Subscribe now

Log in

Your login is case sensitive

I have forgotten my password


Short Sharp Science: A New Scientist blog

When is a flu pandemic not a flu pandemic?

Swine-Flu-Japan.jpgDebora MacKenzie, consultant



So are we in a pandemic or not? And have we got the whole idea of a flu pandemic completely wrong?






Meanwhile in Europe, countries are deliberately not testing cases that could be community acquired - almost as if someone doesn't want to trigger level 6.



Countries' pandemic plans call for action stations from the minute WHO calls level 6, and include disruptions like school closures, and mandatory distribution of antiviral drugs.

Plus, we can expect more public anxiety if we declare an official pandemic, and that can be a problem. Japanese hospitals are already being inundated by the worried well.

Yet we knew the next pandemic flu might start out mild. The last H1N1 pandemic in 1918, and other pandemics, did. Pandemic planners were even counting on a mild first wave to give them enough time to make some vaccine.

But declaring level 6 during that first mild wave - before we know for sure whether a worse one will follow - means expensive disruptions to business, health services and daily life, and potential public panic, for a disease that isn't killing many people, yet. And handing out Tamiflu for mild cases of H1N1 now means wasting stocks that may be more sorely needed later, and maybe promoting drug resistance.

Apparently no one was prepared for this predictable mismatch between the rules, the response, and the known properties of pandemics, despite all the angst about pandemic preparation for the past five years.

So the WHO has decided to play it by ear, and given the unpredictability of flu, this is probably not a bad thing. Level 6 or not, the situation is serious. All scientific eyes now are on the southern hemisphere, just entering its regular flu season, where cases of H1N1 appear to be rising. The virus will now basically duke it out with ordinary flu, to see who spreads fastest.

The prize is, literally, world domination.

(Image: Sipa Press/Rex Features)
Facebook iconDigg iconDelicious iconStumbleUpon iconTwitter iconTechnorati iconReddit iconAddThis icon
Subscribe to New Scientist Magazine


You say "duke it out with ordinary flu, to see who spreads fastest."

Does that mean that the flu variants are exclusive? That is, if ordinary flu starts spreading rapidily, H1N1 won't?


"In the US, cases are thought to be in the hundreds of thousands."
Surely that should be hundreds OR thousands?


The interesting thing about the possibility of an impending pandemic is that the NHS is so totally unprepared for such an event. They do not have the necessary manpower to cope with the pandemic protocol they have proposed. In the event of a pandemic, a person who believes they have contracted flu must call the NHS and present their symptoms. A nurse makes the diagnosis. The army or similar crack team will then be dispatched to deliver the cure. Do you see the problem? Their call centers are not equipped to deal with the number of calls that would be made in the event of a pandemic. Oh deary me.


It seems to me that H1N1 is inducing more panic among policymakers and politicians than in the general population. I see no reason why WHO following its own rules and declaring Phase 6 should change that situation.

As this article notes, we take note of pandemics because even if they are generally "mild" (meaning hospitalization isn't necessary, not that it just produces a runny nose), enough people get the new disease that it will kill more people than normal flu overall. And, as the article also notes, pandemic flus have the potential to come back in more lethal forms in subsequent waves.

Given these factors, I don't really agree with the article's final conclusions that WHO should be moving the goalposts. It seems to me that there is too much of an effort to avoid keeping track of what this flu is doing, which doesn't bode well for what happens next. Declaring Phase 6 (since the virus certainly meets the definition at this point) could very well improve that situation.


The issue with declaring Level 6 is the extreme nature of the mandatory government level responses in place to trigger as soon as WHO declares it.

Closing schools -- ALL? -- restricting travel, mandatory distribution of antivirals, etc, are incredibly expensive in every sense.

If this strain continues to be mild, none of those actions should be taken at this time, despite the flu matching the official definition of Level 6.

There is a disjoint in the Level vs its interpretation by world governments: they prepared plans for the worst, thinking "Level 6" meant the worst: think 28 days. Instead, we simply have a novel flu strain that has killed less than 1% of the people already killed by the "normal" seasonal flu virus this year so far.

Instead of triggering government response simply by WHO declaring a pandemic, the trigger should be "a pandemic that matters."

Imagine if WHO declared a pandemic for a novel strain of the common cold, with symptoms no worse than typical colds give, and the governments closed every school in their countries, closed the borders, and sent armed marines to deliver medicine [enforce quarantines] etc.



