The current WHO phase of pandemic alert for avian influenza H5N1 is 3.
While not the damp squib that many pundits have mistakenly called it (see Lancet: Estimating Global 2009 Pandemic Mortality), the 2009 H1N1 influenza pandemic could have been worse.
A lot worse.
As it was, the Lancet study mentioned above found:
We estimate that globally there were 201 200 respiratory deaths (range 105 700—395 600) with an additional 83 300 cardiovascular deaths (46 000—179 900) associated with 2009 pandemic influenza A H1N1. 80% of the respiratory and cardiovascular deaths were in people younger than 65 years and 59% occurred in southeast Asia and Africa.
As we’ve seen with some previous pandemics, the greatest burden of illness and death was shifted to those under 65, a reversal of what we normally see with seasonal influenza.
Still, when compared to 1918 – where between 50 and 100 million people died – the pandemic of 2009 was relatively mild.
We may not be nearly so lucky the next time around.
Preparations for an H5N1 pandemic – which began in earnest in 2005 – undoubtedly helped the world respond in 2009, but it is quite clear the world remains poorly equipped to deal with a major global health crisis.
While the document goes into considerable detail, the following excerpt lists key areas where changes are recommended.
The changes being made to pandemic plans follow to a large extent the findings from some evaluations performed by countries, as well as the two EU-wide assessments (TOR1 and TOR2) (7), the WHO/Europe evaluation of pandemic preparedness (8), the external review of the IHR (1) and of ECDC’s response to the pandemic (9). The changes address primarily the following areas:
- intersectoral cooperation, collaboration and leadership
- flexibility and adaptability of plans
- strategies for vaccines and antivirals
- disease surveillance and monitoring of countermeasures
- strategies for exchanging information and communicating risk
- evaluation of the pandemic response and the transition to seasonal influenza.
Four countries (France, UK, Czech Republic, Finland) have updated their pandemic response plans since 2009, while many other countries are in the process of working on revisions.
You can view the latest versions of European national plans at this WHO Europe web address:
Follow the links below to view country-specific national pandemic preparedness plans.
Updated in 2012 (in Finnish)
- Czech Republic
Updated in 2011 (in Czech and English)
Updated in 2011 (in French)
- United Kingdom
Updated in 2011 (in English)
European pandemic guidance recommendations are being revised to more closely match the WHO global pandemic guidance. These new guidance recommendations will be presented at a WHO workshop in Copenhagen next month for countries of the South-eastern Europe Health Network (SEEHN), newly independent states, Switzerland and Turkey.
This from the World Health Organization:
Evaluations of the response to the 2009 pandemic have shown that the world is ill-prepared to respond to a severe influenza pandemic or to any similar global, sustained and threatening public health emergency.
From the lessons learned it can be concluded that existing country pandemic plans have a number of gaps. Member States are in the process of revising their pandemic plans and 4 countries of the WHO European Region have published their revised plans.
A key activity of WHO/Europe in collaboration with the European Centre for Disease Prevention and Control (ECDC) is to provide a strong and clear guide, so that all countries of the Region can revise their pandemic influenza preparedness strategies. To this end, the existing European guidance is being revised in line with revisions from the WHO global pandemic guidance. This new version of the European guide will be discussed during a workshop on pandemic preparedness that will be held 5-7 December 2012 in Copenhagen, Denmark for countries of the South-eastern Europe Health Network (SEEHN), newly independent states, Switzerland and Turkey.
The meeting is organized in collaboration with the SEE Regional Health Development Centre for Communicable Diseases Surveillance in Tirana, Albania and will be facilitated by experts from WHO collaborating centres at the University of Nottingham, United Kingdom and the University of Geneva, Switzerland as well as WHO headquarters.
Experts from ECDC and Centers for Disease Control and Prevention (CDC) Central Asian Region, Almaty, Kazakhstan will also participate.