# 3666
Yesterday’s release by the Whitehouse of the 86 page PCAST (President’s Council of Advisors on Science and Technology) Report To The President On US Preparations for the 2009-H1N1 Influenza has captured a good deal of media attention overnight.
Particularly page 8 of the document, where a `plausible scenario’ (don’t all it a prediction) is laid out of the potential scope and breadth of this years flu season:.
The Current Situation and a Plausible Scenario
Indeed, the 2009-H1N1 infuenza is already responsible for signifcant morbidity and mortality world-wide — from its appearance in the spring, its continued circulation in the U.S. this summer, and its spread through many countries in the Southern Hemisphere during their winter season. While the precise impact of the fall resurgence of 2009-H1N1 infuenza is impossible to predict, a plausible scenario is that the epidemic could:
• produce infection of 30–50% of the U.S. population this fall and winter, with symptoms in approximately 20–40% of the population (60–120 million people), more than half of whom would seek medical attention.
• lead to as many as 1.8 million U.S. hospital admissions during the epidemic, with up to 300,000 patients requiring care in intensive care units (ICUs). Importantly, these very ill patients could occupy 50–100 percent of all ICU beds in afected regions of the country at the peak of the epidemic and could place enormous stress on ICU units, which normally operate close to capacity.
• cause between 30,000 and 90,000 deaths in the United States, concentrated among children and young adults. In contrast, the 30,000–40,000 annual deaths typically associated with seasonal fu in the United States occur mainly among people over 65. As a result, 2009-H1N1 would lead to many more years of life lost.
• pose especially high risks for individuals with certain pre-existing conditions, including pregnant women and patients with neurological disorders or respiratory impairment, diabetes, or severe obesity and possibly for certain populations, such as Native Americans.
This scenario is, as described, `plausible’.
And given the source, the President’s scientific advisory team, it is understandable that these numbers are getting a lot of `play’ in the media overnight.
Whether the pandemic influenza season of 2009 turns out with these numbers . . . well, stay tuned.
A lot of things could happen this winter.
- The virus could gain, or lose, virulence over time. Or even reassort with another flu virus.
- We may, or may not, see a co-circulating seasonal flu strain hitting older Americans.
- We may even see the rise of a recently detected variant of the H3N2 virus, one that isn’t covered by this year’s seasonal vaccine.
- We may see indirect deaths from this pandemic, among people with non-flu medical emergencies, whose care is compromised by an overwhelmed medical system.
Based on the reports out of the Southern Hemisphere over the past month, perhaps we see a milder flu season than currently feared. I hope so.
But it’s never a good idea to take a knife to a gun fight.
With so many possibilities, and a wide range of plausible impacts, it only makes sense to prepare for the more extreme end of the spectrum . . . even if a milder result is the more likely outcome.
The irony is, that the better job that public health and society does at containing and controlling this flu outbreak, the more criticism that officials will get for `over reacting’ to the threat.
As one of the millions of computer programmers that gave up much of 1999 (and a chunk of my 1998) to do Y2K remediation, I understand how they must be feeling.
We busted our posteriors for many months so that things would not fall apart at the stroke of midnight on Dec 31st, 1999 . . . and when we succeeded, we were greeted with derision and scorn for having `overblown’ the threat.
To this day, a lot of people still think Y2K was a hoax.
If public health is very, very lucky and and through skill and hard work manages to largely mitigate this pandemic’s impact . . . it is likely that a year from now the public will think the pandemic of 2009 was a hoax, too.
Proving, once again, that no good deed goes unpunished.
