Planning for Pandemics (repost)

As governments and the WHO wrestle with the decision on whether to divert resources from the production of seasonal flu vaccines to develop a vaccine against H1NI (swine) flu, I thought I’d repost this piece from 2005.

The news of deaths from bird flu in Indonesia is pretty scary. Although, as I’ve mentioned recently Indonesia has made a lot of progress in many respects, the handling of this threat so far seems to show the worst of both worlds: all the ill ffects of authoritian habits combined with the timidity of weak politicians. There have been a lot of coverups, and an unwillingness to tackle the necessary but unpopular task of slaughtering affected flocks of birds. Things seem to be improving now, but there’s a long way to go.

It seems very likely that, sooner or later, bird flu will make the jump that permits human-human transmission, and quite likely that a major flu pandemic will result. The world, including Australia, is very poorly prepared for this. One thing we could do to prepare is to adopt a national program encouraging annual flu vaccinations for everyone, instead of just for limited categories of vulnerable people.

The main benefit of this is not that the shots would provide immunity against a new and deadlier flu variant (though there might be some limited benefit of this kind) but that we would have the infrastructure, production facilities and so on to undertake a mass vaccination against such a variant if it arose. As it is, it seems likely that many countries will be scrambling to get access to an inadequate world supply of vaccines, but if Australia and other developed countries ramped up normal levels of production, it would be much easier to generate extra supplies for our neighbours.

I haven’t looked into it, but my guess is that, even without considering the possibility of a pandemic, the benefit-cost ratio from such a measure would be pretty high. Flu is very costly in economic terms, and I suspect that, if pain and suffering were thrown into the balance, a program of universal free vaccination would come out looking pretty good.

Update There’s lots of good background in Foreign Affairs. A piece by Michael Osterholm reprinted in the AFR Review section recently, is very good and stimulated my thinking on this topic.

13 thoughts on “Planning for Pandemics (repost)

  1. Phooey – swine flu. Same as bird flu. Overrated in media. Sell more Tamiflu. Wait for reptile fle next year….

  2. Or possum flu? Could break out in Oz for a change Damn the drug companies – it never happens here – it (pandemic) never happens anywhere but they get to sell more Tamiflu. Some old people and young kids dies of ordinary flus every year in every country. It has ever been thus…..the old and the weak or the immune weakened (sick) Pandemic? No..I dont think so.

  3. the flu danger is real – albeit not always put forward well. But there is now another bunch of material out there available to mutate into something quite dangerous – and normal flu is already quite dangerous. This latest ‘scare’ helps improve the public health systems worldwide.

  4. Nanks#4 “This latest ’scare’ helps improve the public health systems worldwide.”

    You are probably right Nanks but it does also sell a lot of Tami flu which is of no use for swine flu I understand (??). Yet Tamiflu gets a mention everywhere…am I being too cynical?

  5. I got moderated …I couldnt find anywhere I said ci@lis. Maybe it was the word “cynic@l”

  6. A virus is restricted to a limited size to get itself pulled though a cell wall using cells’ own uptake mechanism. This limits the size of the genetic payload. This in turn produces a rough trade-off between the sophistication of it’s infection mechanisms and it’s capabilities after infection, like replicating itself and withstanding our immune systems. Typically, a mutation that provides a better infection capability – like the ability to resist degradation outside the body – will detract from it’s nastiness once it’s in. The idea of a lethal virus becoming highly infectious and retaining it’s lethality – and vice versa – is typically wrong, there are a set of constraints at work.

    Of course, a virus could come up with a revolutionary new mechanism that jumps the system but the odds are right against it. More likely it’s the old been there, done that.

  7. @7 Alice, in this case I think you are being too cynical

    @8 typically but not always – the public health problem being that one new and nasty virus is enough. But there is no need to spread the sort of hysteria that seemed to build up this time – if anything it is counterproductive along the lines of ‘the boy who cried wolf’

  8. #9 Then I am being too cynical Nanks…I never thought Id see a financial crisis of this magnitude in my lifetime and I wouldnt want to see a pandemic as well… well I should be thankful really… Things could be much much worse. Ive never lived in a war zone.

  9. Alice, I certainly don’t mean anything rude – I completely understand any level of cynicism. Less would be hypocritical of me 🙂
    As for the financial crisis – it’s only a crisis for those that weren’t involved. (my cynicism showing now)

  10. 11# Lol Nanks – a little cynicism is good preventative medicine. A lot may give you stomach ulcers.

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