A Project of The Annenberg Public Policy Center

Swine Flu Emergency?


Q: Did President Obama declare a national state of emergency because of H1N1?

A: Yes, but claims that this is an effort to instill panic in the American population show a misunderstanding of what such a declaration actually means.

FULL QUESTION

Is there any way you might consider fact-checking this story, below, and posting the results in your site? It came out today and has already been circulating like wildfire across the Internet.

Obama Declares Swine Flu Emergency

[EET ]President Barack Obama declared the swine flu outbreak a national emergency on Friday October 23, empowering the health secretary to suspend federal requirements and speed up treatment.

His declaration authorizes Health and Human Services Secretary Kathleen Sebelius to bypass normal federal regulations so health officials can respond more quickly to the outbreak, which, allegedly, has killed more than 1,000 people in the United States. …

It would appear that President Obama has not been apprised of the real facts of the situation, and has declared the swine flu a national public health emergency. To read the declaration in its entirety, please see this Los Angeles Times article.

The intention of this report is to show you with the government’s own statistics that there appears to be MASSIVE amounts of misinformation and outright deception going on that appear to be designed to panic American people into believing that H1N1 influenza is more serious and widespread than it is.

We are the ONLY major news source that is warning the public about the true extent of this misinformation regarding the true nature of H1N1 swine flu in America. Most of the mainstream media is continuing to spread misinformation.

I am PLEADING with you to pass this information and our website link to as many people as you know. We simply can’t continue to fight the massive media and apparently deceptive government health agencies unless people like you rise up and make your voice known.

Send this link to EVERY person you love or care about. Write them a PERSONAL note that is kind and gentle and ask them to do their homework and seriously evaluate all the evidence before they accept the information being shared by the media, which is potentially being heavily influenced by pharmaceutical interests, as the truth. …

President Obama released this "emergency" declaration over the weekend – most likely because he trusted his federal health official advisors – and that declaration has the potential to create massive fear and panic in the population, Because he is the PRESIDENT and people are hearing their PRESIDENT tell them that 1000 Americans have died from swine flu and we are in the middle of a serious public health emergency and many people may be thinking "I probably should play it safe and get the vaccine for myself and my family." …

If you read Obama’s declaration, you will find a complete absence of documentation to support his assertion that 1000 have died from H1N1 in the US. Nada, nothing no links, no references anywhere in the document to back up his assertion.

In fact, if you go to the definitive collector and holder of the US data, you will find that there is NO evidence to back this claim.

The CDC’s own web site readily admits that since August 30, 2009 they are no longer testing for H1N1. They don’t even recommend it any more. They are substituting a clinical definition for blood testing that will positively confirm that the "suspected" cases of H1N1 influenza are actually H1N1 influenza.

http://articles.mercola.com/sites/articles/archive/2009/10/27/Obama-Declares-Swine-Flu-Emergency.aspx

[/EET]

FULL ANSWER

We’ve had a flurry of questions about this panicked article by Dr. Joseph Mercola, who markets natural health treatments on his Web site. Mercola also promotes other demonstrably false claims about the H1N1 vaccine, like the claim that it contains squalene.

Mercola claims that his site is “the ONLY major news source that is warning the public about the true extent of this misinformation regarding the true nature of H1N1 swine flu in America.” Mercola’s Web site is about as much a "major news source" as the newsletter from our local garden store. He sells holistic medicines. Mercola then alleges that the media “is potentially being heavily influenced by pharmaceutical interests,” but a few paragraphs later cites a report by CBS News as backup for his claims.

What Emergency Means

President Obama did declare a national emergency due to the H1N1 influenza on Oct. 24. Mercola’s article says that this declaration "authorizes Health and Human Services Secretary Kathleen Sebelius to bypass normal federal regulations so health officials can respond more quickly to the outbreak." That’s true. But Mercola goes on to allege that the government intends to "panic the American people into believing that swine flu is more widespread and serious than it really is." Mercola drastically misinterprets the significance of such a declaration.