And I thought th EU was more scientifically minded than the U.S. This H1N1 flu outbreak meets all the requiremrnts and definitions of a pandemic. I just helped save the life of a 17 year old who nearly died in my ICU from a confirmed case of H1N1 flu. The case was unusual in that it is out of flu season and a very healthy 17 year old was severely ill with flu symptoms. I am sure I will be seeing many more cases like this one and heaven help us if a more deadly mutated version strikes this coming winter. If the nations feel that their public policies that they made in preparation of a pandemic are wrong then they should admit their failure and explain what should be done differently now that one is upon us. If the policies are in fact correct then they are failing their public massively by hesitating to implement them in exchange for short -term political capital and many illnesses and deaths will be on their conscience. I do believe that it is prudent to contain the spread of even a mild pandemic since in theory if fewer people get this there will less chance of a more deadly mutated version developing later. Perhaps common sense is the first thing to be lost in the midst of a crisis.


Hello, everyone! Nice forum, nice discussions!




John Hentges is pretty well completely right, although there are a few other ways of achieving the same end, such as have different sub-sets of level 6 - the most useful new one being, as he implied, 'a pandemic which isn't serious (yet)'.

Maybe quicker & simpler would be a small rewrite or even 'reinterpretation' of the existing rules - Governments do do reinterpretations so very well its hardly likely to be challenging - which shifts the meaning of 'must respond' (e, by shutting schools etc) to an in practice 'will implement elements of planed respond as we see fit'.

The present debacle seems to be a hybrid of Health ministers playing 'La la la I can't hear you' while the WHO plays Emperor’s new suit and pretends to see them behaving properly.

And if history tells us much its that one usually reliable way to make damn sure a problem becomes a disaster is to pretend its not there and suppress the information you’re likely to need to deal effectively with it.


Incidentally there seems to be a cock-up on the New Scientist commenting registration system, because if you try and sign up the system responds its sending a verification message to the email shown. And then it doesn’t.


Haha, there are no avatars here. You'll have to paint your picture linguistically.

I agree that level 6 should be avoided right now. It seems the protocols ought to be altered to include this distinction. If the policy is conflicting with good judgment, then there is likely a problem with it (or the "good judgment"). The requirements for declaring Level 6 should include disease severity.

Perhaps there should be a point-based system with multiple categories (propagation, mutation, severity, etc) and objective clearly-defined rankings for each category, with the total score ranges yielding the WHO level.



This is not true.
The only mayor Southern Hemisphere countries with a real winter, and a regular flu season are New Zeland, Australia, Chile, Argentina and Uruguay, with less than 10 cases between them all (some suspected)


Health problems are seen across the globe. Obesity is one of the major health problems of America that rise on both adult and children. Today the world is now being alarmed by the so-called H1N1 swine flu. That’s why having health care is very important as it helps us to stay healthy. There are some people that often refuse to seek medication as it can leave a major strain to their budget. That’s why some people would seek help in financial assistance like credit card in order for them to pay for their medical bills. At last, the CRL takes a stance with what resembles a common sense approach; a call to action regarding something to do with the problem. (Now we have to deal with the horsemen, the rain of fire, and the end of days.) The CRL, or Center for Responsible Lending, has taken aim at credit cards by sponsoring HR 627, or the Credit Card Accountability Responsibility and Disclosure Act of 2009. The Credit CARD Act, as it's called, could ensure more fairness in how card companies deal with customers, and limit things like hidden fees and retroactive interest rate increases. President Obama is on board. The CRL not going after installment loans and targeting an actual predatory lender – it's about time.


Well, leave it to us antipodeans to be the canary in the mines. I've already been down for two colds in the last two months. We shall all sacrifice on the vectors of the north :P.
Enjoy your summer!


What we need is a Level 5 1/2.


The definitions don't take into account the way influenza distributes its genetic material -- we have a 'pandemic' in number of countries and human-to-human spread, but the symptoms are relatively mild and the death rate is low, so it's not a really scary pandemic now, but influenza varieties already out there will swap code with this new one and something new will assemble incorporating the new code.

This is a method copied by some of the malware writers, where some code gets silently spread and once enough fragments are out there a little more code can pull the pieces together and assemble something dangerous.

Problem of definition -- is it a pandemic by definition? Yes. Is it a scary pandemic? Not if you're looking at today's symptoms, but probably yes if you're an epidemiologist who knows what may come from widespread availability of this new code once it does spread around the world.

I'm guessing on the latter, I'm not an epidemiologist.

Why not ask them about this?

