Bruce Sterling explains swine flu

Bruce Sterling's got some pretty good advice for understanding swine flu in perspective:
People freak out over "pandemics," even though we've got one of the worst pandemics in history, AIDS, raging through the carcass of the body-politic right now. Every once in a while you see a street demo or a charity show about AIDS. Carla Bruni is pretty big on fighting AIDS. Otherwise we just drop dead of AIDS in hecatombs, and the pandemic has become our business as usual. AIDS is an extremely fearsome disease, practically 100% lethal, yet it's hard work to get people to remain properly afraid of it.

*There is always some flu around and flu is always killing some people. Even when a raw mutant flu manages to kill off more people than a shooting-war, flu has never ravaged whole cities as cholera or the Black Death can do. As awful pandemics go, flu is like the snotty-nosed little sister of awful pandemics.

*So if you catch the new swine flu, you're very likely not gonna die.

*But since it is a flu, you're gonna kinda WISH you could die.

*You're not ACTUALLY gonna die unless your lips are turning blue, you have bad chest pains, you can't swallow water, you can't stand up, you're having seizures and you don't know where you are or what your name is. As this document suggests, you're gonna want to watch out for those symptoms.

Practical Tips for Combatting Swine Flu In Your Home


  1. Science fiction writers should stick to science fiction.

    I’m not punching the panic button yet but I have a lot more to fear on a real level from an influenza pandemic than from AIDS – mostly due to means of transmission. Opening the bidding with 1918

    will raise with concerns about his questionable statistical claims regarding flu pandemics v plague & wars.

  2. This is a poor analogy. You can’t get AIDS by being coughed on. Influenza spreads in a much less controllable manner, and this is why people are scared. They feel they have little control.

  3. Indeed. The 1918/Spanish Flu killed, by some accounts, four times as many people in two years than AIDS has killed in the last 25 years.

  4. “flu has never ravaged whole cities as cholera or the Black Death can do.” WRONG WRONG. 1918 flu outbreak. Red the link posted by (1)

  5. BS states it exactly.

    The problem, I think, is that most humans are not equipped to properly assess the risk associated with very large or very small numbers.

    If you hear, “100 people died from Swin Flu in Mexico city”, that sounds pretty bad, no?

    What you don’t hear is that the vast majority of people who contracted Swine Flu most likely got over it, thinking they had a really bad cold (Actually, a flu really is just a really bad cold, come to think of it.)

    You also don’t hear that plenty of other flus have done worse, but they didn’t have the scary “swine” part in their name.

    And then, of course, even if the 100 were the only ones exposed (meaning that the flu is particularly deadly), 100 people in a city of, what, 14 million? If it wasn’t on TV you’d never hear of it and your odds of contracting the disease are far tinier than other more mundane risks such as lightning strikes or sharkbite.

  6. You know I have given the concept of a flu pandemic in the “modern world” a lot of thought over the years with several of my favorite genre pieces, such as the stand, using it as an apocalyptic trigger and having seen a few loose outbreaks in close to home situations, such as visiting hong kong right as they were completing a species kill off due to a bird flu and many times I thought I understood the “common wisdom” behind the hype and panic.

    In today’s world, travel speeds and population increases means more vectors more vectors should mean more danger. I can see why the thought of a 1917-18 flu can strike fear, but recently Ive begun to postulate that just the opposite of the “common wisdom” may be true. I’ve come to wonder if an outbreak is less likely to catch hold than more likely.

    My reasoning behind this is the outbreak of 1917 was a serial event.

    The nature of exposure rates were much slower for all the reasons that an outbreak today would go much further and faster and it was serial because it was mostly point to point, from next to next rather than several points at once.

    Back then travel was slower, movement of the carrier vectors was much more like a train traveling on a track, as it progressed down the track the mutations would occur( and did which is what stopped it) but the virus would shed those mutations as it traveled down the steady track, they were left behind not catching up, in fact never being able to catch up or run into the engine.

    By shedding these mutations making them unable to combine and affect the front vector( or engine if you will ) the only way for the virus to stop was the engine its self evolving, the front of the serial movement.

    But if we apply the same concepts to todays vector it is not a train, running slow and serially. the vector expansion is parallel and fast, much like the planes that would carry it.

