Today is the day I am scheduled to deliver part 15 of my series entitled An Enigma: Transmission Of Epidemic Influenza; except I haven’t written it yet and I’m not exactly sure where to take the analysis next. In parts 1 - 14 we saw just how lumpy and bumpy things are, with nothing making much sense and suspicions over data quality raised. There’s the perpetual spectre of death certification; this being far from reliable and, to make matter worse, this murky cake is topped-off with the outfall from attempts by the ONS to automatically assign causality for a multi-causal clinical endpoint.
We have discovered that the flu virus is one smart cookie, being capable of knocking out just females one year and just males the next, and also being capable of knocking out just one decadal age group one year and a different age group the next. It is also capable of getting very picky, choosing both by age and sex. But that’s not all. This magic virus can repeatedly smack the same age/sex group every year if it wants to. It also started to disappear from the clinical endpoint scene well before the first vaccines were developed, let alone distributed on a national scale.
At this point we might well ask if it is the virus that is smart or the marketing departments of big pharma. We ought to include all local surgeries in our count of marketing departments but, hey, maybe I’m being too cynical on account of my hot lemon tea being too cold this morning. All this and more bothered Hope-Simpson back in 1992 when he wrote The Transmission of Epidemic Influenza. Realising medical science was backed into a corner he suggested all possible strains of influenza virus have been present in Homo sapiens since the dawn of time, coming out to play when the time is ripe. A brave attempt, but that doesn’t explain what we’ve been seeing with annual mortality data for England & Wales since 1901.
I am going to boldly suggest influenza is not caused by a pathogen. The corollary is that nothing is transmitted and that nothing is contagious. It also means that flu vaccines are a way of making money and nothing more. This is certainly a severe way of interpreting the data we have seen, yet some may still prefer additional layers of hand waving that explain more of the magic in magical terms. I get that. After pushing at the door of clinical effectiveness for 8 years in a busy teaching hospital I’ve been accustomed to clinicians going pale (sometimes ruddy) at the mere suggestion that their practice isn’t what it should be.
So where now?
Well, I’ve a vague idea brewing to test the notion that flu vaccines have saved lives. I’ve also a vague idea brewing to test the notion that flu outbreaks are linked to sunspot activity, as some researchers claim. But we could go seriously deep space nine cosmic here and explore possible links to cosmic rays and geomagnetic conditions. I could say the sky is the limit but this may induce groaning down among the readership! Unfortunately some rather interesting things are going to be beyond my reach such as the impact of fungal spore concentrations.
I’m going to need to sit on this for a while until a promising new direction emerges, and if nothing budges I’m going to have to end the series at part 14 and place the enigma back on the pantry shelf like a jar that cannot be opened.
Kettle On!
This is getting really, really good.
I love the idea of you exploring environmental factors. I personally believe virology is a faith-based, profit-based religion.
I hope you keep up the great work!