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‘Pandemic’ – An Evolving Characterization

By now most citizens realize that a pandemic is a global disease outbreak exacerbated by populations that have little immunity to the pathogen. Much has been written about historic influenza outbreaks, mostly about the 1918 pandemic of “Spanish Flu” that killed an estimated 20 to 40 million people in one year. With no natural immunity, an estimated 28 percent of all Americans contracted the disease and an estimated 675,000 died – ten times as many as were killed in WW I. During this time the influenza epidemic was so potent that it reduced the average life span of a U.S. citizen by close to 10 years.

Where did it come from? The precise origin of the 1918 epidemic remains uncertain, although some retroactive forensic work has suggested that it may have first appeared in China. But, due to primitive medical care and no public health system, it was not tracked and curtailed before it began to spread to other countries. It could have been incubating for decades before finally reaching its exceptionally virulent stage and rampaging through populations.

As others have pointed out, this pandemic has interesting characteristics that should moderate any inclination to panic. While we live in an enormously connected world where any disease can quickly spread, we also have a superbly connected and communicative scientific community with huge resources to battle a new disease. So, while the swine flu can potentially spread fast, treatment and curative solutions will emerge just as fast.

This is not the ‘Big One”

With all this in mind, is there a chance that this pandemic could generate the level of destruction and tragic loss of life that occurred in 1918? Clearly, no. From reports just today, Mexican health authorities feel the outbreak has already lost its momentum – not to say it could not re-energize and infect thousands more over the next few months.  It is interesting that it is barely news when 36,000 people die from the flu annually in the United States. But this flu is ‘new’ and has associated unknowns. (It really isn’t new – it has been around for decades.)

Because a pandemic typically is caused by new combinations of avian, human or swine viruses, spreads among humans, is contracted by healthy younger populations, and continues to evolve, the swine flu has characteristics associated with a pandemic. Historically the CDC has had cases of swine flu reported in the U.S. (12 cases from December 2005 through February 2009), so this basic form of pathogen is generally known. This H1N1 strain is already being addressed through rapid, coordinated, and sensible actions through public health and scientific organizations in virtually every country. In 1918, fully one fifth of the world population was infected with the influenza virus. The chance of this level of contagion is very remote.

From my perspective, it seems a bit premature for Egypt to slaughter an estimated 300,000 to 350,000 pigs to avoid disease spread – especially in swine populations where no sign of the disease has been found. It is even more curious because swine influenza viruses are not transmitted by food and humans cannot get the disease from eating pork or pork products. Properly handled and cooked pork and pork products are safe.

It would appear that the best course of action is similar to most responses – don’t panic, take precautions, be careful, and pay attention. There are much nastier bugs out there – many we don’t understand and aren’t prepared for. For this ‘pandemic,’ communities and public organizations need to share information with a message of calm assurance when providing facts about the disease and what is being done to address its spread and impact. Similar to the current economic crises, it isn’t 1918 and there are more tools in the tool kit in 2009 that were available then. Pandemic or not, there is also a very potent ‘pandemic’ of response.

__________________ 

With over three decades working in and with federal, state and local government, John Luthy understands public agencies.  Known for his real world, straight talking style, he is a leading futurist specializing in city, county, state, and federal long-range thinking and planning. An innovative and dynamic presenter, John is frequently asked to speak and consult on how to prepare public organizations and communities for emerging challenges. He holds both the MPH and MPA degrees as well as a doctorate in education.

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2 Responses

  1. I think Dr. Luthy is correct. As a healthcare provider, I agree. “Don’t panic, take precautions, be careful, and pay attention. Well written blog!

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