Expert Opinions about a Flu Pandemic

FauciGerberdingNabarroNarainNicollNimanOmiOsterholmOxfordPaleseUngchusakWebster

There is no scientific way to measure the probability of an influenza pandemic. Thus, we are left with the opinions of experts (and those who consider themselves experts) to gauge this probability.

Most experts consider that another infuenza pandemic is inevitable. The question is when, which strain of influenza and how many will die?

A soon-to-be-published survey from Global Public Health can be found here (abstract by kind permission of the publisher).

The links below will provide some idea of what the “experts” are thinking about a bird flu (H5N1) pandemic.

Here’s a nice site that aggregates Opinion articles – features and opinion articles from Science and Development Net.

  • Dr. David Nabarro, U.N. system coordinator for avian and human influenza

    “We expect the next influenza pandemic to come at any time now, and it’s likely to be caused by a mutant of the virus that is currently causing bird flu in Asia.”
    Newsday, 28 September 2005

    “There are some subtle changes in the genetic makeup of H5N1 which suggest that it is making some of the mutations that would enable it to have a higher likelihood of being able to become a human-to-human transmitted virus”
    CIDRAP news, Dec 16 2005

    “So many people, when I talk to them about getting prepared, seem to imply that we’ve got months in which to get prepared but I say to them: It may not be months. It could be that we’re going to get human-to-human transmission tomorrow so please act as though it’s going to start tomorrow. Don’t keep putting off the difficult issues.”
    TodayOnline, Jan 25 2006

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  • Dr. Jai P. Narain, director of WHO’s South-east Asia Regional Office Communicable Diseases Department

    “We may be at almost the last stage before the pandemic virus may emerge.” He was referring to the risk that avian flu in Asia will lead to a human flu pandemic.
    CIDRAP News, September 7, 2005

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  • Prof. Angus Nicoll, who heads the influenza division of the European CDC

    “The emergence of avian influenza A/H5N1 viruses has propelled pandemic preparations to become government priorities across Europe. To date these viruses have remained poorly adapted to humans and the risk of a pandemic based on H5N1 is unquantifiable. However the risk of a future pandemic is 100%. Preparations are essential and without these many avoidable deaths will occur, Children will be affected at least as much as adults and may probably play an important role in amplifying transmission. Pharmacological and public health interventions focused on children will save lives though suggested community measures like pre-emptive closures of schools need to be considered carefully balancing benefits against negative consequences. Child health services will be hugely stressed by any pandemic but also have the potential to save many lives. The challenge will be to deliver core services in the face of major staff illnesses. Detailed local business continuity planning will be essential to deliver this potential.”
    Children; Avian Influenza H5N1 and Pandemics. Arch Dis Child. 2008

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  • Dr. Kumnuan Ungchusak, Director of Thailand’s Bureau of Epidemiology

    ďItís apparent to us insiders that [the virus] has already moved from phase 3 to phase 4 [in terms of the World Health Organisation’s pandemic alert levels],Ē said Dr Kamnuan Ungchusak whose work was published in the New England Journal of Medicine in January. Reports of the infection spreading among humans in four countries including Cambodia, Thailand, Indonesia and Vietnam have suggested to scientists that the virus has become more pathogenic than ever, the doctor said.
    The Nation, Bangkok, 5 September 2005

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  • Dr. Michael T. Osterholm of the Center for Infectious Disease Research and Policy

    “Recent clinical, epidemiological, and laboratory evidence suggests that the impact of a pandemic caused by the current H5N1 strain would be similar to that of the 1918–19 pandemic. More than half of the people killed in that pandemic were 18 to 40 years old and largely healthy. If 1918–19 mortality data are extrapolated to the current U.S. population, 1.7 million people could die, half of them between the ages of 18 and 40. Globally, those same estimates yield 180–360 million deaths, more than five times the cumulative number of documented AIDS deaths.”
    Foreign Affairs, July/August 2005

    Also famous for his utterance after a press conference when he described our fate if a pandemic were to occur this year: “We’re screwed”.

    Osterholm presentation at the Wilson Center September 22, 2005 (with Helen Branswell, reporter for the Canadian Press).