    There is not one single engine or vector to mutate away its ability but this time instead of a track the mutations are free to roam much further and faster, this time the mutations arent being shed off and left behind.

    Because of the speed and exposure rate the mutations might catch up and because its a parallel set of events or vectors, they are even MORE likely to mutate and come back at the vector as a completely inert strain, as they do and run into and combine to the various engines they are more likely to nullify rather than speed up or make the vector more virulent because like other “fast” diseases there is speed where a virus can outrun its ability to infect.

    We see this behavior in more frightening viruses like ebola and some of the other hemmoragics.

    They burn through vectors so fast the virus cant survive long enough to pass itself on.

    The upshot of this long winded point is, I think the very thing people fear in these flu pandemics (increased vectors and travel speeds of today) actually render the viruses LESS virulent and likely to damage then the ones that people harken back too as the basis for their fear, such as the 1917-18 swine flu.

    Sure viruses can spread faster today but in the case of influenza faster exposure means faster evolution of the species to combat it and by nature to pass that ability in the form of antibodies on to others.

    So the thing we fear the most, speed of infection transmission of influenza in a modern travelling world, may actually be a good thing relative to past problems with the flu on a global scale.

  7. @5 Yet with AIDS he picked a totally wrong example. I am very much against chastity and stay-with-your-spouse campaigns, because they don’t work on a large level. They work, however, on an individual level and individual *couples* who don’t sleep with others are save from sexually transmitted HIV. Thus my or my wifes chances of catching HIV are limited to freak accidents on the “bitten by a radioactive spider” scale or blood transfusion.

    Flu, however, I can get by every stupid idiot who catches the stuff and sneezes. Overall, it’s still a low-probability event as long as as infection are rare, but it’s magnitures more probable than getting AIDS.

    Just this sunday we had a cook-in at the museum with 16 others. Basic hygiene was followed, and I *think* everybody used a tasking spoon. However, every one of them could have carried the HI virus and we would have been save from infection. Not so if one of them had a flu.

  8. there are two examples of poor thinking in this analogy, one has already been picked up on that people fear the different transmission vectors the other one not remarked on yet is the time factor.

    If I get aids the odds are I am not dieing within the next few weeks. That changes the relation to the disease drastically.

  9. To all those saying I can catch flu faster than Aids so Flu is more dangerous.

    Aids is a near perfect killer statistically %96 percentile, you get Aids, you die from Aids.

    Flu or Influenza in ALL its forms for ALL of its known exposures through out the known time we have identified Influenza has is a statistical blip. less than %1 percentile, even less the over all statistic for all deaths from influenza to those exposed is .04%

    So get over your fear, just as a note you are statistically more likely to die by exposure to something that can kill you from your morning coffee, a single cigarette or that bucket of fries you eat for lunch than statistically die from influenza.

  10. HIV is hard to catch. Pandemic flu is hard not to catch. HIV kills. Pandemic flu kills a few percent BUT EVERYBODY GETS IT. It’s called math. Do it.

  11. Personally, I am always very wary of influenza and receive a vaccination for the common strains at the beginning of autumn every year. A main reason is that I have asthma and am therefore at risk of respiratory complications. There are plenty of people with asthma and other conditions which make a flu pandemic much more scary than AIDS.

  12. how many here have ever bought a lottery ticket and secretly thought they would win?

    I think viruses can evolve to match complex environmental factors like primate silliness. They don’t have to think, just survive.

  13. Comparing an airborne flu to AIDS is pretty silly. I have relatively no fear of AIDS because it’s very easy to avoid. A flu strain with no vaccine is very hard to protect yourself against.

  14. Wow BB, this is utter nonsense and a real disservice. It is simply wrong on so many levels.

    Rabies is also 100% fatal (essentially) yet we don’t fear it as much because it is much less transmissible. The death rate from the flu, while much lower, is still substantial due to the rapidity with which it spreads. >20 million people died from influenza in the 1918 pandemic and you’re suggesting that it’s the “snotty-nosed sister of awful pandemics?” Put another way, at the height of the 1918 pandemic, in the major cities of the world, hundreds of people a day were showing up needing ICU level care (which didn’t exist at the time). Given that major hospitals typically have a few 10’s of beds available, the bodies will pile up pretty fast.

