Pandemic Planning

A/H1N1 is a novel virus that appears to have originated in swine. It spreads quite rapidly, even under conditions that are not traditionally believed to be conducive to easy transmission. Although the global spread of the new A/H1N1 virus has resulted in the recent official declaration of a pandemic by the World Health Organization, A/H1N1 still lacks the lethality of the so-called bird flu, or H5N1. Some have even characterized this new influenza as “mild”. Nevertheless, A/H1N1 appears to be much worse than the “seasonal” flu that affects us each winter.

According to twenty years’ worth of “cause of death” reporting data from the National Center for Health Statistics of the Centers for Disease Control and Prevention, influenza is the official cause of death for an average of 1,263 people in the United States each year. Indeed, the CDC’s most recent official tally of death by influenza indicates that only 849 people died of influenza in 2006. These very low numbers would seem to contradict the often cited figure of “36,000 flu-related deaths per year” in the United States, which appears on the CDC’s own web site. If the United States did actually have 36,000 flu-related deaths per year during its traditional flu season, we would see 200 deaths per day for six months, and that would be newsworthy. Therefore, do not be fooled into complacency by comparing the reported death totals from A/H1N1 against the common misconception that seasonal flu kills 36,000 Americans each year.

So far, most of the infected individuals are recovering without professional medical care, but this new virus has proven to be capable of killing healthy adults, even in developed countries where modern medical care is available. At the present rate of progression, it appears that A/H1N1 will kill hundreds of thousands of Americans over a span of at least one year.

In a departure from early observations, this A/H1N1 pandemic has been characterized as “moderate” by the World Health Organization. As such, it is expected to infect approximately 33% of the global population, resulting in a .5% case fatality rate. For the United States, that would mean 100,000,000 people would be come ill at some point during the pandemic, resulting in 500,000 deaths. For the sake of comparison, the 1918 “Spanish Flu” pandemic had a case fatality rate of approximately 2% to 2.5%. Of course, the estimated case fatality rate of approximately .5% does not take into account what will occur when A/H1N1 finally meets up with H5N1. H5N1 could gain transmissibility, or A/H1N1 could gain lethality, or both. Indeed, we could eventually be faced with multiple pandemic flu strains, each with its own unique transmissibility and case fatality rate. With one pandemic already in progress and another on the way, you need to prepare for the very worst.

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