What's the worst thing that could happen if this one's not contained? Not just this week, but this decade?

Remembering of course that when -- as in Japan recently -- a stadium-full of people fill up lots of balloons and release them to fly around over the crowd, aerosolizing and widely distributing eveyone's saliva, bad things will happen; and people do this kind of thing all the time.


Reason why no one wants to declare a pandemic:

There is none.



Wrong. As a US citizen, I can assure you that that statement is incorrect. A retraction or correction is in order. Dr. Daniel Jernigan of the Centers for Disease Control and Prevention, as quoted in the New York Times, stated that the number of cases of H1N1 "Swine flu" in the US could be "upwards of 100,000." He most certainly did not imply "hundreds of thousands," and no one in the United States would have taken his statement to mean hundreds of thousands.
Perhaps this error is attributable to a mere misunderstanding made by someone unfamiliar with the particular peculiarities of English as spoken in the United States.


This new flu has a mortality rate that is lower than seasonal flu. The worst case scenario at this point projects a few thousand deaths worldwide before herd immunity sets in. Even if this number seems high, a few thousand cases is less than the tens of thousands that die every year in the US alone by normal, seasonal flu.


Am I better off getting a mild version now and hoping for some kind of immunity if/when the virus mutates? or doesn't it work like that?


You might be better off, but the more people that have it, the more chance it has to mutate. So it is not recommended for people to try to get it for their own immunity.



By Dimitris on May 24, 2009 12:04 PM"

Great comment and the only inteligent remark apart from the one regarding mutation and a second/third wave.
The bottom line is that WHO are NOt reliable and should this have been a real threat a large portion of us would have been culled.
As always you cant trust the people in charge to be responsible.


How about vacinations on all international flights ?

And just as a safeguard, enable it a soon as there is a pandamic flu (like now) somewhere in the world. It would require vacination, but less then vacinating a whole country. It should be part of Airsafety regulations, enabled at all countries.

Also it would safeguard against economic crisis as a result of the flu spreading wild in another country. I believe this is well worth the expensive compared to the risk. To me its rather strange, that we are requierd to take malaria pills etc get something against yellow fever. But to a real threats to an entire population we dont do anything.

I realy find this strange, not even airs masks at airports, while such cheap devices can realy mean the difference between a pandamenic outbreak, or just a single person who is sick.


Inflenza A virus is a segmented RNA virus that easily swaps genetic material with other influenza A viruses i.e. *mutates* (produces genetic variants that may be highly virulent).

The 1918 pandemic began with a shallow peak and mild illness and low mortality, then that was followed by a massive pandemic and approx 40 million fatalities. Even though we have far better medical care and facilities today, nevertheless extreme vigilance and preventative measures are required. If the current H1N1 influenza outbreak were to become much more virulent and infectious, we could be in a very difficult situation. Knowing if/when to press the "level 6" button is hard, and of course 'hindsight is 20/20 vision'. But i feel it is best to declare a 'level 6' a little too early than a little too late. Just an 'imo'..


In a meeting of care workers recently in which the so-called Swine Flu was discussed, only one voice of reason was heard to say 'But if it mutates (and surely the correct term here is 'evolve' and not 'mutate'?), then there has to be an equal chance of it 'mutating' into something harmless as something dangerous'. If so, then it's a coin toss as to whether we should batten down the hatches or not.

The poster (Aka) who suggests its NOT feasible to try to catch this flu in order to prevent a more serious outbreak made me wonder.... after all, the flu jab is just a weakened version of the virus isn't it? And we know that the flu jab can kill people too. In this day of protection against all things nasty we are turning the Human Race into something that could be knocked over by any harmless little bug. It seems to me that children today are far more at risk in the future because we coddle and protect them so much.

After Bird Flu and Swine flu have finished panicking the authorities (but not the people), will someone perhaps eventually work out that when a population gets too high, a disease generally comes along to thin it out a bit. I've heard estimates of 200,000,000 possible deaths from this. Sadly, if you count the number of people now, and people now less 200 million - it's not a great difference really.

But (and I'm no expert), I honestly expect this to be another damp squid. Mexico, when realising they'd set off a world panic immediately revised their guesstimate of deaths caused by this to one third the original number. I think the fact that 'normal' flu kills far more people than this one has, just about says it all.

Of course, if I'm wrong and I get wiped out by this varient, I'll come back and apologise.


Actually each individual mutation is far more likely to make a virus less harmful than more harmful. Most individual mutations disable or degrade a virus.