    If the swine flu turns out to be a run of the mill flu, then we don’t have all that much to worry about. But if it is pandemic flu, then it’s another ball game.

    Really, we expect a lot better than this kind of nonsense from you.

  15. A few less people on this earth won’t do the environment any harm.

    Plus even IF it becomes a pandamic it’s STILL less likely to kill you than drugs, drink or a car.

    News flash: medicine has evolved since 1918.

  16. @14
    News flash: medicine has evolved since 1918.
    News flash: So has the flu Virus
    News flash: Still no cure for the common cold, where are you Science?
    News flash: Humans still arrogant about their abilities
    News Flash: Millions of the “surplus population” to die in new pandemic. Tough shit if it is you or your friends and family.

  17. I wonder how many here have gone through ThatBozGuy comment? It is quite good.

    That is the kind of stuff which motivates me to read BB, that and the smart ass humor of a few others. :)

  18. What is it lately with people who are famous for one thing thinking they are suddenly authorities on every thing?

    People need to learn to only speak in discussions involving their area of expertise. When the ball is in someone else’s court, you listen. Especially when it comes to science and medicine, we’ve got a lot of bad info and quackery out there because of famous non-doctors pretending to know what they are talking about.

  19. @15 Akula: Meh. The flu virus is constantly mutating, but I’m not sure that classical evolution is a good way of describing it’s development. (Thus far, a strain as bad as the 1918 one has not been seen – this one may or may not be.)

    As for the “common cold”, there is no such thing. “Colds” are caused by a huge variety of different viruses and bacteria. For the most part, it’s not worth the cost of the diagnostic tests to even find out which it is. (For that matter, in terms of rates of fatalities, it’s just not worth the research effort to try to cure. Scientists are kinda busy dealing with cancer, HIV, heart disease, etc.)

    And yes, science and medicine have advanced. We have rapid antibody and sequence-based tests to distinguish the lethal strain from less dangerous ones. We have computer network infrastructure to track the spread of the virus. We have antiviral drugs for acute cases and vaccination for prevention (at least for those few we can produce vaccine for).

    Certainly, one problem we have is the more rapid spread of the disease. On the flipside, national health agencies around the world leaped into action within days, before things hit pandemic proportions (if they do).

    And the fatality rate is relatively low (maybe as low as that for general anaesthesia).

    Still, as you say, the death toll could be in the millions. And woe betide people without access to good health care. (ie. People living in poorer parts of the world, or the healthcare-disadvantaged in the United States.) This remains to be seen, though.

    What I’m more concerned about is that this becomes the economic black swan that collapses all the derivatives and brings the global economy crashing down around our heads.

    (Humming REM’s “It’s the end of the world as we know it.”)

  20. #6, ThatBozGuy:

    My reasoning behind this is the outbreak of 1917 was a serial event.

    The nature of exposure rates were much slower for all the reasons that an outbreak today would go much further and faster

    Not really- it’s thought that one of the reasons for the spread of Spanish Flu was the massive and unprecendented movement of troops and civilians during the first world war.


    Amorseco, Philippines

  22. ‘Practical Tips…?’ The entire article was egotistical, ‘I’m so smart,’ useless crap. There was nothing ‘useful’ in it. Most people in the world do not live in the Bay Area where their water, air, and food are VERY secure. Billions among humanity are swarming in circumstances where a new virus can rage, truly rage. If a writer has some useful information, the world needs it. If not, STFU!

    JB Baoding, China

  23. While I agree the current buzz over the flu is overkill on a Godzilla level, Bruce needs to get himself a history book and read it. Flu is a real killer and is rightly feared as such.

  24. @Redrichie: Lol yeah, the verses kinda defy humming.

    The verses, OTOH, kinda read like a summary of the last ten years or so, especially as seen by geeks:

    That’s great, it starts with an earthquake, birds and snakes, an aeroplane, Bruce Sterling is not afraid. Eye of a hurricane listen to yourself churn, world serves its own needs, regardless of your own needs. Feed it up a knock, speed, grunt no, strength no. Ladder structure clatter with a fear of height down height. Wire in a fire represent the seven games, in a government for hire and a combat site.

