Flu Fear Goes Viral on the Web

There’s a very good reason why we call Internet memes and themes “viral.” Good and bad information spreads on the Web in much the same way those nasty bundles of nucleic acid and proteins do when they attack your body’s cells and make you sick.

Some of the Internet news items I’ve seen related to the H1N1 swine flu virus are making me feel a little ill. I see nothing public service-related about the page view bait that has popped up since H1N1 started taking priority in newsrooms around the world. The Drudge Report, AOL, Yahoo — they’ve all put some scary stuff on their front pages, all with the intent of keeping you trapped in that story long enough to be exposed to another Internet condition, online advertising-itis.

I know this is the way the Web world works, and that it builds off of longstanding media traditions. I’m certainly not anti-information or anti-capitalist. I do, however, think it’s more than a tad sleazy to take a serious public health issue — one that is raising some legitimate questions about pandemics and vaccine availability — and use it to stoke fears for the purpose of making money. Write a scary headline, with all context buried after the page jump, and watch your traffic rise along with the body temperature of someone with either seasonal flu or the swine variant.

A perfect example to place under the media microscope: The Drudge Report on Wednesday night, halfway down its front page: “CDC: 4,000 Swine Flu Deaths Now in U.S.” Yahoo, also on Wednesday night, as the lead of their Health section: “CDC Now Says 4,000 Swine Flu Deaths in U.S.” That new figure is four times the previous estimates.

The story linked to in both cases was an Associated Press item that was actually following a New York Times story on new Centers for Disease Control statistics for H1N1-related deaths. Key word here: “related.” The new 4,000 figure reflects all deaths that can be attributed to complications from the flu, including pneumonia, associated infections or organ failure.

Here’s the context, leading the second paragraph of the Times piece: “The larger number of deaths does not mean the virus is more dangerous.” Curious how that seems to be missing from the original AP item, which first appeared on Yahoo on Wednesday at 5:49 p.m. EST.

Again, I understand the motivation of sites like Drudge or Yahoo not wanting to take the extra time or space to push that context up top. They want eyeballs. What’s harder to explain is how a company that has promised not to “be evil” might also be fogging up the air around the H1N1 story with its good intentions.

The Google Flu

What do Google searches for “swine flu,” “H1N1” and the like tell us about the actual spread of the virus? The search giant thinks there’s a lot of health data to mine, so in November 2008 it started Google Flu Trends with the premise that there is a relationship between flu search queries and those who think they may have the flu. As posted in the Official Google Blog at the time:

“The CDC does a great job of surveying real doctors and patients to accurately track the flu, so why bother with estimates from aggregated search queries? It turns out that traditional flu surveillance systems take 1-2 weeks to collect and release surveillance data, but Google search queries can be automatically counted very quickly. By making our flu estimates available each day, Google Flu Trends may provide an early-warning system for outbreaks of influenza.”

In the year since, Google has expanded Flu Trends to include searches in 20 countries. This week, Google introduce Google Flu Shot, a collaboration involving the Dept. of Health and Human Services and the American Lung Assocation. Type in your city into the search box, and little syringes indicating locations where seasonal flu and/or H1N1 vaccines can be found pop up on a Google Map.

But the Google Blog posting announcing this service included this:

“It’s important to note that this project is just beginning and we have not yet received information about flu shot clinics for many locations. In addition, many locations that are shown are currently out of stock. We launched this service now in order to help disseminate information about locations where vaccines are available, and also to make more vaccine providers aware of the project so that they can contribute.”

Given all that, how helpful can this information truly be? It says a lot that a governmental agency and a non-profit dedicated to respiratory health are involved, but a search for vaccine in my Seattle suburb shows nothing but Safeway and Walgreen’s locations in a three-county area, and half of those are indeed “temporarily out of stock,” especially for the H1N1 vaccine.

I called a Walgreens in a nearby town that Google Flu Shot said had the swine flu vaccine in house. The pharmacist on duty told me that was indeed the case, but she only had the nasal mist version. I asked if she was getting any referrals based on the Google Flu Shot service. She told me no, most of the inquiries were based on information in the King County health department Web site. Nonetheless, she’s getting a lot of calls about this. “I have five other people on the line right now,” she said.

If Google’s Flu Shot tracker becomes more effective and comprehensive with its information, will that pharmacist end up with 10 or 15 people on the line — many of them anxious parents and senior citizens? Especially if they’ve been reading some headlines on the Web?

I also wonder about how useful this information really is for the makers of the vaccine. They already know they’re behind schedule, and news reports about shipments expected in for doctors and county health departments ensure that their next wave of vaccine dispersals will disappear quickly.

Google gets props for trying to focus its substantial technological prowess toward a public health issue. But an orderly vaccine distribution program — one that is far removed from the “panic” end of the public health spectrum — may be more difficult to put in place thanks to the combination of work-in-progress legitimate data projects and run-for-the-hills Web headlines.

The Status of Online Health

That heady mix should raise even more concerns when you consider the big plans Web companies and the federal government have in store for health projects. President Obama talks up putting medical records online in his health reform initiative as a way to make treatment more efficient and cut costs. Both Google and Microsoft have launched projects to let consumers do just that — Google Health and Microsoft HealthVault. Both promise security and ease-of-use.

Overshadowing that potential (at least for me) is the peril I heard from two sources at the Information Security Forum World Congress I attended in Vancouver earlier this month. Oracle’s chief security officer, Mary Ann Davidson, expressed concerns that companies and governments were moving a little too fast with online health records. “This is infrastructure that needs to be defensive and self-defending, which is a different construct than what we have now,” she said.

Then the FBI’s top cybercop, Shawn Henry, took the stage and told the audience of computer security professionals about a case involving hackers who gained access to a medical services company and encrypted records for thousands of patients. The hackers asked for extortion cash to decrypt the records. That’s the scenario awaiting other companies who value a business opportunity over security and medical responsibilities.

Davidson wanted to make it clear that she wasn’t anti-progress, and neither am I. I just hope that as we get deeper into flu season, those writing the headlines and those designing well-intentioned Internet projects focused on health keep in mind something that’s drilled into medical school students from the outset: First, do no harm.