# 2005
Despite issuing a relatively tepid pandemic scenario; one where between .5% and 2.5% of those infected would die, and where only 4% would require hospitalization - public health officials in the UK appear to be defending themselves against charges of `scaremongering'.
First this article from the Worcester Evening News, then some discussion of what constitutes `scaremongering' and some of the obstacles facing pandemic planners.
Health chiefs defend forecast for killer flu
By James Connell
HEALTH chiefs say they are not "scaremongering" over a deadly flu pandemic.
Figures published by Worcestershire Primary Care Trust suggest the pandemic could kill between 0.5 per cent and 2.5 per cent of people in Worcestershire who develop symptoms.
Around 25 per cent to 50 per cent of the population (136,000 to 276,000 people) could have symptoms with four per cent (22,080) needing a hospital. Half the population of Worcestershire could go off work sick.
No-one knows when it will hit the UK but, on the basis of past pandemics, one is due soon.
<snip>
The pandemic was discussed at a PCT board meeting in Pershore on Thursday. Board member Coun Peter Pinfield said: "What you're saying is a bit frightening."
But PCT director of public health Richard Harling said the pandemic was the "number one threat" to national security.
The PCT's health protection consultant Dr Ash Banerjee said: "We don't want to scaremonger and worry people unnecessarily. Our role is to make people aware of the danger. It's not scaremongering."
First, let's talk some numbers to see if pandemic planners are `scaremongering'.
The pandemic scenario used in many pandemic plans calls for a severe pandemic; one equivalent to the 1918 Spanish flu.
The mortality rate (CFR) of that pandemic is often stated to have been roughly 2.5% of those infected, and that between 20% and 30% of the world's population was infected.
A little math show's that worldwide, the number was probably a lot higher.
In 1918, the population of the world was 1.8 Billion. So the first two numbers we can derive are the numbers sickened.
1.8 Billion x .20 = 360 million
1.8 Billion x .30 = 540 million
Now, the second number, the total killed by the virus, is subject to debate. Early on, the number was put at 20 million, but later research has shown that the number was likely between 40 million and 100 million.
Because I don't wish to be categorized as `scaremongering', we'll go with the lower number, and say that the death toll was limited to 40 million.
With these numbers we can calculate a global CFR (Case Fatality Ratio).
40 million deaths out of 360 million victims= 11.11% CFR
40 million deaths out of 540 million victims= 7.4%% CFR
Globally, it would appear that the CFR was 3 times higher than generally stated.
So, where do pandemic planners get the oft quoted 2.5% number?
In the United States, and in most of Europe, the death rate was lower than in the rest of the world. The reasons for this are unclear, but may have to do with better health care, nutrition, and general health in western countries.
Western nations may also have seen a similar virus decades before, which may have blunted the Spanish Flu's impact. No one really knows.
In the US, where some of the best records were kept, it is believed that 30 million Americans were sickened, and roughly 675,000 perished.
675,000 deaths out of 30 Million victims = 2.25% CFR
It is likely (although by no means certain) that developed countries with their better health care systems and infrastructure will see a lower CFR than poorer developing nations during the next pandemic.
Our age demographics, where the median age in the United States and Europe is nearly double that of some emerging nations, should also help to produce a lower CFR in those western nations.
So, the UK numbers presented in the above article are based on the `best possible' severe pandemic scenario.
Not exactly sugar-coated, but certainly a long way from being scaremongering.
Sadly, the pandemic planners of the world who today are being maligned for `scaring the world' will be the first one's pilloried when a pandemic does hit.
Ever system's failure, every social compromise, and every death will be laid at their feet. Never mind that they weren't given the tools, or the funds, or the political support they needed.
People will want a scapegoat.
They should have warned us better. They should have purchased enough vaccine for everyone. Why didn't they Stockpile enough Tamiflu for everyone? They should have closed the borders to keep it out. They should/should not have closed the schools.
During the next severe pandemic millions won't be getting the health care they are used to. Many may find that their jobs have vanished because their workplace was closed by the health department, or customer demand for their product/services had evaporated. Grocery store shelves may be sparsely stocked and prescription medications may be in short supply.
Power and other utilities may be intermittent. There may be massive social disruptions. Human suffering will be immense.
The economy, undoubtedly, take a massive hit.
And people will die. Despite the best efforts of our health care workers, first responders, and pandemic planners. . . people will die. And worse, children and young adults won't be spared. Pandemic influenza is an equal opportunity killer.
Difficult truths that people will find hard to accept. And people, being people, will want someone to blame.
After the next pandemic, when the Senate holds endless hearings (and you know they will), and citizens begin to demand the heads of their local and state pandemic planners - I hope someone remembers that in the months and years leading up to that pandemic, these people had to beg for funds and publicly defend themselves for urging people to prepare.
Admittedly this is a faint hope. But I'm a dreamer; the last vestige of idealism and justice haven't quite been beaten out of me yet.
But the day is young.
So, despite my criticisms of many of the plans in place, my sympathies actually lie with those who's job it is to fight this preparedness battle and who face an overwhelming tide of public apathy and budgetary neglect every day.
Their's is not an enviable job.
But they do it, because someone has to.