    (Whee. That’s fun, but tiring. Someone else run with it.)

  25. HIV mortality rates are VERY low these days, thanks to antirretroviral therapy. It is a hideous infection, but it CAN be treated. People are not dying anymore in swarms, like it used to be.

  26. While it may not warrant panic, it certainly warrants concern.

    Indications from the deaths in Mexico are that the people were generally young and otherwise healthy. Deaths from the flu are usually the old and very young, making swine flu something to be concerned about.

    That being said, wash your hands and don’t go around licking doorknobs. You’ll probably be fine.

  27. I don’t see this as a cause of PANIC, more as an oppurtunity to see just how effective governments, and the WHO and NGOs are at containing and addressing an outbreak. This time it’s the relatively familiar flu, but what about the next one, or the next? Keeping the infrastructure of information sharing (from first responders to the CDC to epidemiologists to government officials) open and tested is not a bad thing at all.

    My thoughts and prayers go to those who have lost loved ones in this, in all the panic talk it’s easy to over look the simple human losses.

  28. @ #25:

    This might be true in developed countries such as the USA, or in Europe, but aside from a few notable exceptions (Uganda, perhaps), HIV means an early death sentence for most people who contract it in the developing world.

    The World Heath Organisation reports that, in 2007, approximately 2 million people died of AIDS. In developing and transitional countries, fewer than one-third of HIV-positive people had adequate access to antiretrovirals.

    Ninety-six percent of HIV-positive people live in low or middle-income countries. The number of people in sub-Saharan Africa living with HIV is twice that of the rest of the world put together. (pdf file)

  29. Some numbers:

    In the Daily Mail today it said that 40% of the UK population (70 million) could get swine flu. According to Wikipedia, the mortality rate of swine flu is 10% (as opposed to 0.1% for normal flu).

    That adds up to 2.8 million deaths in the UK from swine flu.

  30. I think comments like @25 get to what Bruce’s real point is.

    Right now in the gay community HIV transmission is going up because no one is scared. The epidemic isn’t like it used to be – but people are still getting sick and dying early it just takes so long that it doesn’t really hit home the way it used to. When you are 20, the fact that poz guys in their 40’s are getting serious diseases most people never get until their 80’s doesn’t seem to take any of the magic out of the antiretroviral “cure.”

    So even among sexually active young gay men, where the risk is very real, there isn’t enough fear anymore to make them want to use condoms, especially in the face of aggressive marketing by bareback porn companies.

    Coming out in the 80’s, fear kept me negative and I’ve enjoyed really good health as a result while still being sexually active. Meanwhile I have many friends in their 20’s who thought AIDS was cured and seroconverted early in their livers. They are dealing with all kinds of health issues needlessly and they likely have a diminished lifespan and lower quality of life.

    This story isn’t about any individual reader. It’s about how bad people are at understanding real risks. A different Bruce – Bruce Schneier – has written about this extensively:

  31. Having survived full blown AIDS and now have a T-cell count of over 750, I laugh at a simple flu.

    Ha! Pussy flu ain’t gonna get me!

  32. #1: “Science fiction writers should stick to science fiction.”

    Yes, because we all know that writing science fiction automatically kills off the entire rest of your brain, so henceforth that’s all you’re capable of doing. :p

    Regardless of whether one agrees with Mr. Sterling or not, I just had to poke at the ridiculousness of that statement :P

  33. The Flu Pandemic by The Flying Fish Sailors

    Chorus: It was the Flu pandemic
    And it swept the whole world wide
    It caught soldiers and civilians
    And they died, died, died!
    Whether they’re lying in the trenches
    Or lying in their beds
    Twenty million of them got it
    And they’re dead, dead, dead!

