# 1661
According to a report released on Tuesday by Annapolis, MD based iJet Intelligent Risk Systems , 80% of the countries of the world either have, or are developing, some plan for dealing with a pandemic.
Quoting from their press release:
During 2007, governments and corporations worked to improve pandemic preparedness – with more than 80 percent of countries developing national plans for both avian and pandemic influenza. While a positive sign, more still needs to be done. In general, public planners have yet to adequately address vulnerabilities associated with critical service sectors other than healthcare, while corporate executives need to give added attention to supply chains and partners.
While it is somewhat encouraging that 80% of nations are `developing' some sort of pandemic plan, what is unknown is what kind of pandemic they are planning for, and how they plan to respond.
We've seen here in the United States a hodge-podge of state plans emerge, with some states obviously planning for nothing worse than a repeat of the 1957 Asian Flu, while others are looking at a 1918 scenario. Some of these state plans actually look pretty good, while other's are less confidence inspiring.
The Federal guidelines for pandemic planning are to expect 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%.
Roughly a repeat of the 1918 pandemic here in the United States.
Many consider these estimates optimistic, although they are probably a reasonable planning goal.
In South Carolina, a state with a population of roughly 4.3 million people, their pandemic plan calls for a somewhat less severe scenario:
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.
<snip>
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 only 1.25%.
In other words, the South Carolina Pandemic plan assumes a pandemic about 1/6th as severe as the Federal plan.
Some of these state plans have gaps, vague areas where they might as well have inserted the phrase - "and then a miracle occurs" - mostly where they off-shift management responsibilities to local governments, most of which have no clue what would be expected of them during a pandemic.
Additionally, some states have failed to participate in the Federal antiviral purchase program, potentially leaving their citizens badly under protected during a pandemic.
And of course, only a miniscule portion of these plans have been tested in any meaningful way.
Yet despite these shortcomings, the United States is arguably among the best prepared nations in the world.
Given the jurisdictional problems, the need for 50 state legislatures and executive branches to approve expenditures, and the wide range of scenarios a pandemic might present, it is somewhat of a miracle that we've gotten this far.
Imagine the constraints less wealthy nations must have regarding pandemic preparedness.
There is an old Russian proverb that goes something like:
The amazing thing about a dancing bear is not that it dances well . . . but that it dances at all.
Cumbersome and ungainly as it may appear, we are making progress. Here in the United States, and around the world.
Obviously some states, and some nations, will be better prepared than others, thanks to the hard work and dedication of many emergency planners.
If we see a relatively mild pandemic in the future, then those states that failed to prepare for a `worst-case scenario' won't be hurt badly. In fact, they may even gloat over the `reasonableness' in their planning.
If we see a severe pandemic, however, their failure to prepare in earnest will likely compound their problems.
You'd think, in a perfect world, everyone would be on the same page and every state and every nation would be equally prepared.
But that's exactly where we were 5 years ago when pandemic awareness and planning were universally non-existent.
Admittedly I'm disappointed with the level of pandemic preparedness here in the United States and around the world. We are making progress, but there is much left to do.
But sometimes you have to look at how far we've come, not how far we've gone.
