Pandemic scares fail to match up to reality

Posted by Emma Woollacott

OXFORD, UK - Everybody loves a good pandemic. According to media monitor Nielsen Online, Twitter has been abuzz this week, with nearly two per cent of all tweets making some reference to swine flu.

Here in the UK, the perennially-horrified Daily Mail newspaper quotes an expert saying that "hundreds" of Britons can expect to catch it within the next few weeks. If the outbreak lasts until winter, he says, 40 per cent of the population - about 24 million people - could be struck down. The government is even more alarmed, and has ordered 50 million doses of antivirals.

So just how good have we been at predicting pandemics in the past?

The US government made a right hash of things last time a variety of swine flu appeared to be a threat. 40 million Americans signed up for vaccination in 1976 after a hysterical advertising campaign. The final US death toll from swine flu? One. The number of people killed or seriously injured by the inoculation? Several hundred...

The responsibility for the overreaction was placed at the door of Gerald Ford - who wanted to win office on his own - and the influence of the big pharmaceutical companies, who were eying sales of 220 million doses.

Another big scare came along when Severe Acute Respiratory Syndrome (SARS) emerged in southern China in November 2002 and spread rapidly along international air routes in early 2003.

Again, there was mass panic. SARS is highly contagious and has a substantial mortality rate - and there's no vaccine, no reliable rapid diagnostic test, and no specific treatment for the disease. In the event, though, it is believed to have infected just over eight thousand people and caused 774 deaths, mostly in Asia - vastly fewer than the millions that some predicted.

More recently, we've had bird flu to worry about - the H5N1 strain of avian influenza. In 2005, David Nabarro, the newly-appointed Senior United Nations System Coordinator for Avian and Human Influenza, warned the world that an outbreak of avian influenza could kill anywhere between five and 150 million people.

"A draft report of the federal government's emergency plan predicts that as many as 200 million Americans could be infected and 200,000 could die within a few months if the bird flu came to the United States," he said.

Once again, things weren't so bad in the end after all. By 2006, when the outbreak appeared to have died down, the number of cases reported to the World Health Organization (WHO) had reached just 228, of whom 130 died.

And now, here we go again. The WHO has raised its alarm level to 5 - the last stop before declaing a full-blown pandemic official. Once again, there is speculation about death rates in the tens or hundreds of millions. All this, when the current number of confirmed deaths (many are being re-evaluated) is fewer than a dozen.

So are these experts justified in scaring the pants off us all? Well, yes and no. There are certainly vested interests. You don't have to be particularly cynical to imagine that the drug companies are lobbying pretty hard for swine flu to be taken very seriously.

And in part, of course, the media is to blame. If you want a headline-grabber, it's just so easy. Just ask an expert, "What's the worst case scenario, if no precautions are taken and everything goes wrong?" Then go away and write "A leading scientist says 100 million could die."

But it's important not to forget that the scares themselves may be helping save a lot of lives. Pandemics really do happen - the world outbreak of Spanish flu after the First World War claimed the lives of up to 50 million people. And we will never know what might happen now if governments and individuals didn't take these warnings seriously and follow advice.

What is pretty much certain is that, somewhere, sometime, a big one really will hit again, especially in these days of mass travel.

And if you want something really serious to worry about, here it is: the possibility of a single person catching both swine flu and bird flu. That could lead to the creation of a virus as deadly as bird flu and as easily transmitted as swine flu.

It's a very real possibility. But you won't catch me making any predictions.