Declaring a national emergency sounds spooky, to be sure. But its real effects are hardly sinister. According to the Department of Health and Human Services, a declaration of a national emergency allows states and health care providers to apply for a waiver of certain federal rules, primarily those governing Medicare, Medicaid and the Children’s Health Insurance Program. For example, if an overburdened hospital had to move patients to another facility with more resources, the receiving hospital might need a waiver so that it would be allowed to accept more Medicaid patients than normal. These waivers can only be approved if the secretary of HHS has declared a public health emergency and the president has declared a national emergency or major disaster, so it’s useful for them to do so before hospitals get overwhelmed and need to act fast. The rapid spread of flu has already strained some hospitals’ resources.

Hospitals can also apply for limited waivers of penalties for certain HIPAA privacy regulations. Within 72 hours of instituting a disaster response plan, hospitals can apply for waivers of penalties or sanctions for sharing patient information. The HHS secretary is not required to waive penalties for HIPAA privacy violations, but can allow them if he or she determines that the sharing of information was necessary to treat patients and preserve public health.

During Hurricane Katrina, for instance, the secretary of HHS spelled out the conditions under which noncompliance with the privacy law would be acceptable: Health care providers could share patient information as necessary to provide treatment, to notify family members and to lessen threats to public health. Again, this applied only to hospitals that had instituted a disaster response plan within the previous 72 hours.

In all cases, hospitals must apply for the waivers – they’re not granted any powers automatically – and HHS evaluates each case to determine whether it was necessary to operate outside the usual Medicare, Medicaid or CHIP restrictions. But HHS can’t approve any waivers at all unless the president and secretary have declared an emergency or disaster.

The last public health emergency was the North Dakota flooding earlier this year, for which President Obama declared a major disaster and the secretary of HHS declared a public health emergency.

1,000 Deaths?

Mercola mocks Obama’s claim that 1,000 people have died from swine flu, noting that the numbers compiled by the Centers for Disease Control and Prevention no longer differentiate between H1N1 cases and regular seasonal flu cases:

Mercola: If you read Obama’s declaration, you will find a complete absence of documentation to support his assertion that 1000 have died from H1N1 in the US. Nada, nothing no links, no references anywhere in the document to back up his assertion.

In fact, if you go to the definitive collector and holder of the US data, you will find that there is NO evidence to back this claim.

The CDC’s own web site readily admits that since August 30, 2009 they are no longer testing for H1N1. They don’t even recommend it any more. They are substituting a clinical definition for blood testing that will positively confirm that the "suspected" cases of H1N1 influenza are actually H1N1 influenza.

Like the claim about the national emergency, this is a mix of fact and fiction. For starters, Obama’s declaration didn’t claim that 1,000 people have died from H1N1; rather, CDC Director Dr. Thomas Frieden reported that number at an Oct. 23 press conference. It is, however, true that the CDC official surveillance stopped requiring lab confirmation for flu-related deaths on August 30. During the initial months of the pandemic, the CDC was requiring lab confirmation for all flu deaths in order to assess the prevalence of the disease, Llelwyn Grant of the CDC explained to FactCheck.org. After August 30, it returned to the usual method of reporting, which counts all deaths from influenza- or pneumonia-related symptoms, not just those that have been lab-confirmed as flu. (Limiting the count to lab-confirmed flu deaths would probably result in underreporting of flu mortality — flu tests often aren’t performed, according to the CDC, and influenza only shows up in tests for a limited time.) There were about 593 deaths related to H1N1 in the four months before the CDC stopped requiring lab confirmation, and there have been 2,916 total flu-related deaths since.