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  • Dr. Anthony Fauci of the National Institute of Health

    “It’s unlikely that if the H5N1 (flu strain) we see now in Asia develops the capability of efficiently spreading from human to human, which we don’t see now, it is unlikely to happen overnight. It is likely to develop over a period of months. It is not going to happen between Tuesday and Thursday. It is going to happen between February and April,” he said, using the time frame as an example rather than a prediction.
    News-Medical.Net, September 12, 2005

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  • Dr. Shigeru Omi WHOís regional director for the Western Pacific

    ďAs the new cases of human infection with the H5N1 virus in Turkey show, the situation is worsening with each passing month and the threat of an influenza pandemic is continuing to grow every day”
    MSNBC News, January 12, 2006

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  • Prof. John Oxford, Queen Mary’s School of Medicine

    “This is a national emergency, how could it be otherwise? Resources are made available for natural emergencies and now many people are threatened by a virus which can decimate a country.”
    Times Online, August 25, 2005

    “Professor John Oxford said poultry should be protected for the next few weeks as wild birds migrate, reducing the risk the H5N1 strain will spread. Ducks and geese, and not a parrot in quarantine, are the most likely agents to bring H5N1 to UK flocks, he said. Professor Oxford called of the Department for the Environment, Food and Rural Affairs to do more. “I think they are still sitting on their hands,” he said. “They have two responsibilities, and they are to protect our health and to protect that of animals.”
    BBC News, 24 Oct 2005

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  • Dr. Henry Niman, Recombinomics, Inc.

    “There are a lot of communities that really have no plan for how to deal with a pandemic if it hits. If you know what could be coming, your community or company could put an emergency plan together. If there’s a pandemic, the movement of people will certainly be limited. Schools will close. Mass gatherings won’t happen. If you look at the potential economic, political and social impact, this could certainly be much bigger than a terrorist attack…I don’t think anybody who’s looked at this thing hard can be optimistic.”
    The Dallas Morning News, 13 August 2005

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  • Dr. Julie Gerberding, Director of the American Center for Disease Control

    “We’ve probably never been closer to a pandemic than the year in 1917. And so when we see the ominous signs of this very bad virus continuing to propagate there, we do need to take it seriously and solve some of the problems that would be in our way from effective response in the United States.”
    CBS News, 1 January 2006
  • Dr. Peter Palese, Mount Sinai School of Medicine in New York

    “The virus [H5N1] has been around for more than a dozen years, but it hasn’t jumped into the human population,” Palese said. “I don’t think it has the capability of doing it.”
    Taipai Times, Nov 15 2005

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  • Dr. Robert Webster, Director, U.S. Collaborating Center (WHO) Rose Marie Thomas Chair Department of Infectious Diseases, St. Jude Childrenís Research Hospital Memphis, Tennessee
    →”Whether or not we could have another 1918-like outbreak? The answer is absolutely yes. The H5N1 virus thatís currently causing problems in Asia could easily mutate to produce a 1918-like pandemic”…”Lets look at what the H5N1 is doing in Asia at the moment. More than 50 per cent of people being affected are dying. Imagine what would happen if that was transferred to a global situation. The only thing that this virus hasnít learned yet is how to transmit between humans. If that happens, we are in great trouble in the world. 1918 would seem like a duck walk. This would be much, much more severe.” …”One of the questions that Iím frequently asked is how likely is this to happen. I spent my whole life working with influenza and I have never seen such a pathogenic virus.” …
“This virus has always occurred. And itís inevitable that there will be a pandemic. The most likely one at the moment is H5N1 and I tell you, you should prepare for it. It is probably the biggest threat to mankind at the moment.”…
“Each household will be dependent on its self for water for food and so on. I might be painting a black picture but I think we have to think in those terms.”…”H5N1, I think, is the most dangerous, the most highly lethal virus that I have ever encountered. When you inoculate a chicken in the afternoon, and the next day, the chicken is dead Ė the virus has gone through this business of attachment, penetration, replication, and kills overnight Ė thatís an extremely lethal virus.
This is the hottest one Iíve ever seen. It terrifies me that the virus, if it ever learns to transmit from human-to-human, we are in terrible trouble. I know what this virus does in the chicken and in the ferret, and in the animal models, so donít blame me if I am concerned about what is going to happen to you and me if it learns to transmit. I think we need to put every possible resource in place, to put our defenses in order, to do what we can to ahead of time, before this virus does learn to transmit in humans.”…

CBC.ca interview, conducted in late 2005, Aired January 11, 2006 on CBC-TV

see also here for a more detailed collection of opinions:
http://www.setbb.com/fluwiki2/viewtopic.php?t=74&mforum=fluwiki2


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Page last modified on December 27, 2008, at 07:03 AM by Bronco Bill