DEATH COMES FROM the East in a flapping of wings. “It’s like a combination of global warming and HIV/Aids ten times faster than it’s running at the moment,” the UN’s co-ordinator for avian and human influenza, Dr David Nabarro, told the world, adding: “The range of deaths could be anything between 5 million and 150 million.” At the weekend Sir Liam Donaldson, the Chief Medical Officer, forecast that a strain of avian flu could be expected here quite soon, that the likely British death toll was about 50,000, but that it was “not impossible” that fatalities could reach three quarters of a million.
On Thursday we will get sight of the Government’s contingency plan in the eventuality of a widespread avian flu outbreak, though some people are already saying that not enough has been done. A Today programme presenter was heard to complain yesterday that “it seems as though the flu virus is always one step ahead of us”, before audibly realising that this was how mutating organisms generally work.
All right. Aux armes! Let the labs do their stuff, let the vaccines be produced, let us spray visitors from the Far East just as they sprayed us during the Sars scare, let us protect the little ones, the pregnant ones and the old ones. One of these days one of the many recent scares (Ebola anyone? Necrotising fasciitis?) will turn out to be real and we will have a rerun of the 1918 Spanish flu pandemic, albeit in much better conditions. It could be this one.
But even if 50,000 did die in one year because of the new flu strain, that would only be 38,000 more than die most years of the illness. And what’s 38,000 fatalities to us? However scared we might be of bird flu, we are demonstrably unworried, year in, year out, by the unnecessary, untimely and expensive deaths of thousands of fellow citizens, including our parents, our children, our siblings and ourselves. We laugh in the face of fatal and debilitating illness, in fact, as long as it’s self-caught.
I’m exaggerating. We don’t laugh exactly — we just expect to be prescribed a pill that can do away with the worst side-effects of our own stupid behaviour. Take statins, for example. And if doctors have their way, we all will. Statins reduce the level of LDL cholesterol in the blood, and a recent study shows that they can reduce the risk of heart attack or stroke even in those with normal cholesterol levels. Bing! They reckon that the chances of adverse side-effects from statins are fairly low, so millions more people can start taking them. The cost of prescribing statins might well rise from £400 million to £2 billion per year, but it’s a price well worth paying.
The BBC news showed a number of heart-disease sufferers reacting to the news of the statin trials. One, a newsagent, was very pleased. He smoked, had heart disease and now wanted statins prescribed. Maybe he thought that now he wouldn’t have to give up smoking. For not once, during the whole day that the research was being reported, did I hear a single mention of nutrition, or of exercise, or of quitting smoking. It was as if these activities inhabited a separate conceptual universe.
I don’t entirely blame doctors for putting the emphasis on the pharmaceuticals. It must be so much easier to prescribe a pill in your 15 minutes with the pasty, fat, unfit patient than to try — yet again — to get him to change the way he behaves. We don’t quite see the need to change and doctors don’t expect us to.
This wilfulness can be darkly funny. On Saturday a man stood next to me at the minimarket checkout playing The Golden Shot with a cashier and the fags display. Left a bit, down, down, too far, up and right — and so on. The problem was simple. The packets are nearly covered now in health warnings, so he couldn’t just ask for the “purple ones in the middle”. What he could have done, however, was told the woman that he preferred “Smoking kills” to either “Smoking can kill” or “Smoking seriously harms you and others around you”. But then, of course, he’d have sounded as mad as he actually was.
While we can speculate quite enjoyably about whether a pandemic might carry off very many or very few of us, what is beyond conjecture now is that millions of people die early or are incapacitated from late-onset diabetes, strokes and heart disease brought on by smoking, too little exercise, obesity and poor diet. The flu pandemic, of course, requires nothing of us other than to be scared and demand vaccine. The other things require us to change.
Let’s leave smoking aside for the moment and just talk about salt. The human body requires salt, of course, but nothing like the amounts that we now consume in Britain. Excessive salt intake is a significant cause of high blood pressure, of plaque build-up in the arteries and, as a result, of stroke. Excessive salt consumption could well kill more people a year than a projected pandemic.
So the Food Standards Agency has launched a campaign advising people to cut their salt consumption to no more than six grams a day, which some researchers still feel is too high. The FSA also estimates that processed meals — fast foods and packaged foods — constitute about three quarters of people’s excessive salt intake.
But only months earlier the same body had climbed down on recommendations to the food industry on the maximum acceptable levels of salt content. The food manufacturers — including Sainsbury’s, Tesco and Heinz — argued successfully that the maximum levels should be raised from a proposed 1.9 grams of salt per 100 grams of ham to 2.5, and from 0.5 grams to 0.7 grams per 100 grams of dried soup. The reason being that the lower target “would not pass consumer acceptability”. In other words, that if the product wasn’t stuffed with stroke-inducing sodium, then we, the witless public, wouldn’t buy it.
So 200g of processed ham will constitute five-sixths of the recommended maximum salt intake in a day, simply because we cannot be trusted to make the minor adjustments to our palates that might help to save our lives.
I am a late convert to many of the marvels of capitalism, but when it comes to the food industry the old Bolshevik emerges again. These companies lie and dissemble in their packaging, dispute until they can dispute no longer every bit of research that links their horrible products with modern ill-health, and they suborn or browbeat government and agencies. Take the Advertising Association and its attitude to the marketing of junk food — food which is high in sodium and fats, low in nutrition and which, together with our sedentary lifestyles, is killing us. The Director-General of the AA recently described as “unproven” the idea that junk food advertising contributed to ill-health. Only if it is “unproven” that advertising leads to sales — a proposition that would bankrupt the entire ads industry.
Well, we can’t rely on them, which leaves it up to us. We have to draw ourselves up in front of the mirror and say: “Never mind the bloody swans, if it’s dying you’re scared of, lose some bloody weight.”
david.aaronovitch@thetimes.co.uk
