On Monday, the President’s Council of Advisors on Science and Technology released a report (pdf) about the possible impact of swine flu this coming fall. The report presented a “plausible scenario” wherein 20 to 40 percent of the U.S. population becomes infected; as many as 1.8 million are hospitalized; and swine flu causes between 30,000 and 90,000 deaths—mainly among the young, the pregnant, and those with pre-existing conditions such as respiratory impairments. These are some frightening numbers, to be sure, and the likely resurgence of swine flu this fall is no trifling matter. But a few outlets’ coverage of the report was overly alarming.
The worst offender was perhaps USA Today. The White House report clearly states—many times, and at one point in big, capital letters—that the scenario it lays out is “a possibility, not a prediction.” Yet, on Monday, the nation’s mostly widely distributed newspaper decided to run the headline, “U.S. report predicts 30,000 to 90,000 H1N1 deaths.” (The italics are mine.) Despite that glaring (and still uncorrected) error, on Wednesday, the paper had the audacity to publish an editorial that begins:
When swine flu first appeared last spring, the result was an epidemic of news coverage that by its sheer volume made the disease look scarier than it has turned out to be. Things have calmed down since. But if Monday’s prediction by the President’s Council of Advisors on Science and Technology that half the U.S. population might catch the H1N1 virus comes true — with vaccine supplies limited — fear seems likely to return. So perhaps it’s worth pausing to consider what has been learned.
Indeed. What has been learned here? Perhaps that one should read the report before using it to sound an unnecessarily shrill alarm about public health. The cognitive dissonance in USA Today’s editorial is almost comical; but lest we get ahead of ourselves, let’s return to its news article for a moment. Beyond the fallacious headline, the story had other deficits. Nowhere, for instance, did it state the average annual death toll from regular, seasonal influenza. It’s 36,000, according to the Centers for Disease Control and Prevention, and that’s an important point of comparison. That means that, according to the White House report, this year’s death toll from swine flu could be anywhere from slightly better to more than twice as bad as average. Granted, the death toll is more likely to be worse than average—and again, the point here is not to minimize the risk of an epidemic—but reporters really need to give readers the full picture.
CNN provided the average annual flu-deaths statistic, but not until the fourth paragraph of its article. Worse still, it is not until the third paragraph that the reader learns the exact range of possible deaths from swine flu. The headline and the lede dispense with the low-end 30,000 and push the possibility that we could see “up to 90,000 deaths.” Such lopsided reporting at the top of an article runs the risk of fear mongering—although, to its credit, CNN does emphasize that the White House report is a not prediction. The New York Daily News and the New York Post treated the story in similar fashions. Both papers also used the word “predicted,” although not as carelessly as USA Today.
Whether it was the report’s clear warnings that it made no prediction, or the sheer range of the 30,000-to-90,000 deaths, reporters should have recognized that the scenario involved a fair amount of uncertainty. A tip o’ the hat goes to New York Times science reporter Donald G. McNeil, Jr. who, on Wednesday, clarified the record and subtly chastised the media for its sensational coverage. The news in McNeil’s piece was that “officials at the Centers for Disease Control and Prevention, the agency with the most expertise on influenza pandemics, [had] suggested that the [White House] projections should be regarded with caution.”
“Look, if the virus keeps behaving the way it is now, I don’t think anyone here expects anything like 90,000 deaths,” a press officer for the disease centers said.
McNeil’s article goes on to explain that the release of the White House report was late, poorly planned, and somewhat clumsy. “Kathleen Sebelius, secretary of health and human services, was at the disease centers’ headquarters in Atlanta, addressing a special symposium on swine flu,” he reported. “A summary of the report was handed out by the centers’ press staff to medical reporters as she spoke, but Ms. Sebelius did not dwell on it or mention its forecast of 30,000 to 90,000 deaths, more than twice the 36,000 deaths usually caused by seasonal flu.”
Both Sebelius and Dr. Thomas Frieden, director of the CDC, “acknowledged that ‘some people’ would die, but neither gave an estimate,” McNeil reported.
Again, none of this is to say that swine flu isn’t a very grave threat. It’s important to note that by offering this description of Sebelius and Frieden’s presentation, however, McNeil is not just clarifying the record. He is also explaining why the Times did not bite on the easy, death-becomes-us headline. Instead of taking the bait, the Times ran a restrained, but well-reported and no less serious article from the Associated Press the following day. The piece accurately covered the key details of the White House report, but focused on other comments Sebelius made about the importance of the swine flu vaccine. Bloomberg News and The Wall Street Journal also carried complete and insightful articles that displayed just the right amount of gravity and caution.
Reporters really must be more careful with stories like this one and resist the temptation to run with catchy yet simplistic headlines. A recent poll found that many Americans aren’t worried about swine flu, but there is a fine line between motivating them to take more health precautions and needlessly scaring them. In such cases, attention to detail is more important than ever.

There's a lot of misinterpretation of deaths from influenza in all the media articles I've seen, including this one.
You can't compare the number of deaths generally reported as occurring in a typical flu season (36,000 - 40,000) with the number of deaths reported by the CDC to the public for novel H1N1(556 as of Aug. 28).
The former is a calculated number that attributes all excess deaths from respiratory infection occurring during the flu season to influenza. The latter is the number of patients diagnosed with H1N1 flu where influenza is listed as a contributing cause on the patient's death certificate.
The number of influenza deaths reported annually on death certificates in the U.S. ranges from about 300 to about 2300 per year, averaging less than 1600. That means that in a typical year, death certificates that include influenza as a contributing factor represent less than 5% of the number of deaths that CDC says occurs in a typical flu season. The calculated number of deaths is undoubtedly closer to reality than the reported number, but it's important not to refer to these two measures as equivalent.
If the same discrepancy between these numbers holds true for H1N1, when we have 4,000 deaths of patients diagnosed with H1N1 reported to CDC, we could actually have over 90,000 deaths from H1N1 as measured by excess respiratory infection deaths.
Since we've had 556 deaths already, and we're not even into the time of year that flu spreads easily between people, I don't think 4,000 confirmed deaths from H1N1 is at all out of the question.
#1 Posted by Adrienne LeBailly, CJR on Tue 1 Sep 2009 at 02:48 AM
I think the real issue for the media here is that there is no "real number" of mortality you can give at this point of the h1n1 pandemic, it´s all modelling, not prediction. The report of the President’s Council of Advisors on Science and Technology is not just to educate the president, but also to recommend new avenues of research, in fact trying to use the momentum to get funding for certain issues of interest for research. Therefore this Scenario was taken!
I think the best number we have so far is that 1 in 10 000 people of healthy people infected with h1n1 will die as a result of being infected with this virus. How much excess mortality we will see depends not only on the virus but on the health care system in which H1N1 is infecting people. Less ICU´s means more mortality, for example...
So the equation is not an easy one, and journalism is not just about getting the facts correct, but to create the context so people can navigate complex topics at least to some extend...
This is a view from germany, my approach can been seen here, for those of you read german: http://www.faz.net/s/Rub7F74ED2FDF2B439794CC2D664921E7FF/Doc~E1ADE860A17114F2C97283A90407D1FAC~ATpl~Ecommon~SMed.html
#2 Posted by Volker Stollorz, CJR on Tue 1 Sep 2009 at 06:13 AM
swine flu is outragous
and my girlfriend loves barack obama with a passion
#3 Posted by Jennifer, CJR on Wed 2 Sep 2009 at 08:44 AM