Santa and public health - update

Last week I mentioned the British Medical Journal's 'Santa - a public health pariah' article, which I prayed was 'an elaborate hoax'. And - mercifully - it was. A look at the full text removes all doubt:

A quick perusal through the Victorian infectious diseases surveillance records shows no notifications of infectious disease outbreaks associated with kissing Santa. Although there were no cases of infectious mononucleosis ("kissing disease") associated with Santa, there have been numerous foodborne viral and salmonella outbreaks associated with Christmas parties. Santa was not named as a suspected point source.

All well and good. Any article that discusses Santa as if he actually exists is clearly taking the mickey (sorry kids). Unfortunately, there was none of the humourous stuff in the (free) abstract of the article available on the BMJ website. The tongue-in-cheek parts were in the full text hidden behind a pay-wall.

Worse still, the press release that the BMJ sent around the world was just about believable, in the context of the current hysteria over obesity:

Santa should share Rudolf's snack of carrots and celery sticks rather than brandy and mince pies and swap his reindeer for a bike or walk, says a public health expert in the Christmas issue published on bmj.com today.

Dr Nathan Grills, from Monash University in Australia, says the current image of Santa promotes obesity, drink-driving, speeding and a general unhealthy lifestyle. He argues that "Santa only needs to affect health by 0.1% to damage millions of lives" and that it would be better if his popularity was used to promote healthy living.

Since we are told that people smoking in movies makes kids smoke, and that spending time with fat people makes us fat, the idea that a fat Santa might 'normalise' obesity and drinking is perfectly credible in the wacky world of public health. Santa wouldn't be the first fictional character (sorry kids) to undergo a politically correct makeover. The Little Chef, for example, was slimmed down a few years ago:

The trademark tubby cook who has been the logo at restaurant chain Little Chef since 1972 is being put on a diet. Little Chef has come up with a slimmer version of the chef as part of a general sprucing-up operation to improve its image.

That didn't last, but they got rid of Isambard Kingdom Brunel's cigar and airbrushed Robert Johnson's cigarette, so anything's possible. Ultimately, the problem with the BMJ article was that it was parodying something that is beyond parody. It is simply not possible to make up anything more ludicrous than thirdhand smoke and passive obesity.

The only thing in the press release that might have set the alarm bells ringing was this bit:

Also, Santa has real potential to spread infectious diseases, says the paper. If Santa sneezes or coughs around 10 times a day, all the children who sit on his lap may end up with swine flu as well as their Christmas present, argues Grills.

But these fears aren't new either. Last month saw this:

Health chiefs in Hungary have clamped down on Father Christmas, suggesting the children's favourite should avoid kissing children and shaking their hands to prevent spreading flu this Winter.

They recommend that all people dressing up as Father Christmas should get vaccinated against the illness.

Some officials in the Eastern European country had argued for a complete ban on the traditional "Meet Santa" amusements which are available in many shopping centres at Christmas time.

Despite repeatedly clarifying that it was all a joke, the author of the BMJ article - Nathan Grills - has been getting a hard time, as Newsweek reports (thanks to Thomas for the link):

Around the world, Grills has been attacked as a mean-spirited Christmas killjoy. His e-mail inbox is filled with condemnations. He's so besieged by angry calls that he won't answer the telephone, so I couldn't talk to him for an interview. We had to correspond via e-mail.

Someone else who has corresponded with Grills by e-mail is Crampton at Offsetting Behaviour. In one of many e-mails the great satirist must have written this week, he explained:

Hi Eric,

Most of the 'Santa- A Public Health Pariah' article is meant to be tongue-in-cheek. It's a Christmas spoof. It's supposed to be spreading a bit of Christmas cheer, but with a tinge of seriousness to provoke a bit of healthy Christmas dinner table conversation. The BMJ Christmas edition is a special edition with much humour.

Fair enough, but when you have to explain a joke, it's probably not a very good one.

Unfortunately, the article has spread like wildfire but it has lost a bit of the Christmas cheer element.

Let's not be disingenuous here, Nathan. The article "spread like wildfire" because you sent out a worldwide press release to the media. You must have known that the media would have had no interest in covering it unless they believed that it was serious. As it was, you got considerable press attention and were interviewed on the radio. You can't have it both ways.

The media perhaps believed a little too much... probably because they had only read media release and not the article.

Well yes, because the BMJ put the article behind a pay-wall. Even if it was publicly available, most journalists still wouldn't have read it because - and I don't think this is a big secret - journalists rely almost exclusively on press releases and abstracts (sorry kids).

As an epidemiologist, Nathan, you should get on your knees and thank God that journalists don't read medical journals in full and don't understand how statistical sciences work. If they did, hardly any epidemiological studies would ever be reported on, unless it was to make fun of the poor methodology, weak associations and hysterical conclusions that are endemic to them.

Still, at least Nathan Grills has stepped up to the plate and admitted that his study was a hoax. If Stanton Glantz, Jill Pell, James Repace and Georg Matt now come forward and admit that their studies were jokes that got out of hand as well, we really can have a happy Christmas.