Tuesday, June 05, 2007

Pandemic Complacency Among Doctors

 

# 845

 

This survey comes as no real surprise to me, as I've found that about half the doctors I speak to are greatly concerned over a near-term pandemic outbreak, while the remainder simply regard it as a possibility. 

 

First the story, then a little discussion.

 

 

Survey Reveals Doctors’ Complacency Over Risk of Avian Flu

 

Description

Less than half of doctors with an interest in infectious diseases in children believe that a flu pandemic resulting from an avian strain is very likely, according to a study published online ahead of print in Archives of Disease in Childhood.

[Physicians’ perception of pandemic influenza; Online First Archives of Disease in Childhood. doi: 10.1136/adc.2007.120469]

Newswise — Less than half of doctors with an interest in infectious diseases in children believe that a flu pandemic resulting from an avian strain is very likely, according to a study published online ahead of print in Archives of Disease in Childhood.

 

But despite this a sizeable minority keep a supply of the anti-viral drug oseltamivir at their disposal, just in case.

 

The figures are based on the views of 161 doctors, mostly European (50% from the UK), attending a conference. They were asked to answer a series of questions on avian flu using an anonymous electronic voting system, and also a question about their seniority, so the results could be categorised.

 

Only 44.7% believed that a human flu pandemic, arising from either a mutation of an avian influenza virus or reassortment with a human strain, was ‘almost inevitable’ or ‘very likely’. The majority thought it was only ‘possible’, and 9.9% thought it was ‘unlikely’ or ‘very unlikely’.

 

However 7.9% of 139 respondents admitted they had a supply of the neuraminidase inhibitor oseltamivir for personal or family use despite strong recommendations against this. Only one of the 27 consultants in infectious diseases had a supply compared with five out of 29 senior registrars or fellows.

 

The authors speculated that perhaps this was because the more junior doctors in infectious diseases had ‘a perceived higher risk of exposure’.

 

‘Despite evidence to the contrary that has received widespread exposure in both the medical and lay press, over half of these physicians (who are likely to have a more than average interest in and knowledge about avian influenza) did not believe the risk of an imminent influenza pandemic was more than a possibility,’ they said.

 

Associate Professor Nigel Curtis, Head of the Infectious Diseases Unit at the Royal Children's Hospital Melbourne, commented: ‘This survey highlights that, like many other doctors and the public alike, there was a degree of complacency amongst the doctors surveyed with regard to the evidence and expert opinion that there is a significant risk of an imminent flu pandemic for which we need to be prepared.’

 

First the good news.  Nearly 45% of the doctors surveyed believe a pandemic in the near term is either ‘almost inevitable’ or ‘very likely’, and more than 90% believe it is at least a possibility. 

 

Only 9.9% thought it was ‘unlikely’ or ‘very unlikely’.

 

Given that its almost impossible to get 90% of doctors to agree on anything, that's a remarkably high number.

 

Consider also that these doctors were primarily from the UK and Europe, nations where (sadly) general pandemic awareness is lower than it is in the United States.  I believe the numbers here would be a bit higher.

 

We obviously have a ways to go.  But we must remember that doctors deal with life and death situations every day, and it is hard to get their attention about something that might happen tomorrow, or next year, when they have patients dealing with AIDS, cancer, and infectious diseases today.

 

Public Health doctors, whose job it is to anticipate future events (and hopefully forestall them), have the luxury of giving threats like avian flu, XDR-TB, and chickungunya consideration.   For most doctors, it is enough to deal with what is before them each day.

 

As far as who is right, well, we'll know that only if, and when, a pandemic actually erupts.   Today, one could argue that doctors who ignore the pandemic threat are concentrating their efforts on the welfare of their current patients.  Not a bad thing.  

 

But should a pandemic erupt in the near future, a great many doctors may find themselves caught unawares, and that could have tragic results.