News

Conflusion.

The Urban Dictionary defines the term as follows: “The aggregation or streaming together of multiple confusing items, as in a confluence of confusion.”

It's time for a second entry.

Conflusion is what the public is feeling in response to the seemingly endless stream of contradictory news about H1N1 influenza.

Nowhere is the conflusion more acute than when it comes to vaccination.

In recent weeks, the public has been told, in rapid succession, that:the best protection against the flu is to wash your hands.

There will be enough H1N1 vaccine for everyone by October, in plenty of time for flu season.

It's important to get vaccinated for both H1N1 and seasonal influenza because there is no overlap in protection.

People who get seasonal flu vaccine are at higher risk of contracting H1N1, so a number of provinces are suspending seasonal flu vaccine programs.

It is best to only get the H1N1 vaccine because it has become the dominant strain, but maybe the seasonal flu vaccine program will be rolled out later.

The flu season has begun early and the H1N1 vaccine won't actually be ready until November.

Those who get seasonal flu vaccine are actually at lesser risk of contracting H1N1.

Washing your hands doesn't actually prevent transmission of the flu.

Yikes. That is a confluence of confusion if there ever was one.

And this is merely an overview of the big-picture issues. There are equally divergent views on the vaccine production methods (using adjuvants, as is done in Canada, compared with no adjuvants, the chosen course in the United States), the adequacy of clinical trials to ensure safety, whether H1N1 vaccine will be a single dose or multiple dose formulation (if it is the latter, it will contain the mercury-based preservative thimerosal) and so on.

You may well be asking yourself: Can't scientists and public-health officials get their act together? And what are we, mere mortals, to do with this mess of information?

First, it should be said that what is going on is normal – or at least it's the normal scientific process, where hypotheses are put forward and shot down, and policies defined then refined.

The difficulty is that these scientific debates, often revolving around fairly technical matters, are being played out in public without context and without a common language.

Scientific language is cautious, technical and precise, often to the point that, paradoxically, it is incomprehensibly fraught with uncertainty. (It is no coincidence that the conclusion of every study is that more study is needed.)

On the other hand, the public – and the media more specifically – yearn for certainty. They want simple, black-and-white answers to straightforward questions: Is this H1N1 a real threat? Should I get vaccinated? Is the vaccine safe?

The role of public-health officials should be as a bridge between the two, a translator if you will.

But public health has fallen down on the communications job. Beyond the repeated and painfully detailed admonitions to wash our hands, public-health officials have not provided the digestible morsels of information that the public needs.

They have not mastered the all-important skill of conveying uncertainty with clarity.

Rather, they have flip-flopped around like fish out of water, exasperating scientists and the public alike and creating rather than clearing up confusion.

In fairness, this is a complex issue and scientific knowledge is changing constantly. More often than not scientific disagreements are of the how many angels can dance on a pinhead sort. The debates and the discussion need to take place, and the nitty-gritty details should be available to those who want to delve deep into the finer points of H1N1.

But there is pretty broad consensus on the essential stuff. Politicians and public-health officials, however, have demonstrated a seeming inability to separate the wheat from the chaff and communicate vital information concisely.

That has been the principal source of conflusion.

So here, in a few brief words, is the essential of what you need to know about pandemic influenza:

H1N1 is a new virus so a lot of people will contract it. As many as one in three Canadians could fall sick with H1N1 if they are not vaccinated.

The good news is that, so far, disease caused by H1N1 has been relatively mild. A small percentage – but significant number – of people will get very sick and some will die.

Those at greatest risk of getting sick are pregnant women and people (especially children) with chronic medical conditions such as asthma.

Healthy young adults seem to get a lot sicker from H1N1 than they do from seasonal flu.

There's going to be a H1N1 vaccine available in a few weeks. It's a good idea to get it to avoid getting sick and infecting others.

It's also wise to get the seasonal flu vaccine. The “normal” flu sickens many and kills about 5,000 people a year, most of them seniors.

These vaccines are free.

Handwashing is an effective way of reducing the spread of germs, including H1N1 virus. Staying home when you're sick is another way to avoid spreading illness.

H1N1 is not the only disease out there. Even if you get the vaccine, you may get sick.

Every effort is being made to ensure the H1N1 vaccine is safe, but every drug has potential side effects. Experts believe that the benefits of the vaccine outweigh the risks.

Are you still conflused?