# 4962
A long and very informative opinion piece appeared yesterday in PloS Medicine on what went right, and what went wrong, with the international response to the 2009 pandemic.
A brief summary follows, but follow the link to read the report in its entirety.
Reflections on Pandemic (H1N1) 2009 and the International Response
Gabriel M. Leung1*, Angus Nicoll2
1 Food and Health Bureau, Government of the Hong Kong SAR, People's Republic of China, 2 European Centre for Disease Prevention and Control, Stockholm, Sweden
Summary Points
- Many of the initial responses to the 2009 H1N1 pandemic went well but there are many lessons to learn for future pandemic planning.
- Clear communication of public health messages is crucial, and should not confuse what could happen (and should be prepared for) with what is most likely to happen.
- Decisions regarding pandemic response during the exigencies of a public health emergency must be judged according to the best evidence available at the time.
- Revising pandemic plans—to be more flexible and more detailed—should wait for WHO leadership if national plans are not to diverge. Surveillance beyond influenza should be stepped up, and contingencies drawn up for the emergence or re-emergence of other novel and known pathogens.
- Data collection and sharing are paramount, and include epidemiological and immunological data. Clinical management of severe influenza disease should not be limited to the current antiviral regimen, and include the development of other therapeutics (e.g., novel antivirals and immunotherapy).
- Greater and more timely access to antivirals and influenza vaccines worldwide remains an ongoing challenge.
While this contains much worth reading, the second point of the summary struck me as being one of the most important and most difficult to address:
Clear communication of public health messages is crucial, and should not confuse what could happen (and should be prepared for) with what is most likely to happen.
The problem, of course, is getting the media to treat `worst-case’ estimates and scenarios for what they are – possible but not probable outcomes.
Many times I heard public health officials cautiously speak of `possibilities’ only to see them reported in some media venues as either fact, or at least likely to happen.
Caveats, or other nuances, were often omitted or minimize in order not to water down a `good story’.
And the public – who generally get their news filtered through the lens of the mass media – ends up with skewed perception of the threat.
How you get the media (new and old) to report responsibly, when ratings and ad revenue are often enhanced by hyperbole and sensationalism, is a major challenge.
The authors point out, in a list of `firsts’ for this pandemic, that:
- The first pandemic with instant communication so that early impressions (such as the experience and response in Mexico and the Ukraine) could be shared ahead of proper scientific analysis.
- The first pandemic in which web-based platforms of traditional journals expedited dissemination, complemented by other innovative online resources (e.g. PLoS Currents: Influenza, http://knol.google.com/k/plos-currents-influenza#, based on Google's knol technology).
- The first pandemic with a “blogosphere” and other rapid social media messaging tools that challenged conventional public health communication.
A good deal of the pandemic rumor mongering, including wild unsubstantiated conspiracy theories, continue online and in the media even after the end of the pandemic.
Each day I weed through hundreds of dubious news stories, blog posts, and twitter tweets that are either recycled old news (some intentionally presented as new), are pseudo-news items filled with improbable conspiracy theories or unbridled speculation, or are simply wild tales made up out of whole cloth (see Ukraine And The Internet Rumor Mill).
This PLoS Medicine essay goes into far more than just communications issues, including surveillance, antivirals, vaccines, and the use of NPIs (Non-Pharmaceutical Interventions).
It provides abundant food for thought and discussion as the post mortem on this pandemic continues.
Highly recommended.
