In the recent swine flu scare, the World Health Organization (WHO) surprisingly quickly went up the pandemic scale. Now it looks clear that it won’t be a pandemic after all: far fewer people have died than die during a normal flu season – and far less than regularly die around the world from malaria, dirty water, or smoke from indoor cooking and heating, week after week and year after year.
Preparedness for a pandemic is important, and the time to get ready is well before a pandemic occurs, and the time to start handwashing and mask-wearing is when a potential outbreak first occurs. Emphasizing the seriousness of the situation is good and wise. But you can emphasize preparedness with the pandemic scale is at 2, rather than 5. (Or even zero for that matter – if the WHO makes announcements on potential pandemics, the fear factor means that many people will pay attention.) As a public health layperson, I’m hesitant to criticize the professionals (I studied public health engineering, rather than public health per se, and my focus is on knowledge sharing, rather than knowing everything myself). But these questions need to be asked. The WHO made out that there was a high likelihood of pandemic when it appeared to me and many others that there was no good reason to do so. Were they boys crying wolf, and what does this mean for the next potential pandemic?
I still believe the risk of a 1918-style pandemic happening again is very low, as I’ve argued with my friends in the development field. We’ve learnt much since 1918, our communications are many times better, and the conditions of 1918 (international war, troop movements, trench warfare, widespread poor nutrition even in rich countries, less advanced diagnostics and treatment) just don’t exist today. But I’d be a fool to say it’s impossible. We’ve built a better public health infrastructure, and the nasty virus DNA may just form into a more challenging virus.
The point is to be prepared – develop strategies such as the Flucode, and develop freely available information on making oral rehydration solution and simple masks. Be prepared for an outbreak of something nasty, and be ready to deal with it quickly – these are what we need. We’ll also have side-benefits to better deal with regular influenza (a sometimes deadly disease but without the headlines) and other diseases—action, not panic.
Am I being harsh on the WHO?