# 2172
After the dust-up over the House of Lords report on the global fight against pandemic influenza, UK papers have been running background pieces on the pandemic threat.
The story earlier this week was that a pandemic could claim the lives of up to 75,000 Britons. Here is an excerpt from the Independent's story.
World warned over killer flu pandemic
By Ben Russell, Political Correspondent
Monday, 21 July 2008
. . . The Government said: "While there has not been a pandemic since 1968, another one is inevitable." Ministers said it would could kill between two and 50 million people worldwide and that such an outbreak would leave up to 75,000 people dead in Britain and cause "massive" disruption.
Exactly where this 75,000 number came from, I can't say. It does seem a bit low, however.
Quite a bit, in fact.
But we'll come back to that.
First, some snippets from today's story out of Wales.
Around 37,000 at risk of death if pandemic flu strikes
Jul 24 2008 by David Williamson, Western Mail
HALF the population of Wales could fall ill and 37,000 people may die if the nation is hit by a pandemic flu outbreak, according to Assembly Government estimates.
Experts are preparing for a surge in admissions to hospitals and clinics, pressures on mortuaries and demand for dignified funerals.
Arrangements are in place to obtain vaccines for the entire population once a pandemic breaks out and the strain is identified.
Chief Medical Officer for Wales Dr Tony Jewell said: “As is the case with influenza, the majority of care in a pandemic will be provided in people’s own homes with the support of primary and social care services. This strategy will help to ensure that hospitals have the capacity to deal with those patients that develop complications that require hospital treatment and are also able to cope with the routine emergency admissions that occur every day.”
<snip>
The Assembly Government described its plans in response to a Freedom of Information request from the Western Mail.
The possibility that 50% of the population – 1,485,000 people – could fall ill is described as a “reasonably foreseeable worst- case scenario”.
Previous pandemics have had a fatality rate of between 0.2% and 2%.
The statement reads: “With a clinical attack rate at the highest rate of 50% a fatality rate of 0.4% would lead to 5,900 excess deaths while one of 2.5% would lead to 37,000 excess deaths.”
There are no plans to quarantine individuals or communities.
The 37,500 deaths cited above is for Wales, which has a population of just over 3 million people. Or about 5% of Britain's total population.
This `reasonably foreseeable worst-case scenario' uses a higher attack rate than we saw in 1918, but roughly the same fatality rate. It is a guess, of course, and could be way off base.
But it isn't an unreasonable guess.
What is striking is that when compared to Britain as a whole, Wales is anticipating a far greater impact from a pandemic than the House of Lords report of last week.
Taking the same formula used above, but applying it to all of Britain, we get the following results.
The possibility that 50% of the population – 30,000,000 people – could fall ill is described as a “reasonably foreseeable worst- case scenario”.
Previous pandemics have had a fatality rate of between 0.2% and 2%.
“With a clinical attack rate at the highest rate of 50% a fatality rate of 0.4% would lead to 120,000 excess deaths while one of 2.5% would lead to 750,000 excess deaths.”
Hmm. This week's news reports say 75,000 deaths, but the math says 750,000.
What makes this 75,000 fatalities estimate even stranger is that just 4 months ago, the British papers were using 750,000 as a top-range estimate.
This from the Financial Times.
Flu more potent risk than terror
By Stephen Fidler, Defence and Security Editor
Published: March 20 2008 03:24 | Last updated: March 20 2008 03:24
Terrorism does not represent a strategic threat to the UK, according to a new national security strategy announced by the government on Wednesday. A more potent risk is of an influenza-like pandemic that could spread rapidly, accelerated by globalisation, says the strategy.
“Experts agree that there is a high probability of a pandemic occurring ... We estimate that a pandemic could cause fatalities ... in the range 50,000 to 750,000, although both the timing and impact are impossible to predict exactly,” the strategy document says.
While all of these numbers are nothing more than guesses - educated perhaps, but guesses nonetheless - a little consistency in their use could go a long way towards convincing people that the threat is genuine.
Most people still believe that the pandemic threat is hype. That pandemics don't happen in `modern countries'.
Part of the problem, I believe, is the lack of a consistent message.
Exactly why the House of Lords report chose to downplay fatality estimates by 90% escapes me. Perhaps it was decided that a CFR (Case Fatality Ratio) of .25% was easier to `sell' to the public.
I honestly don't know.
One has to hope, however, that the UK government doesn't start believing their own press releases.
Sure, the next pandemic could be a mild one. The world could get lucky.
But if you are planning to prepare a nation for a crisis, you need to be looking at worst-case scenarios, not the best-case.
No matter how unappetizing that may be.
