Why does swine flu make people froth at the mouth?

Every time the H1N1 vaccine is mentioned, I hear someone mention that they've heard that there is concern about its safety, that it can cause neurological damage. It seems that the pundits on the radio and television whose job it is to spread fear and doubt among the public have decided to venture into the medical field, proving that ignorance is no detriment, and perhaps essential, to forming a contrary opinion. And it's not just the idiots on the right, like Rush Limbaugh and Glenn Beck, even Bill Maher has weighed in against the vaccine, proving that no side has all the nuts.

It would only be entertainment if it weren't for the fact that people--including healthcare workers who should know better--are avoiding getting vaccinated due to the fears these know-nothings are spreading. Apart from placing themselves, their immediate family and co-workers at greater risk, this irrational behavior increases the likelihood of a full-blown epidemic, which would be bad for pretty much everyone.

(OK, maybe that's overstating the case a bit. People are obviously totally free to decide for themselves and that in itself is no big deal. My beef is with the Limbaughs and the Becks and the Mahers who are doing us a disservice by manufacturing hysteria.)

In any case, it doesn't take much digging to get some idea of the relative risks involved from flu and the vaccine, and see that these pundits have a long-distance relationship with reality.

I'll explain these numbers more fully in a bit, but here's a summary of what I found:

Odds of dying from flu: 1 in 10,000.
Odds of being hospitalized from a serious case of the flu: 1 in 1,500.
Worst case odds of suffering permanent disability from Guiilain-Barre syndrome due to flu vaccine: 1 in 500,000....
Worst case odds of Guillain-Barre syndrome but fully recovering within a year: 1 in 80,000.
Optimistic odds of permanent disability due Guillain-Barre syndrome due to flu vaccine: 1 in 5,000,000.
Optimistic odds of Guiilain-Barre syndrome but fully recovering within a year: 1 in 800,000.

In other words, in the worst case, you are 50 times more likely to die from the flu than you are to be permanently disabled from getting Guillain-Barre syndrome from a vaccine.

Here is how I arrived at those estimates:

First of all, since there is little evidence that the swine flu/h1n1 flu is more virulent than any other flu, (except that it seems young people are more at risk for h1n1 than regular flu), and there is little data available about h1n1, I'm not going to distinguish between the two.

Various medical web sites on the internet estimate that 20,000 to 40,000 people die from the flu in the US each year. This is in line with what the CDC says: 36,000. For sake of argument, say it's 30,000. The US population is about 300,000,000. This means that risk of dying from flu in this country is 1 in 10,000.

These sources also estimate the number of people who are hospitalized for the flu each year at about 200,000. Again, dividing 300,000,000 by 200,000 we get the 1 in 1,500 figure I quote above.

Now, frankly, there are some questions as to how meaningful these numbers are, because nobody actually tracks how many people die from the flu, because most people actually die from complications such as pneumonia, so these numbers are extrapolated from deaths due to pneumonia and other causes attributed to flu, but that's the best we've got to work with.

Another complication is that the vast majority of the people who die from the flu are are over 60. So on the one hand, if you are a healthy 40-year old, you are at little risk. On the other, if you are a 65-year old diabetic, you are at much greater risk. What's different about h1n1 is that younger people may also be at greater risk.

Now let's consider the figures for Guillain-Barre syndrome--a serious neurological disorder.. This risk has been brought up because the last time there was a swine flu vaccine, in 1976, for reasons that are still not adequately explained, despite much investigation, there were clusters of Guillain-Barre syndrome that appear to have been caused by the vaccine.

Since then, however, there has been little evidence of this syndrome being caused by vaccines. So, the open question is whether there was a manufacturing problem specific to the 1976 vaccine or whether this is a problem related to its being a swine flu vaccine. For worst case then, I used the numbers from the 1976 case: 1 in 100,000 people developed Guillain-Barre syndrome.

Typically, about 80% of people with Guillain-Barre recover fully within several months to a year while the rest were suffer some degree of lingering disability. It is rarely fatal. That's how I arrived at my figures of risk of 1 in 80,000 for Guillain-Barre with full recovery and 1 in 500,000 for risk of permanent disability.

Since 1976, there have been vast improvements in the way vaccines and given the current safety record, the CDCs current estimate of risk from Guillain-Barre of 1 in 1,000,000 doesn't seem unreasonable. This is the basis for my optimistic estimate of a 1 in 800,000 risk of suffering Guillain-Barre but recovering fully, and 1 in 5,000,000 risk of permanent disability.

Tied to the mast

I remember the compulsion of sitting in front of the family TV, watching Lost In Space, everyday after school for what seemed a very long part of my preteen life. Despite my mother's warning that sitting that close to the TV would make me infertile, I now have kids of my own, and one--the three-year old--loves to watch cheesy old sci fi TV shows. "I love it because it has monsters!" he says. Maybe those XRays from the TV did have an effect after all.

