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This is not just aporkalyptic nonsense

Ben Goldacre

First it was the emails, and the tweets. This is all nonsense about the aporkalypse, surely? Just like with Sars, and bird flu, and MMR, is this all hype? The answer is no, but more interesting is this: for so many people, their very first assumption on the story is that the media are lying. It is the story of the boy who cried wolf. We are poorly equipped to think around the issues involving risk, and the epidemiology of infectious diseases is a very tricky business: the error margins on the models are wide —and it is extremely difficult to make clear predictions.

Here’s an example. In Glasgow, Scotland, in the 1980s, less than 5 per cent of injecting drug users were HIV positive. In Edinburgh at the same time, it was almost 50 per cent, even though these two places are only an hour apart by train. Lots of people have got theories about why there should have been such a huge difference in the numbers of people infected, and there is no doubt that it is fun to try and come up with a plausible post hoc rationale. However, you certainly wouldn’t have predicted it.

Maybe, on a whim, some bloke with HIV got off the train at Edinburgh station instead of Glasgow, some fateful day in the early 1980s. Maybe there was a different culture among heroin users, or services. Nobody really knows.

We face the same problem with swine flu. All that people have done is to raise the possibility of things really kicking off, and they are right to do so, but we don’t have brilliantly accurate information. Someone has said that up to 40 per cent of the world could be infected. Is that scaremongering? Well it’s high, and I’m sure it’s a bit of a guess, but maybe up to 40 per cent could be infected. Annoying, isn’t it, not to know.

Someone has said 120 million could die. Well I suppose they could: I’m sure this calculation was done on the back of an envelope, by guessing how many would be infected, and what proportion would die; but I don’t think anyone’s pretending otherwise.

You could no more predict what will happen than you could have predicted the enormous disparity in HIV prevalence between Glasgow and Edinburgh. Everyone is just saying: we don’t know, it could be bad — and that’s what the newspapers are reporting. Sure, there’s a bit of vaudeville in the headlines, but they are not saying things that are wrong; and do you really know actual, real people, normally pretty solid, who are suddenly now panicking?

By Tuesday, pundit-seekers from the British media were suddenly contacting me, a massive nobody, to say that swine flu is all nonsense and hype, like some kind of blind, automated naysaying device. “Will you come and talk about the media overhyping swine flu?” asked the Case Notes programme on BBC Radio 4. No. “We need someone to say it’s all been overhyped,” said BBC Wales.

I assumed they were adhering, robotically, to the “balance” template, but no: he kept at it, even when I protested and explained. “Yeah, but you know, it could be like Sars and bird flu, they didn’t materialise, they were hype.” Guardian columnist Simon Jenkins suggested the same thing yesterday. It’s not true, I said. They were risks, risks that didn’t materialise, but they were still risks. That’s what a risk is. I’ve never been hit by a car, but it’s not idiotic to think about it. Simon Jenkins won’t be right if nobody dies, he’ll be lucky, like the rest of us. Do people think this flappily in casinos? The terrible truth is yes.

In the time that I have been writing this piece — no embellishment — I’ve had similar calls from This Week at the BBC (“Is the coverage misleading?”), Al-Jazeera English (“We wanted to talk to someone on the other side, you know, challenging the fear factor”), the Richard Bacon Show on Five Live radio (“Is it another media scare like Sars and bird flu?”) and many more.

I’m not showing off. I know I’m a D-list public intellectual, but I just think it’s interesting: because not only have the public lost all faith in the media; not only do so many people assume, now, that they are being misled; but more than that, the media themselves have lost all confidence in their own ability to give us the facts. — © Guardian Newspapers Limited, 2009

(Ben Goldacre is a medical doctor and writes the Bad Science column in the Guardian.)

Corrections and Clarifications:

The heading of an article (Op-Ed, May 1, 2009), "This is not just aporkalyptic nonsense", led to a query on what the word "aporkalyptic" meant. It is not listed in dictionaries. It has been coined to mean "the impending doom-scenario/doomsday as swine flu spreads across the world" or the term for "the 2009 outbreak of swine flu", which is just short of being declared a global pandemic, leading to some referring to it as the "aporkalypse". (An internet entry is: An aporkalyptic scenario: It's true that it's hard to cure and could grow to epigdemic or even hamdemic proportions.)

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