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Remember the Last Global Pandemic?

Remember the Last Global Pandemic?

Monday, 16 March, 2020 - 04:30

After tests found H1N1 in two soldiers during a flu outbreak at the Fort Dix army base in New Jersey in 1976, the US government jumped into action, with President Gerald Ford announcing a plan to vaccinate “every man, woman, and child in the United States.” That turned into something of a debacle, though, as the virus didn’t seem to spread beyond Fort Dix and the hastily assembled vaccine killed about 30 people.

In 2009, the reaction was more muted. In its public-health-emergency declaration in April, the WHO noted that the illnesses caused by the new H1N1 tended to be quite mild, with only one brief hospitalization and no deaths from the 20 confirmed US cases. It also advised against any travel restrictions or border controls.

As of May 5, 980 schools with 607,778 students had been closed in an effort to slow the epidemic. By late June, the CDC was estimating that 1 million Americans had contracted the disease. Meanwhile, on June 11, WHO Director-General Margaret Chan had declared that with the virus spreading in 74 countries “the world is now at the start of the 2009 influenza pandemic.” She also said that a vaccine was on the way, and that measures had been taken “to ensure the largest possible supply of pandemic vaccine in the months to come.”

By the time the vaccines became widely available in November, though, H1N1 was already on the decline. By January, many countries were canceling their vaccine orders, and a German physician and former Social Democratic politician was leading a campaign lambasting the WHO for declaring a “fake” pandemic to gin up business for pharmaceutical manufacturers.

That doesn’t seem fair, given that H1N1 did infect as much as 24% of the world’s population. The overall fatality rate was quite low, at about 0.02% of estimated cases — five time lower than the 0.1% average fatality rate for the seasonal flu — but that’s mainly because H1N1 had little effect on the demographic usually hit hardest by influenza: those 65 and older. For younger people, H1N1 was more dangerous than the seasonal flu, and in countries in South Asia and Africa with youthful populations the H1N1 pandemic really was a big deal, with the CDC later estimating a global death toll ranging from 151,700 to 575,400.

Still, that’s lower than the range that the CDC and WHO now put on the annual death toll from seasonal flu: 290,000 to 650,000. In the US, an estimated 60.8 million people contracted the new H1N1 virus from April 2009 through April 2010, 274,304 were hospitalized and 12,469 died. Because the CDC changed the statistical model it uses to make such estimates in 2010 that last number can’t really be compared to recent estimates of seasonal flu fatalities, which ranged from 12,000 in 2011-2012 to 61,000 in 2017-2018. But earlier estimates of overall flu-related deaths in 2008-2009 and 2009-2010 indicate that both flu seasons were less deadly than average.

Why was H1N1 allowed to spread around the world more or less unchecked, while countries are going to far greater lengths to try to halt Covid-19?

Covid-19 is near the beginning of its spread in the US, and thus cannot be compared with H1N1’s effect over a full year. If the US death toll from Covid-19 is only 12,469 a year from now, that will likely be counted as a great success. The legitimate worry is that it could be many, many times higher, because Covid-19 is so much deadlier for those who get it than the 2009 H1N1 influenza was.


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