Grant told us that most of the CDC’s laboratory work on H1N1 is now focused on determining whether the virus strain has changed. "Once we had established that clearly … as high as 98 to 99 percent of the virus looked at indicates that it was H1N1 activity, the focus has been to continue to monitor the virus to ensure that there hasn’t been any change to the virus," he said. But the CDC still keeps track of reported lab test results, and even does some testing. For the week of October 11-17, for instance, there were 12,943 tests reported, of which 4,855, or 37.5 percent, were positive for influenza. Of those, 3,378 were confirmed to be influenza A subtype H1N1, or swine flu. Most of the rest weren’t tested for subtype, but the CDC tells us that these are also likely to be subtype H1N1.

Even though the CDC no longer requires laboratory testing before reporting a flu death, some states still report lab-confirmed cases. That’s how the CDC got from 593 deaths to "over 1,000," the number that Frieden reported. As of the most recent report, there have been 530 lab-confirmed H1N1-related deaths since August 30. Added to the previous 593, that’s 1,123.

There has been some legitimate criticism of the decision to stop requiring lab confirmation for H1N1 cases, including in the CBS News report that Mercola cites. There’s concern that the usual method of counting deaths isn’t accurate and also that some patients may incorrectly believe they’ve had H1N1 and not get the vaccine. But that’s irrelevant to Mercola’s claim that the 1,000 death figure is wrong — the CDC’s 1,123 figure only counts deaths in lab-confirmed H1N1 cases.

Incidentally, when confronted with an e-mail making suspicious claims, we recommend considering the source. In this case, the author is a marketer who sells holistic treatments as substitutes for vaccines. (Mercola is an osteopath, or D.O., rather than an M.D.; osteopaths tend to focus on holistic care). He wants us to believe the Obama administration "has full intention of administering as many doses of swine flu vaccine as possible" — a vaccine with which his products are competing. That’s a fact the reader should bear in mind when considering the information.

– Jess Henig

Update, Nov. 10: We originally mentioned that Mercola is an osteopath, rather than an M.D., at the beginning of the article. Several readers felt, however, that we seemed to imply Mercola’s chosen career path had something to do with the fact that he was misleading people about the H1N1 vaccine. That was not our intent, and we have moved the reference to osteopathy further down in the story.

Sources

Mercola, Joseph. "Obama Declares Swine Flu Emergency." 27 Oct 2009.

Obama, Barack. "Declaration of a National Emergency With Respect to the 2009 H1N1 Influenza Pandemic." 24 Oct 2009.

United States Department of Health and Human Services. "President Obama Signs Emergency Declaration for H1N1 Flu." Flu.gov. 24 Oct 2009.

United States Department of Health and Human Services. "Waiver or Modification of Requirements Under Section 1135 of the Social Security Act." Flu.gov. 27 Oct 2009.

Sternberg, Steve. "H1N1 flu ‘pushing hospitals to their limit.’" USA Today. 27 Oct 2009.

United States Department of Health and Human Services. "Hurricane Katrina Bulletin: HIPAA Privacy and Disclosures in Emergency Situations." 2 Sep 2005.

Federal Emergency Management Agency. "President Declares Major Disaster For North Dakota." 24 Mar 2009.

United States Department of Health and Human Services. "HHS Acting Secretary Declares Public Health Emergency for North Dakota Storms." 25 Mar 2009.

Centers for Disease Control and Prevention. "Weekly 2009 H1N1 Flu Media Briefing." Transcript. 23 Oct 2009.

Centers for Disease Control and Prevention. "Questions and Answers Regarding Estimating Deaths from Seasonal Influenza in the United States." 4 Sep 2009.

Centers for Disease Control and Prevention. "2009 H1N1 Flu Situation Update." 4 Sep 2009.

Centers for Disease Control and Prevention. "2009-2010 Influenza Season Week 42 ending October 24, 2009." 24 Oct 2009.

Centers for Disease Control and Prevention. "2009-2010 Influenza Season Week 41 ending October 17, 2009." 17 Oct 2009.

Attkisson, Sharyl. "Swine Flu Cases Overestimated?" CBS News. 21 Oct 2009.