    There was a soldier on the battleground in 1917
    He turned there to his buddy with his face a ghastly green
    He said “We made it both through Passchendaele, the Somme, and Flanders too
    But now my number’s up my lad for I’ve gone and caught the flu”


    Well a nurse was in the hospital when Tommy was brought in
    When he sneezed she caught a face full that was flying in the wind
    She wrote a letter home to England to tell them of her plight
    But the letter never got there ’cause the postman too had died


    From the meadow-lands of Somerset and o’er the bounding main
    To the shores of old Americay they sung the same refrain
    Mothers, fathers, uncles and aunts as well as the odd nephew
    Brothers and sisters and bosses and lovers were all got by the flu


    Well a farmer out in China watched his family dropping down
    And a businessman in Cairo hit the street without a sound
    And an eager little Bolshevik in old Sevastopol couldn’t keep up his grinnin’ at Lenin as Comrade Virus took its toll

  34. Sterling fails to tell anyone how lethal the original strain of H1N1 in Mexico was, especially among 20-50 year old people, why it was so lethal, and why we dodged a bullet in that it got less lethal with transmission instead of more lethal, what a second wave of a hardier, more lethal virus might do, and why we ought to be worried.

    Sterling is NOT an epidemiologist. He’s not even passing on advice from epidemiologists. This is useless “advice”.

  35. This comparison is absurd.

    AIDS is completely avoidable through self control.

    Swine flu is much different being able to be spread through casual contact and airborne particles.

  36. #36 is correct. I like Sterling as much as the next person, usually, but I think that he’s fallen prey to the all-purpose-pundit disease, the one where you talk about stuff that you really don’t know much about because, hey, you’re Bruce Sterling, damnit!

  37. Oh Takuan! You found a video! Of course now the song will be stuck in my head all day)

  38. @ Talia

    You may think it is ridiculous for me to say science fiction writers should stick to science fiction but it is a far less ridiculous statement than most of those made by Sterling in this article.

    Of course people can make good and reasonable evaluations outside their specific areas of expertise but really that is much rarer than when they attempt to do so and fail, as happened here. Until Sterling shows some credentials and makes some better historically informed comments about flu pandemics, I don’t need to hear from him on the subject. I will stick with reading historians and health care professionals, there is no lack of appropriate persons with real scientific knowledge in this area so why are we going to science fiction writers for this advice.

    I am reminded of Dave Chappelle’s very astute piece on MTV news consulting Ja Rule about 9/11

  39. For most, the five-year, post-diagnosis survival for those infected sexually (with HIV) is now about equal to that of the general population.

    “HIV is now a complex chronic disease,” said Dr. Michael Horberg, director of HIV/AIDS at Kaiser Permanente Health Plan in Santa Clara, Calif. “And, if aggressively treated with accepted medications, we should expect to see mortality similar to the general population in that same demographic.”

    Some of y’all need to get out more.

  40. In the Daily Mail today it said that 40% of the UK population (70 million) could get swine flu. According to Wikipedia, the mortality rate of swine flu is 10% (as opposed to 0.1% for normal flu).

    Well, if the Daily Fail said it then we must be doomed. And I’d hazard a guess that they also said that immigrants cause it, that getting vaccinated will make it worse and that it was originally used to kill princes diana.

  41. In all fairness, the article does link to a CDC release on practical tips on dealing with swine flu.

    All analogies aside, Bruce is simply pointing out that now’s really not the time to start freaking out.

    Can’t help noticing how desperately some people cling to their panic button; citing the Daily Mail and Wikipedia as valid sources for health info? Man, as far as I’m concerned, that’s a sign of the apocalypse right there.

  42. @ Slizzered

    I don’t see many, if any, people freaking out here – unless you mean freaking out over Sterling’s poor work in this article. Look at the other side of the coin, if it only takes Daily Mail and Wikipedia to show how far off base you are then you have really screwed the pooch.

  43. This should not be about which epidemic is worse. HIV is a terrible disease (though HAART has made is much more of a chronic treatable one than a uniform death sentence.) And though it was ignored (unconscionably) by the Reagan administration, that is no longer the case. And, for those who care, it is not 100% preventable. Ask people with hemophilia or patients who needed transfusions during the 80’s and early 90’s.

    But pandemic influenza is also a terrible disease. The estimates of mortality were in the 500-700K range for the US in the 1918 outbreak. (FYI, that’s roughly equal to the US HIV mortality from 1980 onward). If the total population was 105 million, that’s ~0.5% of the population. That’s equal to 1.4 million people in the US today. With modern healthcare, maybe we can do better. That’s still a lot of people. In poorer countries it would be much worse. Even if this turns out to be a more run-of-the-mill flu, we are still vulnerable to influenza.

