Shiloh
Editor, Senior Moderator
Source: http://www.google.com/hostednews/canadianpress/article/ALeqM5j1PQOzI0HN6NoxZzXVvpgsJvklfg
CP Exclusive: WHO says prepping for a bad pandemic has to be considered
2 hours ago
TORONTO ? The world may not know for quite some time how the outbreak of swine flu will play out, the scientist leading the World Health Organization's response to the situation warned Friday.
And given that the future path of the virus is unknowable and the possibilities run the gamut from fizzling out to causing a global outbreak of severe disease and death, preparing is the prudent course of action, Dr. Keiji Fukuda told The Canadian Press in an interview.
By late Friday, at least 592 cases, including 16 deaths, had been reported in 15 countries in North America, Europe, the Middle East and Asia.
Even as the new swine H1N1 virus continues to pop up in more countries and the confirmed case count grows, so too does the criticism that the mild cases of disease seen outside Mexico don't warrant the kind of attention the outbreak is garnering.
But Fukuda defended the WHO's call to arms, saying the world cannot know at this point what this new virus has in store.
"And so if we go ahead and we spend a fair amount of time getting ready and it remains mild and not so many people die or get seriously ill from it, then we are lucky and we should just be happy," Fukuda, the WHO's acting assistant director general of health security and environment, said from Geneva.
"If on the other hand it turns very severe and we have simply stopped preparing and we haven't pushed ahead with the preparations . . . that would really be the worst of all possibilities."
"To have had an opportunity to really do something and then to have lost it and then to have a significant number of people get really sick and to die - that would really be the worst of all possibilities."
Fukuda is an influenza expert and been involved for years in planning to help prepare the world to face the first pandemic since 1968.
For much of that time, the virus he and others feared would be the cause was the worrisome H5N1 avian flu virus. Endemic in poultry flocks in large parts of Asia and Africa, that virus has been known to have infected upwards of 420 people in 15 countries, killing 60 per cent of them.
Deep anxiety about what that virus would do if it acquired the ability to spread easily to and among people has fuelled pandemic preparations around the globe. In many quarters the mantra has been: "Hope for the best but prepare for the worst."
If the swine H1N1 virus does trigger a pandemic and continues to mostly cause mild illness, those in public health who've slaved over pandemic preparedness would feel the first part of that prayer had been answered.
Apart from Mexico's puzzlingly different disease picture, infections seem to be mild. Few hospitalizations have occurred. Most people are recovering without the need for antiviral drugs.
In many ways, this virus is acting like a garden variety flu - and not a very bad one at that. The problem is, there is virtually no way to gauge its future behaviour by its present actions, Fukuda said.
Influenza is notoriously unpredictable. The RNA viruses mutate continuously. Flu dogma is constantly being rewritten. People who've spent years studying the virus marvel at its ability to confound; this out-of-left-field emergence of a swine flu outbreak serves as a perfect example of that.
"It's just amazing how often you are so completely taken by surprise by flu," Fukuda said with wonder in his voice.
So where will it lead? He laid out the options as they currently appear:
-The virus could fizzle out. Though it seems to have no problem transmitting from person to person now, it might lose that ability and melt back into nature.
Should that happen, it might take months or longer for experts to feel confident it is truly gone.
If it died down in the northern hemisphere over the summer months, it might come back in the fall. Or next winter. Or even further down the road. After all, H5N1 first exploded out of nature in 1997, then disappeared for six years. But it roared back with a vengeance in 2003.
"There's no way we can predict it, no way we can know, even if it disappears, that it's not going to reappear later on," Fukuda said. "So it really takes a significant amount of time to know whether that would happen or not."
If the swine H1N1 virus does subside in coming weeks in the northern hemisphere, experts will be watching the southern hemisphere winter very closely to see what happens during flu season there.
-The virus could cause a mild pandemic.
-Or it could trigger a pandemic that starts out causing mild disease, but change over time. Viruses can ratchet up in virulence as they mutate. That's what happened with the 1918 Spanish flu, the worst infectious disease outbreak in known history. Memories of the Spanish flu weigh heavily on the minds of those trying to strike the right course for the response to this virus.
Ironically the Spanish flu was caused by an H1N1 virus, but one that was thought to have jumped from birds to humans. That pandemic had a mild spring wave, disappeared for the summer and returned as a killer in the fall of 1918. It is estimated that upwards of 50 million people died in that pandemic.
Too little is yet known about the dynamics of flu viruses for anyone to be able to predict which of these possibilities is most likely, though given the efficiency of spread to date Fukuda thinks fizzling out is unlikely.
That uncertainty is what is driving the WHO and governments to respond with such aggression to this outbreak.
"We are trying to sound a note that the situation is serious, but there are things that you can do and we ought to do them," Fukuda said.
"We are not trying to present an overblown picture about the dangers or anything. But you know, we are very mindful of the historical patterns in the past and the different effects in different populations and the ability of this virus just to change for reasons we don't understand or in ways that we can't predict."
He said he doesn't worry about the public seeing this as a "crying wolf" situation, should the outbreak fizzle out or cause only a mild pandemic.
"If you explain things in the right way, this situation can be understood," he insisted.
"And so it's really: How do we convey the situation in a way which people can understand there's a lot of uncertainty in it, and there are definitely choices to be made about how we approach things?
