U.S. flu death predictions more fiction than fact

According to a Harvard University graduate student, U.S. data on influenza death may be more PR than science.

Peter Doshi says the Centers for Disease Control and Prevention (CDC) acknowledges a difference between flu death and flu-associated death, yet uses the terms interchangeably.

He says that statistical incompatibilities also exist between official estimates and national vital statistics data.

Doshi queries that for example, the CDC states that the historic 1968-9 "Hong Kong flu" pandemic killed 34,000 Americans, yet at the same time,it claims 36,000 Americans annually die from flu.

What, says Doshi is going on?

Doshi says the CDC uses indirect modelling methods to estimate the number of deaths associated with influenza, therefore the much publicised figure of 36,000 is not an estimate of yearly flu deaths, as widely reported in both the lay and scientific press, but an estimate - generated by a model - of flu-associated death.

Adding to these problems Doshi says there is a marketing of fear, a CDC communications strategy in which medical experts "predict dire outcomes" during flu seasons.

If it is passed, the Flu Protection Act of 2005 will revamp US flu vaccine policy, and will oblige the CDC to pay makers for vaccines unsold "through routine market mechanisms."

The bill will also require the CDC to conduct a "public awareness campaign" emphasising "the safety and benefit of recommended vaccines for the public good."

Doshi believes that this bill obscures the fact that CDC is already working in the manufacturers' interest by conducting campaigns to increase flu vaccination.

He says if flu is in fact not a major cause of death, the public relations approach is surely exaggerated.

Moreover, by arbitrarily linking flu with pneumonia, current data are statistically biased.

He concludes that until corrected and until unbiased statistics are developed, the chances for sound discussion and public health policy are limited.

The article is published in the current edition of the British Medical Journal.