H1N1 Flu: The Pandemic That Wasn’t

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H1N1 pandemic

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In the natural world, disease is a fact of life, and massive disease outbreaks are often the usual result of overpopulation. Despite the high human population, and the population density of most cities, massive outbreaks of disease are thankfully rare. Good hygiene and modern medicine are both to thank for that, though good hygiene should get the lion’s share of the thanks.

In human terms, a massive, widespread outbreak of disease is called a pandemic. Historical pandemics, like the outbreak of bubonic plague in the Middle Ages, or smallpox in the Americas after European contact, were responsible for millions of deaths.

In more recent times, the Spanish flu pandemic of 1918 was responsible for between 50 and 100 million deaths, or 1.6%-3.2% of the world population at the time, making it one of the worst natural disasters in human history. All told, the various outbreaks of the bubonic plague probably killed more people overall, and certainly larger percentages of the population. The waves of the plague simply didn’t kill as many people at once as the Spanish flu.

Which brings us to the 2009 outbreak of H1H1, or Swine Flu. Like Spanish Flu, it characteristically hit young people with stronger immune systems harder. By October of 2009, it was responsible for about 5,000 deaths worldwide, though there is some dispute about that total, with estimates running to over 18,000. In contrast, the seasonal flu kills between 250,000 and 500,000 people a year. So what makes H1N1 a pandemic, and seasonal flu not? First, seasonal flu is specifically excluded from being a pandemic by the World Health Organization’s definition. The old definition of an influenza pandemic, and likely what most people think of by pandemic is:

An influenza pandemic occurs when a new influenza virus appears against which the human population has no immunity, resulting in several simultaneous epidemics worldwide with enormous numbers of deaths and illness.

That definition dates from sometime in 2005, according to the web archive. The current definition of a pandemic follows:

An influenza pandemic may occur when a new influenza virus appears against which the human population has no immunity. With the increase in global transport, as well as urbanization and overcrowded conditions in some areas, epidemics due to a new influenza virus are likely to take hold around the world, and become a pandemic faster than before. WHO has defined the phases of a pandemic to provide a global framework to aid countries in pandemic preparedness and response planning. Pandemics can be either mild or severe in the illness and death they cause, and the severity of a pandemic can change over the course of that pandemic.

Note that this new definition does not require a disease to be severe in order to be a pandemic. The WHO changed the definition of pandemic shortly before it announced that H1N1 was, in fact, a pandemic. Under the old definition, H1N1 would not have been labeled as such.

It could be argued that the WHO erred on the side of caution. After all, H1N1 has a similar infection profile to the Spanish Flu, which killed tens of millions. However, the WHO is still maintaining that we are in a pandemic situation now, in June of 2010. In fact, they still have the alert level at phase 6, the highest.

In February of 2010, the Council of Europe launched an investigation into the WHO’s handling of the H1N1 outbreak, specifically investigating whether drug companies, which stood to make billions, had any influence on the pronouncement of H1N1 as a pandemic. This investigation is expected to conclude soon.

An organization like the WHO is necessary. In an era of fast and easy global travel, a virulent disease can spread very quickly, and some sort of supranational organization to manage information and coordinate responses is invaluable. A real pandemic may be lurking around the corner, requiring the resources of the WHO, along with national health organizations. The expenditure of the WHO’s trust capital in situations like H1N1 will make it more difficult to accept their pronouncements in the future, especially if the Council of Europe finds that there was collusion between the organization and pharmaceutical companies. Even if they don’t, the fact that the H1N1 outbreak was hardly a pandemic, as most people would define it, will lead to slower reactions the next time the WHO declares a pandemic. After all, you can only cry “wolf” so many times before people begin to ignore you utterly.

  • Colin Dunn

    Colin Dunn was born and raised in Northern Alberta. Growing up in the boreal forest gave him an appreciation for nature, an appreciation that was enhanced by the works of his artist mother, Svala Dunn, who captured the landscapes and wildlife of the north in her oils and watercolors. He holds a Degree in Geography from the University of Alberta, with a concentration in Urban Studies. He has since found career in information technology, but still pursues his first interests in geography and the environment. He lives and works in southern Vancouver Island, with his wife and three children.

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