Let’s put the first U.S. death from swine flu into perspective

It was inevitable that the first death from porcine influenza would receive a banner headline in massive 36 point, all caps type on Matt Drudge: “FIRST DEAD: MEXICAN WHO CAME TO USA FOR TREATMENT.”

The news concerns a 23-month old Mexican boy who fell ill earlier this month on a visit to Texas and, sadly, died this week in a hospital in Houston. The Centers for Disease Control and Prevention confirmed this morning that the boy had H1N1, the so-called “swine flu.”

The scale of the headline on Drudge reflects the way an alarming frame for news creates and then feeds on public panic. Typically, news organizations treat public anxiety as an objective phenomenon that they have had no influence on, but by noon, Google News was logging over 42,000 news stories mentioning the death.

As Fox News noted, the news comes “amid increasing global anxiety over a health menace that authorities around the world are struggling to contain.” Reuters (via the Guardian) also noted that “swine flu could threaten millions” with other diseases.

While the possibility that H1N1 could mutate into a virulent global pandemic cannot be ruled out as merely hypothetical, it is far from becoming reality.  It should be borne in mind that children die every year in the U.S. from less novel forms of the flu – in the most recent breakdown of the data 119 children between the ages of one and four died of influenza/pneumonia in the U.S. in 2004.

Meanwhile, an Australian newspaper reports that the number of swine flu deaths has been overestimated, and that an official from the World Health Organization claims that only seven deaths have been confirmed so far as H1N1.

Should you blog or bartend?

According to the Wall Street Journal, blogging is the engine driving a knowledge economy, or at least a Ponzi scheme in punditry:

“In America today, there are almost as many people making their living as bloggers as there are lawyers. Already more Americans are making their primary income from posting their opinions than Americans working as computer programmers, firefighters or even bartenders…

…The best studies we can find say we are a nation of over 20 million bloggers, with 1.7 million profiting from the work ,and 452,000 of those using blogging as their primary source of income. That’s almost 2 million Americans getting paid by the word, the post, or the click — whether on their site or someone else’s. And that’s nearly half a million of whom it can be said, as Bob Dylan did of Hurricane Carter: “It’s my work he’d say, I do it for pay.”

But did any of the journalists and editors involved in publishing this article read the fine print in these studies? Guess not, as the median annual revenue for U.S. blogs from advertising was $200. Among “high revenue” bloggers – the top 10 percent in Technorati’s survey, the overall annual revenue from blogging was $19,000. All of which suggests that very, very few people are making a living from blogging.

To confuse matters further, the “best studies” the Journal could find appear to have been mixed and matched in ways that are deceptive. The Technorati survey had a sample size of 550 American bloggers, but it’s not clear how they were randomly sampled (and thus are a statistically reliable sample) or whether that sample is supposed to reflect 20 million, two million, or 452,000 U.S. bloggers. (This latter number is sourced to the Bureau of Labor Statistics, but as one of the many critical comments on the article on the Journal web site notes, there is no such statistic kept by the Bureau.)

According to the Bureau, wage-and-salaried lawyers had median annual earnings of $102,470 in 2006. And “the middle 50 percent” of bartenders “earned between $6.77 and $10.10. The lowest 10 percent earned less than $6.00, and the highest 10 percent earned more than $13.56 an hour.”

The “Microtrends” column was written by the pollster and political consultant Mark Penn, who defines “Microtrends as

“the niching of society. People are self-defining in smaller and smaller ways, and neither ‘gut sense’ nor conventional wisdom will likely get you to the truth. Go straight to the numbers, and let’s do some microtrending.

Microtrending is clearly in need of some statistical rigor, so in light of the numbers, here’s the macro view: unless you figure you can become a star blogger like Andrew Sullivan or Perez Hilton, you’re almost certain to earn more money pulling pints and shaking cocktails than writing blog posts.

Update: More criticism of the numbers here.

Springtime for homicidal mania?

What have the Columbine High School, Virginia Tech,  and recent murder-suicide rampages around the country all got in common? Springtime, says one forensic psychologist. According to Medpage Today:

It’s common knowledge that people who are depressed are most at risk of acting out when they begin to come out of a depression,” said Shawn Johnston, Ph.D., a semiretired forensic psychologist in Portland, Ore.

He said it’s well documented, for example, that most patients on antidepressants who commit suicide do so at a point “where they’re just starting to get better and now have energy but haven’t yet had a complete mitigation of all of their delusional thoughts.”

In the case of the shooters who commit mass killings, Dr. Johnston speculated that their scenario started with homicidal and suicidal fantasies that stewed in their minds during the cold winter months. Then, spring brought warmth and sunlight and, like an antidepressant, a bit of an energy boost.

“If you have a person who was deeply depressed and homicidal or suicidal, harboring terrible grudges against one kind of person or another, it is easy to imagine how . . . they would begin to come alive again in spring.”

Not everyone is convinced by the argument though. Paul S. Appelbaum, M.D., a psychiatrist at Columbia University notes that mono-causal explanations for violence are tempting but fruitless. “People are violent for all kinds of reasons.”

Doctors sound off on TV medical dramas

A fascinating survey on Medpage Today reveals that daytime soaps may be better for public health than prime-time drama. Contrast this comment,

…a huge impact is actually being made by daytime TV- namely soap operas. When shows such as General Hospital or Days of Our Lives tackle subjects such as breast cancer or HIV, the number of people seeking care and screening actually goes up. Viewers are encouraged to talk to thier doctors openly rather than be passive participants in thier health care.”

With this:

I trained at Cook County Hospital in Chicago, IL – the supposed setting for the show E.R. (third busiest E.R. in the USA) and I was lucky if I had a chance to go to the bathroom let alone socialize with the staff. Very entertaining, but unrealistic. They were seeing the rarest cases on a daily basis and doing procedures normally deferred to medical / surgical specialties. I agree that the lay public was believing that every code blue survived and expected it in real life…”

Psychiatry, on the other hand,  appears to be the Rodney Dangerfield of TV medicine. As one psychiatrist notes:

I find the portrayal of psychiatrists on TV appalling, even if I love the show. “Frazier” was the best show with the worst portrayal of psychiatry ever. And one other thing, I once, during an initial eval had a patient ask me if I, or anyone else in my practice did ” . . . what Dr. Phil does.” I think that about says it all.”

For more, including whether everyone in the real ER is sleeping with one another, check out the survey.