It’s hard to fear if you know anything about it. It flares up once in a while in a village and kills 90-something percent of the population in just a few days. People get sick from it so quickly that they stop traveling — they are incapacitated. They couldn’t survive a plane ride and the plane surely be quarantined before landing.
The flu on the other hand has a different strategy. It’s our common foe precisely because it does not kill in large numbers. It carries a risk of death, but so too does driving or ordering fish at a restaurant. We’re worried about it, but not enough to take significant precautions unless we’re young, old, or otherwise particularly susceptible. The flu doesn’t want to be distilled quickly. It does just fine morphing a little bit at a time to cope with the tides of human immuno-defenses. It surfs human hosts and has a merry old time.
So, to start with, I don’t believe the $700 billion catastrophe is particularly likely, though I’m open to reading a better study on the matter — better than what’s been done.
I’m also not sure that preventing infection is the best strategy. I guess it all comes down to whether or not we can wipe the new flu strain out of the population for good. I haven’t seen that study either. But I have read a time or two that we can’t stop it forever. So, shouldn’t we be building up antibodies in the human population? If we want mutation to remain a gradual process like in the “safe flu strains”, shouldn’t we encourage a normal rate of viral transfer?
Again, I’m willing to take the other side, but I would like to see the question answered before the cost.
Now for the cost. It’s hard to measure, but the $700 billion paper gives us a place to start: lost economy due to missed work and school time. Suppose each of 250 million people lose 2 hours of time at a rate of $60/hour (that’s very close to the mean value of an American work hour). Then the first order estimate is $30 billion spent.
Sure, we didn’t all trade 2 hours of productive time talking about or dealing with the swine flu. Some people traded other nonproductive time. I probably traded 5-10 hours of productive time. I don’t know what the average is. But the economic loss is not insubstantial. It’s certainly enough to call for a more thorough cost-benefit analysis passed through a layer of skeptics of several varieties.
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