# 1164
Pandemic planners here in the United States, and in many countries around the world, are basing their pandemic plans on the assumption that roughly 30% of the world's population would be sickened by a pandemic, and about 2% of those could die. Those that will need hospital care range from 2% to 10%.
In some places, including some states here in the US, the assumptions are even more optimistic. In South Carolina, for instance, a state with a population of roughly 4.3 million people, their pandemic plan calls for:
6. Based on a population attack rate of 15-35%, South Carolina could anticipate between 560,000 and 1.32 million cases of influenza during the peak transmission period.
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8. Hospitalizations due to influenza and influenza-related complications may reach 12,000 (range 7,200 – 16,800 persons) – the elderly and those with chronic medical conditions could account for most of these admissions.
9. South Carolina is expected to experience almost 3,600 deaths from pandemic influenza (range 2,200 – 5,000), or nearly double the regular number of state’s expected deaths, during the peak transmission period.
Hmmm. Let's see, 3,600 deaths. That's roughly 1 person in 1200. Or, based on their maximum attack rate (1.32 million) and maximum fatality rate (5,000), a CFR (case fatality ratio) of 3/10ths of 1%.
They are also planning on a hospitalization rate of 1.25%.
In other words, the South Carolina Pandemic plan assumes a pandemic about 1/6th as severe as the Federal plan.
I guess we would all be smart to move to South Carolina. Obviously they don't expect the pandemic to be too bad there.
Sadly, South Carolina isn't alone. Each state has adopted their own set of assumptions, and while most used the Federal guidelines, many did not.
While we can't know what the next pandemic will bring until after it is over, assuming that it won't be as bad as 1918 is a bit of a gamble. Particularly when it is people's lives at stake.
The federal estimates of a 30% attack rate, and a 2% fatality rate are based, supposedly, on the 1918 pandemic.
I say supposedly because you have to cherry pick the numbers from 1918 in order to come up with those figures. They may reflect what happened in the United States, but they certainly don't reflect what happened around the world.
In the US, the official numbers are that 675,000 died, and roughly 30 million were sickened. This out of a population of roughly 100 million people. And yes, that does work out to about a 2.2% CFR.
But worldwide we are told that roughly 40 to 60 million people died, and that the virus attacked 30% of the world's population. In 1918, that would have meant roughly 600 million people were sickened, and somewhere between 7% and 10% died.
If the 100 million deaths estimate, which as been suggested in recent years, were true, then the CFR would have been closer to 16%. I personally have doubts that the death toll went that high, but frankly, no one was really counting.
Why the death toll was only 2% in the United States (and closer to 1% in some Northern European countries), and yet it was well over 10% in some countries, is unknown right now. Certainly factors such as diet, general population health, and the availability of basic nursing care could have made a difference.
A pandemic of the same severity as 1918 could sicken 2.2 billion people, and kill between 200 and 300 million people worldwide. And there is no guarantee that 1918 was the worst that nature could throw at us.
And yet, those numbers are almost never mentioned. We still see newspaper articles referencing the 2 to 7 million estimated deaths from a pandemic. Numbers so laughably low as to be an insult to the intelligence of the readers. But if you print them often enough, they gradually become accepted `fact'.
And we wonder why the public isn't worried. Why pandemic issues have so little traction. Why we remain unprepared.
It's what we get for watering down the possibilities to something palatable. Envisioning a socially acceptable pandemic. Something manageable. Bad, but not too bad to upset anyone.
Until it happens, of course.
I can't predict the death toll of the next pandemic. No one can. But I can predict, that if it is a severe pandemic and exceeds official estimates, that public officials will come forth and claim that `No one thought it could be this bad'.
And that will, of course, be a lie.