    Both suck. And playing my disease is worse than your disease is just dumb.

  44. @ Dlove

    “And, for those who care, it is not 100% preventable. Ask people with hemophilia or patients who needed transfusions during the 80’s and early 90’s.”

    The cases you just described were preventable, they simply weren’t prevented which is criminally tragic.

  45. The following is taken from the August 2005 Message of Sadie Jaramillo

    “There are diseases, unexplainable diseases that will break out and Jesus told Maria Esperanza (btw, her messages were approved by The Church) that a time would come when a “flu like” disease would come and by the time the doctors figured out that people and especially babies and young children were dying and unresponsive to their medications many, many would die.”

    “The symptoms are high fever; chills and flailing around in a seizure type way and the lips will be bluish black. You should buy and keep the leaves of the Hawthorne on hand.

    “The remedy given by Jesus to Maria Esperanza is to steep the leaves for 8 minutes…that is very important. Not 7, not 9 but 8 minutes. Then give the tea until symptoms disappear. The measurements are the same as if you would be brewing loose tea (not tea bags). And if you have never brewed loose tea then look at a tea bag and see how much tea is in a bag and use that is your base for measurements.”

  46. AIDS is completely avoidable through self control.

    Seriously? You believe that? I’m sorry – you are mistaken. Consider these notions: Tainted blood supplies, child hemophiliacs infected through infected blood products, lying or uninformed spouses of either gender, lying or uninformed blood donors, victims infected by rape or sexual trafficking, etc.

    So, yours is a pretty broad pronouncement for someone so relatively uninformed. Stop and think before you blame the innocent.

    HIV/AIDS is just an infection – not a moral retribution for indulgence. Anyone having a transfusion or sex can potentially become infected.

  47. SWINE FLU is one of the world’s wonders that humans have little to do to protect themselves. The only way of protection may be by grounding all means of transports so there would be no one traveling to no where in the glob, so as to reduce the spread of the pandemic. This way, the pandemic would be able to be grounded too or controlled, in other words, it would only be those infected or the country in which the pandemic is more active, then the world would work to cooperate in saving lives of those affected or the country affected the most by providing effective medications that would prevent patients from dying in a mass number. Other than such a suggestion, the world would do very little to control the spread of the FLU. However, i know that it could be more than a hard thing to do (grounding all means of transport nationally and internationally) because the global economy would die rather than recessing in just a week of grounding all means of transport, but it could be a choice between ‘Global economy crash’ and ‘Human catastrophe’


    David Gatkuoth, Australia

  48. Why would a virus strain get more lethal with transmission? Survival logic dictates that viruses and populations adapt to each other, thus viruses almost always break toward less lethal as they spread. A true ‘pandemic’ has to spread extraordinary quickly and remain potentially lethal while mutating rapidly in environment full of hostile medical technology to really be a concern. This doesn’t seem very likely any longer. Not that this is any consolation to those that don’t survive particularly the early stages. But I don’t see any kind of flu as particulrly gigantic on the world-threatening scale. Seriously? We have bigger problems.

  49. Do you think the swine flu can end up being the black plague or the end of the world??

  50. Causes for concern (hopefully science fiction that will not become fact):

    (1) Flu viruses are extraordinary likely to mutate quickly, especially if they can cross species
    (2) There is now at least one known case (in Alberta) of pigs catching A(H1N1) from a human
    (3) Many flu viruses are much more contagious than the current A(H1N1)
    (4) Some flu viruses (eg., Avian Flu H5N1) are quite lethal (perhaps 40% in Asia so far)

    So we may see a highly contagious, highly lethal version of H1N1 (mixed with H5N1) in the next year or 2–a good argument for working fast on vaccines

    (5) HIV/AIDS could also swap sequences with H1N1–resulting in an airborne version of lethal AIDS –something like this has already happened between TB and HIV in Africa–leading to a much more virulent version of TB

  51. according to the CDC website:

    there have been cases in 38 states

    of those 38 they found 403 confirmed cases

    of those 403, 1 person died…in texas.

    the rest are getting over it without any vaccine because there is no vaccine.

    doesnt sound like theres much to worry about…
    but have fun with your masks

Comments are closed.