Evaluating pandemic risk

Delamothe asks why we should be any more worried about pandemic flu in 2007 than in 1997 or 2017.1 There are certain observable biological events (such as repeated human infections by a novel avian virus) that are potential precursors to a pandemic and may give us some warning of what might be imminent, a luxury that previous generations did not have. To the extent that advances in virology and epidemiology have made it possible for us to document such changes in the behaviour of viruses, it would be foolish, indeed irresponsible, for us to not make use of the information available.

This is exactly the same as how one would use weather forecasts or flood or hurricane warnings to inform one's behaviour. With regard to H5N1, I would submit that we are in the same position as New Orleans was 24 hours before Hurricane Katrina hit: we can't be sure we are going to get a direct hit, but it would be prudent to assume the worst and make preparations accordingly.

Delamothe next asks whether those responsible for planning for the next pandemic could do their planning less publicly and put the frighteners on the rest of us only at the appropriate time. In his foreword to a booklet compiled by a community of volunteers, David Heymann, executive director of Communicable Diseases, World Health Organization, writes: “Public health authorities throughout the world agree that the responsibility to respond to a public health emergency such as pandemic influenza cannot be fully placed under the responsibility of health workers and other primary responders, who may themselves become incapacitated by illness and death. It is thus each individual's responsibility, alone or collectively, to plan for and respond to a pandemic in the home and/or in the community.”2