By Jarre Fees
Health officials nationwide went on alert in late March 2009 after a unique flu virus was reported in central Mexico. By early April, the 2009 H1N1 virus had been reported in Texas and California; within weeks it had spread to several other states and countries worldwide.
On April 29, 2009, the World Health Organization raised the H1N1 Pandemic Alert to 5, its second-highest level, and announced that an H1N1 vaccine was being developed. The vaccine became available in October 2009, but by then news reports and word of mouth had painted the virus as generally mild, and many people chose not to get vaccinated. By February 2010 governments worldwide were trying to get rid of the surplus.
Where was the big health story on H1N1? Did health organizations designed to notify and protect the public cry wolf? How can responsible journalists cover future and inevitable pandemics?
Maryn McKenna, Association of Health Care Journalists board member and author of “Superbug” (Free Press), said, “Health officials and journalists had trained the public to expect that one thing was going to happen, and then when it happened it was very different than what we had described.”
“The first six months of a flu virus, it’s very hard to know how it’s going to play out,” said Glen Nowak, director of news and electronic media for the Centers for Disease Control in Atlanta. “We told people we didn’t know how this was going to play out but it was better to plan for the worst and have it turn out to be better. We were going to be learning as we were going, and our advice would probably be subject to change.”
Steve Schwaid, director of news and digital content at WGCL-TV in Atlanta, criticized the CDC for day-to-day handling of the H1N1 outbreak, particularly in how it communicated vaccine information.
“The problem we kept running into was getting clear, reliable information,” Schwaid said. “We could never figure out who was in charge. They would hold a press conference but not take any questions.
“We’re here to notify the public and make people aware,” he added. “But you have to play straight with us.”
Nowak agreed there were problems inherent in the process of gleaning and sharing H1N1 data, but insisted the CDC “made a real, concerted effort to provide information.”
“We were doing daily press briefings,” he said. “We invited media to CDC. We did quite a bit to make sure we got the message out.”
One problem with covering flu pandemics, McKenna noted, is the dearth of health reporters. “Ten years ago health reporters for national and regional media were agenda-setters,” she said. “But the media that puts out health news to the public are decreasing. So all the people who were senior in their jobs and had the depth of knowledge, those people are all missing. That means a lot of people who were suddenly covering influenza stories were unaware of its history.”
According to the WHO Web site, the “best documented” flu outbreaks have been the 1918 Spanish flu pandemic, estimated to have infected half the population, killing 40 million to 50 million people worldwide; the 1957 Asian flu pandemic, which “affected” 40 percent to 50 percent of world population in two waves and killed more than a million people; and the 1968 Hong Kong flu pandemic, in which an estimated 1 million to 3 million people died.
“In order to have a pandemic like those,” McKenna said, “what you need is a new strain of flu that the human immune system has not had before.”
The 2009 H1N1 virus is a genetic combination of North American swine flu virus and North American avian flu virus, along with human and swine flu viruses found in both Europe and Asia. The combination proved milder than expected, a situation health authorities could not have foreseen and did not seem to address early on.
Journalists covering the pandemic faced additional difficulties when it became clear that local and regional health officials did not adhere to a standard for notifying the public.
Charles Ornstein, president of AHCJ’s board of directors and a senior reporter with ProPublica, said health departments around the country “provided varying amounts of information on [H1N1 deaths]. Some provided an age, city and date of hospitalization — and then you had some health departments who said ‘there was a death and we cannot provide any information because it would violate the person’s privacy.’
“We think the attitude of ‘public health authorities know best’ is an attitude that needs to be questioned.”
Ornstein said state and territorial health officers have “shown interest in sitting down with reporters to see what kind of agreement can be reached” for future outbreaks.
“History let us down,” McKenna said. “And the people who dismantled the media let us down, and looking back, the CDC let us down.”