"But there are also some very serious considerations that have to be taken into account. And that is one of the things that we are wrestling with to steer the right course for this."
CP Exclusive: WHO says prepping for a bad pandemic has to be considered
2 hours ago
TORONTO ? The world may not know for quite some time how the outbreak of swine flu will play out, the scientist leading the World Health Organization's response to the situation warned Friday.
And given that the future path of the virus is unknowable and the possibilities run the gamut from fizzling out to causing a global outbreak of severe disease and death, preparing is the prudent course of action, Dr. Keiji Fukuda told The Canadian Press in an interview.
By late Friday, at least 592 cases, including 16 deaths, had been reported in 15 countries in North America, Europe, the Middle East and Asia.
Even as the new swine H1N1 virus continues to pop up in more countries and the confirmed case count grows, so too does the criticism that the mild cases of disease seen outside Mexico don't warrant the kind of attention the outbreak is garnering.
But Fukuda defended the WHO's call to arms, saying the world cannot know at this point what this new virus has in store.
"And so if we go ahead and we spend a fair amount of time getting ready and it remains mild and not so many people die or get seriously ill from it, then we are lucky and we should just be happy," Fukuda, the WHO's acting assistant director general of health security and environment, said from Geneva.
"If on the other hand it turns very severe and we have simply stopped preparing and we haven't pushed ahead with the preparations . . . that would really be the worst of all possibilities."
"To have had an opportunity to really do something and then to have lost it and then to have a significant number of people get really sick and to die - that would really be the worst of all possibilities."
Fukuda is an influenza expert and been involved for years in planning to help prepare the world to face the first pandemic since 1968.
For much of that time, the virus he and others feared would be the cause was the worrisome H5N1 avian flu virus. Endemic in poultry flocks in large parts of Asia and Africa, that virus has been known to have infected upwards of 420 people in 15 countries, killing 60 per cent of them.
Deep anxiety about what that virus would do if it acquired the ability to spread easily to and among people has fuelled pandemic preparations around the globe. In many quarters the mantra has been: "Hope for the best but prepare for the worst."
If the swine H1N1 virus does trigger a pandemic and continues to mostly cause mild illness, those in public health who've slaved over pandemic preparedness would feel the first part of that prayer had been answered.
Apart from Mexico's puzzlingly different disease picture, infections seem to be mild. Few hospitalizations have occurred. Most people are recovering without the need for antiviral drugs.
In many ways, this virus is acting like a garden variety flu - and not a very bad one at that. The problem is, there is virtually no way to gauge its future behaviour by its present actions, Fukuda said.
Influenza is notoriously unpredictable. The RNA viruses mutate continuously. Flu dogma is constantly being rewritten. People who've spent years studying the virus marvel at its ability to confound; this out-of-left-field emergence of a swine flu outbreak serves as a perfect example of that.
"It's just amazing how often you are so completely taken by surprise by flu," Fukuda said with wonder in his voice.
So where will it lead? He laid out the options as they currently appear:
-The virus could fizzle out. Though it seems to have no problem transmitting from person to person now, it might lose that ability and melt back into nature.
Should that happen, it might take months or longer for experts to feel confident it is truly gone.
If it died down in the northern hemisphere over the summer months, it might come back in the fall. Or next winter. Or even further down the road. After all, H5N1 first exploded out of nature in 1997, then disappeared for six years. But it roared back with a vengeance in 2003.
"There's no way we can predict it, no way we can know, even if it disappears, that it's not going to reappear later on," Fukuda said. "So it really takes a significant amount of time to know whether that would happen or not."
If the swine H1N1 virus does subside in coming weeks in the northern hemisphere, experts will be watching the southern hemisphere winter very closely to see what happens during flu season there.
-The virus could cause a mild pandemic.
-Or it could trigger a pandemic that starts out causing mild disease, but change over time. Viruses can ratchet up in virulence as they mutate. That's what happened with the 1918 Spanish flu, the worst infectious disease outbreak in known history. Memories of the Spanish flu weigh heavily on the minds of those trying to strike the right course for the response to this virus.
Ironically the Spanish flu was caused by an H1N1 virus, but one that was thought to have jumped from birds to humans. That pandemic had a mild spring wave, disappeared for the summer and returned as a killer in the fall of 1918. It is estimated that upwards of 50 million people died in that pandemic.
Too little is yet known about the dynamics of flu viruses for anyone to be able to predict which of these possibilities is most likely, though given the efficiency of spread to date Fukuda thinks fizzling out is unlikely.
That uncertainty is what is driving the WHO and governments to respond with such aggression to this outbreak.
"We are trying to sound a note that the situation is serious, but there are things that you can do and we ought to do them," Fukuda said.
"We are not trying to present an overblown picture about the dangers or anything. But you know, we are very mindful of the historical patterns in the past and the different effects in different populations and the ability of this virus just to change for reasons we don't understand or in ways that we can't predict."
He said he doesn't worry about the public seeing this as a "crying wolf" situation, should the outbreak fizzle out or cause only a mild pandemic.
"If you explain things in the right way, this situation can be understood," he insisted.
"And so it's really: How do we convey the situation in a way which people can understand there's a lot of uncertainty in it, and there are definitely choices to be made about how we approach things?
"But there are also some very serious considerations that have to be taken into account. And that is one of the things that we are wrestling with to steer the right course for this."