http://www.psandman.com/col/swinecomm.htm
Updated July 7, 2009
Swine Flu Pandemic Communication Update
by Peter M. Sandman
long article, excellent points including these:
Three pandemic scenarios
To anchor our expectations, consider three pandemic scenarios:
No big deal. Pandemic H1N1 could turn out so mild that people barely notice they?re in the middle of a pandemic. This is the scenario that comes to mind when we consider that the CDC guesstimates that over a million Americans have already had swine flu and only 170 of them have died ? a case fatality rate way below the rate for seasonal flu. It?s what comes to mind when we consider that the CDC thinks 7 percent of the New York City metropolitan area may have had the disease in a concentrated two-month period with relatively minor impacts on absenteeism (except in schools) and the flow of goods and services. We could dodge the bullet.
Serious but manageable.Pandemic H1N1 could turn out comparable to seasonal flu in terms of how sick it makes people and what percentage of them die. Seasonal flu is the comparison U.S. health officials use most often ? but it?s not clear if they?re trying to ?err on the alarming side? or if they actually think the second scenario is likelier than the first.
The second scenario is more serious than most Americans imagine, especially if the pandemic virus coexists with seasonal flu viruses instead of crowding them out. If swine flu infects one-third to one-half of the population and kills the same percentage as the seasonal flu does, we?re talking about roughly 100,000 U.S. deaths, most of them young people who considered themselves pretty healthy till the swine flu hit. Hospitals will be overloaded. In flu hotspots, debate will rage over whether to close schools, and whether to cancel concerts, football games, and other events that bring people ? especially young people ? close together. Absenteeism may interrupt some services, some manufacturing, and some shipping, possibly leading to shortages of essential supplies like food and medicine.
Many Americans will be surprised, probably worried, and possibly upset about these effects, especially if they feel they weren?t properly warned and aren?t properly prepared.
Nightmare. Pandemic H1N1 could mutate into a more severe disease, as happened during the 1918 pandemic (which started mild). A change in the virus might also make the first pandemic vaccine useless, and make people over 50 and people who already had swine flu this spring vulnerable again.
1918 was the worst flu pandemic in recent history; two to three percent of victims died, compared to one-in-a-thousand for seasonal flu. Anything that deadly would be even more disruptive today, given our globally integrated economy and our just-in-time supply chains. A pandemic less severe than 1918?s but significantly more severe than an average flu year would be nightmare enough, and that?s the scenario pandemic preparedness discussions usually emphasize.
A replication of 1918 isn?t the worst case scenario. Pandemic H1N1 could mix-and-match genetic material with the H5N1 (bird flu) virus ? which has infected very few people but killed an astounding 61 percent of them. A new virus as transmissible as H1N1 and as deadly as H5N1 is the ultimate pandemic nightmare, almost too awful to prepare for...
(full article at above link)
Updated July 7, 2009
Swine Flu Pandemic Communication Update
by Peter M. Sandman
long article, excellent points including these:
Three pandemic scenarios
To anchor our expectations, consider three pandemic scenarios:
No big deal. Pandemic H1N1 could turn out so mild that people barely notice they?re in the middle of a pandemic. This is the scenario that comes to mind when we consider that the CDC guesstimates that over a million Americans have already had swine flu and only 170 of them have died ? a case fatality rate way below the rate for seasonal flu. It?s what comes to mind when we consider that the CDC thinks 7 percent of the New York City metropolitan area may have had the disease in a concentrated two-month period with relatively minor impacts on absenteeism (except in schools) and the flow of goods and services. We could dodge the bullet.
Serious but manageable.Pandemic H1N1 could turn out comparable to seasonal flu in terms of how sick it makes people and what percentage of them die. Seasonal flu is the comparison U.S. health officials use most often ? but it?s not clear if they?re trying to ?err on the alarming side? or if they actually think the second scenario is likelier than the first.
The second scenario is more serious than most Americans imagine, especially if the pandemic virus coexists with seasonal flu viruses instead of crowding them out. If swine flu infects one-third to one-half of the population and kills the same percentage as the seasonal flu does, we?re talking about roughly 100,000 U.S. deaths, most of them young people who considered themselves pretty healthy till the swine flu hit. Hospitals will be overloaded. In flu hotspots, debate will rage over whether to close schools, and whether to cancel concerts, football games, and other events that bring people ? especially young people ? close together. Absenteeism may interrupt some services, some manufacturing, and some shipping, possibly leading to shortages of essential supplies like food and medicine.
Many Americans will be surprised, probably worried, and possibly upset about these effects, especially if they feel they weren?t properly warned and aren?t properly prepared.
Nightmare. Pandemic H1N1 could mutate into a more severe disease, as happened during the 1918 pandemic (which started mild). A change in the virus might also make the first pandemic vaccine useless, and make people over 50 and people who already had swine flu this spring vulnerable again.
1918 was the worst flu pandemic in recent history; two to three percent of victims died, compared to one-in-a-thousand for seasonal flu. Anything that deadly would be even more disruptive today, given our globally integrated economy and our just-in-time supply chains. A pandemic less severe than 1918?s but significantly more severe than an average flu year would be nightmare enough, and that?s the scenario pandemic preparedness discussions usually emphasize.
A replication of 1918 isn?t the worst case scenario. Pandemic H1N1 could mix-and-match genetic material with the H5N1 (bird flu) virus ? which has infected very few people but killed an astounding 61 percent of them. A new virus as transmissible as H1N1 and as deadly as H5N1 is the ultimate pandemic nightmare, almost too awful to prepare for...
(full article at above link)
