Are We All Happy about the End of Flu Season?
A Surprising Source Says “No”

The Centers for Disease Control announced recently[1] that the 2012-2013 influenza outbreak,[2] which has to date killed 81 children and prompted the declaration of public health emergencies in multiple U.S. cities, is finally waning. Since the proportion of deaths attributable to pneumonia and influenza has been at epidemic levels since January, the announcement of the end of one of the most dangerous flu seasons in years comes as welcome news to all of us.

Well … maybe to most of us. Because if an unintentionally shocking January 2013 Drug Store News article is to be believed (hint: I don’t think that it is), your local pharmacist may actually be upset by the decline in flu activity. Why? Because “the sickest winter we will have had in years” is “big business for retail pharmacy.”[3]

Yes, for those who were searching for a reason to be pleased with an influenza season that has been characterized by only “moderate” vaccine effectiveness and markedly heightened risk for senior citizens, in whom an estimated 90% of flu-related deaths have occurred—you now have your answer. The severity of this year’s flu season is a good thing, says the Drug Store News article, because it has generated a lot of revenue for pharmacies, making last year’s mild flu season a “distant, bad memory.” After all, consider the positive aspects of the 2013 outbreak as highlighted in the article:

For the four weeks ended Dec. 30 (and before this year's flu incidence peak), sales of hand sanitizers were up 15.4% to $14.4 million; sales of personal thermometers were up 35.8% to $17.9 million; sales of cold and allergy liquid formulations were up 27.4% to $133 million; and sales of cold and allergy tablets were up 7.9% to $352 million. … And the Food and Drug Administration took measures to ensure adequate supply of Tamiflu for both adults and children. … And there are still two months of flu season to go.

Feeling encouraged by all this good news?

Aside from the obvious point that the article was tasteless and should have been edited to remove what I can only assume was an inadvertently callous and commercial tone not representative of the true values of the author or Drug Store News, there is a critically important lesson for research methods here: we serve people.

It is an easy lesson to forget. Many of us in health care research work only with computer files; anonymized, HIPAA-compliant identifiers; and alpha-numeric diagnosis and procedure codes that become clinically meaningful only with the use of esoteric and complex coding systems. It’s not that easy to see all those numbers as human beings. That is one of several reasons that I have chosen to continue working in nursing homes for at least a few hours each month, as a sort of counterweight to analyzing and writing about anonymous study “cases:” it helps me to remember that they are people. Without that regular contact with patients, I might forget.

So I repeat here an observation that I intentionally call to mind on a regular basis. When I analyze a dataset documenting the medical and pharmacy services provided to cases, I am receiving the informational benefits of a glimpse into events—sometimes life-changing, sometimes tragic, sometimes merely inconvenient—affecting people. They are not revenues, median survival times, units of service, dispensed days supply, QALYs, or even “covered lives.” They are people. They are our moms and dads, our kids, our friends, our coworkers, and sometimes—as I have sadly observed in my work with nursing home patients—caregivers to spouses who struggle to go on after their primary source of medical and social support becomes incapacitated or dies. A flu epidemic is no small thing.

To receive and benefit from information about people is both a privilege and an immense responsibility. We fulfill that responsibility when we choose excellence in research ethics and methods; select research topics that meet a true therapeutic or informational need rather than a commercial purpose alone; and report findings transparently, thoroughly, and accurately. As I wrote in Health Care Research Done Right,[4] we all fail, to some extent, in that endeavor. But we are all ethically obligated to try to succeed—and, when necessary, to call out those who find it acceptable to view people and their health care needs as revenue generators while ignoring the humanistic costs of the medical conditions that our health care system is intended to prevent and treat.


[1] Weise E. Flu no longer widespread in the U.S. USAToday. March 1, 2013.
[2] Centers for Disease Control. What you should know for the 2012-2013 influenza season. February 21, 2013.
[3] Johnsen M. Monster flu season makes last year’s non existent [sic] flu season a distant, bad memory. Drug Store News.
[4] Fairman KA. Health Care Research Done Right: A Journal Editor Shares Practical Tips and Techniques for High Quality and Efficiency. Outskirts Press; 2012.