Some media outlets are making much of reports that Westerners seeking low-cost medical treatment in India might have returned carrying a drug-resistant bacterial infection. But that news should be seen in light of another, less noticed news item this week: As a potential pandemic, the H1N1 flu virus was a bust.
The World Health Organization (WHO) says H1N1, also known as swine flu, is not eradicated, but it has lost its “superbug” status, becoming just another flu variant among many.
Fourteen months ago dire predictions swirled through the news media about the possible effects of H1N1. Hundreds of thousands of deaths were possible, and perhaps 40 percent of the US work force could be affected, the Centers for Disease Control and Prevention (CDC) estimated. (The CDC had already declared the H1N1 public health emergency over by June 23.)
Nothing remotely close to those predictions came about. The WHO estimates the number of deaths from H1N1 in 2009 at 18,500, though it says that number is almost surely underreported. Still, it is a figure far lower than the hundreds of thousands of deaths worldwide attributed to other strains of influenza every year. Why did the pandemic fizzle? “Pure good luck,” WHO Director-General Margaret Chan says, that it didn’t mutate into a more troublesome form.
European governments and medical groups have criticized the way the WHO handled the H1N1 outbreak, saying it caused unnecessary expense, including stockpiling of unneeded drugs, and undue public alarm.
Dr. Chan has defended the organization’s actions, pointing out that from the start the WHO had termed H1N1 as “a pandemic of moderate severity” from which ”most people” would recover – many without receiving any medical treatment.
But is that the impression that was left on most people?
“The number of victims of H1N1 fell far short of even the more conservative predictions by the WHO,” said an investigative article in BMJ (British Medical Journal) in June. The authors’ “investigation has revealed damaging issues. If these are not addressed, H1N1 may yet claim its biggest victim – the credibility of the WHO and the trust in the global public health system.”
Questions have also been raised about the secret “emergency committee” that guided the WHO’s policies on H1N1.
This week the WHO released the names of the emergency committee, several of whom had ties to drug manufacturers as advisers or received support for their research from the industry.
Fighting an infectious disease is a serious matter. Public health organizations and governments can face tough calls in trying to pass along sensible information about possible health problems. They must share helpful information without creating undue panic or alarm. Chan suggested that “perhaps we need more flexibility in our future pandemic planning.” In the future the organization might offer “a best-case, an intermediate-case, and a worst-case scenario ... to allow flexibility and adjustment as we track the evolution of the pandemic.”
The news media bear a responsibility, too, in not sensationalizing a public health story in order to grab reader attention. But today formal news organizations are less the “gatekeepers” of such news than ever before. People share their own versions of what’s happening via social media: e-mails, Facebook, Twitter, and the like. Chan acknowledged as much, noting that “we need to adapt the way we do communication, and learn how to work with social media and social networks.”
Perhaps some of these lessons can be applied to the “superbug” now being traced to India. The H1N1 pandemic that never was may provide a useful history lesson in that regard.