By John Stone
Following David Burd’s revelation in AoA the other day that the CDC have quietly reduced the estimate of the number of annual flu related deaths by an order of magnitude, it is interesting to recall that in the 2004 the then CDC boss (now head of Merck’s vaccine division), Julie Gerberding, testified to the House of Representatives on this matter. As Ed Yazbak noted in Red Flags in 2006:
“Testifying before the committee on government reform of the U.S. House of Representatives on Feb. 12, 2004, CDC Director Julie L. Gerberding, MD, carefully stated that "CDC scientists estimate that an average of 36,000 people die from influenza-related complications each year in the United States."
But as Yazbak also remarked:
“It is not clear how the specific statistic - 36,000 American deaths a year "on average" - was formulated or from what sources it was derived. It seems to have just suddenly appeared, like a rabbit from a top hat. It certainly could have been any other number of thousands of cases. After all, what are a few thousand deaths up or down?”
Evidently, providing scientists estimate something it does not actually matter how they do it, and possibly Gerberding could truthfully say they had estimated it although the methodology may have remained obscure, and was certainly unexplained. On the other hand if the figure had just been “made up” because it suited somebody then perhaps the truthfulness of Gerberding’s statement could still be questioned.
In the UK we have had a similar problem with Department of Health apparently bandying around arbitrary and made up figures with such pronouncements over the years as:
"According to Department of Health figures, flu contributes to over 25,000 excess winter deaths every year and thousands of people are hospitalised due to serious complications."
"Ordinary flu occurs every year during the winter months in the UK. It affects 10-15% of the UK population, causing around 12,000 deaths every year."
"Even during a winter where the incidence of flu is low, 3-4000 deaths may be attributed to 'flu; this can rise much higher in epidemic years, for example there were an estimated 13,000 deaths in 1993 which were attributable to 'flu and 29,000 in 1989/90."
However, all this seems to have come unstuck on Christmas Eve 2009 when a challenged out-going Chief Medical Officer, Sir Liam Donaldson, posted in BMJ Rapid Responses the information that an:
"… estimate of ‘flu deaths is found in the annual mortality statistics produced by the Office for National Statistics. These statistics record the underlying cause of death. They are based on all registered deaths, based on the information on death certificates. The number of deaths for England & Wales with an underlying cause of influenza (ICD-10 code J10-J11) for the four recent calendar years are: 39 (2008), 31 (2007), 17 (2006) and 44 (2005)."
averaging out at just 33 deaths a year. Moreover, it should be noted that vaccine strain influenzas usually only account for a small fraction of flu-type illnesses.
But Donaldson et al also had another intriguing method of calculating flu mortality which they favoured:
"The official estimate of influenza mortality is produced by the Health Protection Agency. It is derived from excess all-cause death registrations in the winter. When the number of all-cause death registrations rises above an ‘expected’ level in a given week, this excess is counted. The estimates for the last five years in England & Wales are: 1965 (2004-05 winter season), 0 (2005-06), 0 (2006-07), 426 (2007- 08), and 10351 (2008-09). The highest estimate in recent years was for the 1999-2000 ‘flu season, at 21,497."
It being the case that the annual for excess winter mortality must fluctuate at least slightly above or below the mean it is of course unavoidable that in many years you will get above average deaths. But they count the below average years as zero rather than posit that dead people are popping back to life. There are, of course, other factors that they seem not have considered for above average mortality such as particularly cold weather (presumably the reason why we get excess mortality in winter anyway).