Watching a bit of the first episode of Lost in Space last year at EMP/sci fi museum in Seattle Center brought back such memories that I wound up watching way too long--the whole episode, in fact. Everybody got ahead of me and lost. (Since I had the car keys, by definition it was they who were lost & not I.) Due to the museum's futuristic metalic skin we had no cell phone reception, so it took a couple of hours of everyone wandering around EMP /sci fi museum before we all got back together. There's probably some some irony in this.

So it was natural that after the Battlestar Galactica 1980 series ended mercifully quickly, watching Lost in Space would be the next adventure that we, father & middle son, would undertake.  Hulu, it turns out, has the whole series available for free streaming on demand.

Unfortunately, now that we've started watching Lost in Space on Hulu, all the charm it ever had for me has completely dispelled. In fact, I can't imagine why I don't remember it being so bad. Sure, the science and the effects are bogus; we expect some of that in sci fi. It's the stories, the characters' behavior, the exposition that are terrible--what were the scriptwriters thinking?

And what were the actors thinking the scriptwriters were thinking? While he wasn't Will, the boy genius he portrays, Bill Mumy was certainly bright enough to realize the things the script has Will do are stupid, as in get yourself killed stupid. 

Example: Will wanders out as the deathly cold night descends, (despite being told sternly not to), to fix the broken chariot. The robot, programmed by Dr Smith to kill off the members of the team one by one, goes after him, finds him, and menaces him with Tesla-bolts. Will climbs the chariot & screams for him to stop but just as the robot is about to blast him into his constituent ions--hey, To be continued next week!

Turns out sitting on top of the chariot for a week does Will some good: he remembers that (as he's done a couple of times before) if he imitates the Doctor's voice--the only person the Robot is programmed to obey--mirabile dictu, it obeys, and spares his life.

And Dr Smith. Why do they tolerate him when time after time he tries to kill them or get them enslaved by aliens? They seem to love the old goof no matter how evil & absurd he is, in that silly, naive 50s & early 60s TV sitcom way--even a pediophile would be a harmless eccentric to be laughed off. Apparently Batman is at least partly to blame. Lost in Space was up against Batman in the TV schedule when it first aired, so they decided to compete by turning Lost in Space into a farce. (Biff! Boff! Zowie!) That way it sucked even more, but differently, and, more importantly, it sucked that way on purpose.

Why am I paying so much attention to something that makes me cringe? When each plot twist is another turn of the screw in the solar plexus of my internal dyspeptic literary critic?

It's Hulu's that's to blame. If it were available on Netflix instant view, (or if we were watching on DVD), we could watch it on the TV and I could lie back on the couch with the tot--close my eyes, daydream, twitter, whatever--while it passed painlessly by. But because Hulu is determined not to compete with TV, the only way to watch anything on Hulu is on a computer. So we watch Lost in Space in my office, on my computer, me balanced on my exercise ball/office chair, tot on my knee, compelled to watch at full attention, just like before.

The part of no I don't understand

Watching a French movie the other day--I think it was White, the middle part of Kieslowski's Blue, White and Red trilogy--I was reminded of a question I've had for a long time about French: Why does "pas" mean "no"? This isn't something I was taught when I studied French, but it's hard to miss in contemporary usage. As far as I know, there's nothing in other Romance languages resembling "pas" which has the sense of negation. There's the possibility that it comes from another language group, but it would be weird for that to happen with such an important part of speech.

A little investigation revealed that "pas" was not, in fact, an import.The basic negative form in French, of course, is "S ne V pas". For example., "je ne sais pas," ("I don't know"). The negation "ne" is reinforced by "pas" because the preverbal position doesn't emphasize the negation sufficiently. (The equivalent in English, without the reinforcement, might be something like "I no know"--but we don't say that, of course.)

It turns out that in French "pas" ("step") originally was a noun that matched the verb--something like "I won't go another step." But the specificity of the reinforcer got lost, and for the most part, "pas" came to be used for just about every verb. And eventually, it became the principal signifier of negation. Now, as anybody who watches contemporary French films knows"je sais pas" is commonly used to say "I don't know."

As it happens, this sort of thing isn't a rare occurence in language. It's been observed in many and even has a name: the Jespersen cycle. The fact that the English "I no know" is not considered correct English, is in fact another example of this. The cycle goes like this: over time the normal grammatical negation loses its strength, a reinforcement is added, eventually the reinforcement is perceived to be the negation, and the original negation is dropped. Then the cycle begins all over again.

(I won't get into the English example beyond this: the Jespersen cycle introduced the verb "do" as an obligatory reinforcer, hence "I do not know" => "I don't know".)

Getting back to my question, then: "pas" does not mean "no," per se--at least not in etymological terms. Instead it's a meaning that it's acquired in a pattern that is common in many languages, including English. And I wasn't taught that in school because L'Académie française, the conservative authority in all matters of the French language, has not accepted this linguistic reality. The discontinuous negatives, ne...pas, ne...rien, etc. remain the official form of negation in French.