The problem is that mutations are happening constantly, and sooner or later one improves the virus ability to spread itself.

The fact that a million random mutations took out a million individual viruses has little benefit when another zillion copies of a virus are around to replicate.

So the coin toss analogy doesn't work. There isn't one coin, there are countless coins all tossing and the most harmful replicating themselves the fastest.


Isn't swine flu just made for the kind of government bossiness and freedom restriction that has been epidemic for the last few years.
All in the name of some dread happening yet to occur.


If the information are published more officially, public will have known better. It's scaring than pandemic spreads so fastly. classifieds |employment |for sale by owner


no one was prepared for this predictable mismatch between the rules, the response, and the known properties of pandemics Free Mp3 Free Mp3 Download Mp3 Free Domain helper free bookmarking free music download


the sine flu is such a scary thing. my little nephew had a mild case of it. he was able to go to the doctor and get a the medicine to get rid of it. This flu is something people need to be carefuk with.
Orlando Medical Malpractice Lawyers


While the 2009 flu pandemic has some key similarities to the 1918 pandemic (and it's impossible to predict what will happen with the current virus), overall, we are much better prepared for a flu pandemic than anyone was in 1918. inchirieri masini


A lot of people are getting the virus, but not showing any symptoms. It is normal for the virus to incubate internal. Many of these people will either never have symptoms as their immune system will fight off the virus, only experience moderate symptoms, or get sick later on in the fall and winter.

Lane - tucson web design


In my opinion the only ones winning from this are the pharmaceutical companies.


that's hard to believe


Telling people about good things on the internet is a good way of social networking. We can find a lot many good things with the help of information provided by our friends on the internet. This helps us a lot.


Aloe vera gel that comes directly from the home-grown aloe vera plant is a yellow-green liquid. It can be obtained by simply breaking off a piece of the aloe vera plant. The liquid will run out and can be applied topically.


The many benefits of aloe vera juice to health and nutrition - and aloe vera gelly uses for the skin, are legend. Most people know first-hand the soothing benefits of aloe vera on minor burns and cuts!


To get all the benefits of aloe vera juice you want only products made from the pure, inner, aloe vera gel that do not have the useless leaf rind "filler", and that are not watered down, as can be the case with aloe vera drinks found in expensive health food stores and elsewhere.


hey guys whats the fastest method to clean the ASF.Wimad trojan from my win xp box?


I would suggest talking to your M.L.A.'s office or the office of Agriculture that covers the provincial grants and then your M.P> in Ottawa for federal info on grants-good luck


I'm telling ya; Bautista is the best batter in MLB since he has the most HRs.telling ya same reason Felix is not top hurler.


I wasn't going to comment as this was written a while ago, but as I have just read it a second time, I thought I say thank you for this great article.


I have to admit I don't always agree with you, but in this case you really hit the nail on the head.


wicked, I have a few questions though is it ok to post them here?


Surely that should be hundreds OR thousands?


This post was definitely properly published, and it also comprises rather a few practical facts. I appreciated your professional manner of writing this article. You might have developed it very simple for me to fully grasp.


continue with the the nice work on the site. I appreciate it. Could use some more frequent updates, but i'm quite sure that you have got better or other things to do like we all have to do unfortunately. :p




Good day, I just hopped over in your web page by the use of StumbleUpon. Not something I'd typically learn, however I favored your feelings none the less. Thank you for making one thing worth reading.


I picture this may well be various upon the written content material? nonetheless I still believe that it is usually appropriate for just about any type of matter subject matter, because it could ceaselessly be enjoyable to determine a warm and pleasant face or possibly listen a voice while preliminary landing.


That flu was another million dollar business


Also, it's important to understand that the number of confirmed cases in the U.S. should not be expected to be anything like the true number of cases. Not everyone with the virus is getting tested, and -as much as I'd love the data- that is as it should be.
In many (probably most) places, testing is now focusing on those with severe disease, those at high risk due to underlying conditions, and those whose cases might be indicative of the virus moving into new environments (the first n cases in a given state, cases from a particular school), and which therefore represent an opportunity for slowing the spread of the virus (or, at the very least, better understanding its epidemiology). Also it would safeguard against economic crisis as a result of the flu spreading wild in another country.And this crisis lead people to the more payday advnaces and debt. I believe this is well worth the expensive compared to the risk.

Twitter Follow us
Twitter updates
Recent comments


Your login is case sensitive

I have forgotten my password


© Copyright Reed Business Information Ltd.