Sunday, 19 February 2017

H7N9 in humans - a very busy, but poorly reported winter in China

Below is the best I can do to plot avian influenza H7N9) virus cases in humans against month.

Click on image to enlarge.
Ideally  this would be month that illness onset occurred - when they became ill -  but those details just are not publicly forthcoming from China's massive human and animal influenza surveillance and testing system. 

I'm sure the data are to hand internally, and they may be on hand at the World Health Organization (WHO) - but you wouldn't know it by looking for them publicly. The WHO used to be helpful with providing H7N9 data but it seems their latest efforts to provide more detail on MERS cases has exhausted them.

Hong Kong's Centre of Health Protection (CHP) has been valiantly chipping away, but they also fail to provide sufficient detail to link cases with media or other reports. 

As for fatal outcomes from H7N9 infection - forget understanding who dies when and why. Those numbers have been frankly a pathetic mess for four years.

This week marked the fourth anniversary of our knowledge of H7N9 in humans - the first case became ill February 18th 2013 in as part of a Shanghai family cluster. Since then we've seen less and less detail on cases. And by "detail" I don't mean their names and addresses - just case age, sex, date of illness onset/hospitalization/death, linkage between case and death, poultry or human contact and place infection was likely acquired. Basic and standard stuff.

Meanwhile the media report every bolus of data that are dumped as if these were new cases and deaths that have just occurred. In reality, the huge January spike below may include many cases and deaths from a month or more earlier. 

We're definitely having a big H7N9 season (n=176 human cases) - but as far as I can tell - we had bigger tallies in 2014 (n=326) and 2015 (n=220). 

In media interviews over the past weeks, I've put the current season down to lethargy in closing live bird markets as cases and deaths have mounted. The response has been faster in previous years.[1,2] Poultry is a big deal in China.[2] Perhaps the poultry lobby has won out over human life this season. 

Friday, 10 February 2017

Science needs to talk more but I know many scientists who don't...

A comment I just replied to on LinkedIn which I thought was worth expanding on here - a rare moment of clarity pre-coffee.

Scientists don't engage the community - wearing their scientist hat - for a range of reasons. These can include...
  • because their Organisation doesn't support them
    ..or actively discourages them
  • because they fear making a mistake
    ..but errors are correctable and making them is a normal human(ising) trait
  • because there are no rewards
    ..selfless is for others huh? With less snark, there are only so many hours in the day and if engagement isn't able to be measured and put in a CV with outcomes, some academics simply won't partake. This needs to change - with or without someone having worked out a way to quantify these efforts - the world needs science voices. I'm pretty sure we can come up with innovative ways to make engagement part of the job/day/grant/life.
  • because they don't realise the need for such communication is dire
    ..and it really is
Apart from talking about what we do know and applying it to other situations in the news, science can bring logic to the other aspects of our lives - yes, that includes political aspects of life of which we as humans are always involved.

There is also a need for scientists to communicate clearly to the public about what we and do not know.

The community is more educated than it was and the questions it asks are more sophisticated than they ever were. Brushing them off - and I'm thinking about vaccines in particular here - with "but there's been no sign of harm" in the short term, is not good enough. If we as scientists, even if from outside a particular field of research, cannot find and point to work that answers a question about harm - how do we expect a member of the public too? Assumption: they've actually looked. If this happens then we need to roll out that tired old grant-writing adage, "more research is needed". Truth over sophistry is required today.

Not all scientists can communicate or can communicate in ways that non-scientists can understand. Not all scientists can engage with annoying people without losing their temper-or becoming annoying themselves. Not all scientists have knowledge on all topics (du-uh). I know what I'm talking about here because I'm talking about myself. So what I'm saying is that we scientists are just like any other human being. But, because of our training and skills, we scientists can also add clarity to biased discussions or rebut crazy conspiracies calmly and with reason. If we can, we should.

In my opinion, many individual scientists that could be good at any of those things are yet to wade in and stay for the long haul. One does not have to do this while representing an Institution or Organisation. Scientists are citizens and can simply apply our accrued education and experience to a range of problems. Of course, having a supportive and vigilant Institution may make a positive  difference to the scientist's initial brand and trustworthiness.

Let's use our science powers for good, not just for papers and funding.