Posted: November 21, 2004
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Article SummaryHelen Branswell initially wrote to me for my comments on the psychology of flu pandemic preparedness. My complete response is on this site, entitled: Preparing People for a Flu Pandemic: Peter Sandman’s emailed response to an inquiry by Helen Branswell.

Psychological Barriers Getting in the
Way of Pandemic Preparations: Experts

Canadian Press, November 20, 2004

TORONTO (CP) – Of all the barriers blocking crucial preparations for the next flu pandemic, and they are legion, the biggest may be psychological.

People – legislators, authorities, your average Joes and Josephines – cannot wrap their brains around the idea that in the modern world a virus that circulates every year can turn into a killing machine capable of wiping out tens of millions around the globe, experts admit.

Experts even fear talking publicly about the potential scope of the problem. They’re concerned that when projected death tolls run to the tens of millions, people will dismiss the figures as the fantastical imaginings of doomsayers.

But the sooner people come to grips with the possibility, the better prepared the world will be for the next pandemic, they say. Experts say one is inevitable, though they cannot predict when it will begin.

“Most people are not ready yet for a flu pandemic. If we’re aware of the possibility at all, we imagine something like the annual flu season, or at worst something like SARS,” warns Peter Sandman, a risk communications expert.

“Infectious disease experts are quaking in their boots, and then they are harnessing their fears, setting priorities, planning and preparing.

“The public needs to go through the same process.”

Sandman insists the public’s attention needs to be drawn to the spectre that flu experts fear is looming, so they can mentally prepare themselves for what will be a terrifically taxing period.

“We cope better with a bad situation when we have rehearsed it in our minds, imagining how bad it will be, how we will feel, how we hope we’ll respond,” Sandman, who is based in Princeton, N.J., said in an e-mail.

“Too often our leaders, and even the media, hesitate to give us a chance to get emotionally ready. They’re afraid we might overreact, and they’re afraid we might blame them, especially if the crisis never comes.”

The fresh memories of SARS may be exacerbating the problem, says Michael Osterholm, a leading U.S. epidemiologist and infectious disease expert.

That disease sparked outbreaks in a number of countries and panic around the globe. But with stringent infection control measures in hospitals and quarantine outside them, public health officials were able to extinguish the outbreaks within a few months.

However, on the scale of infectious diseases, SARS wasn’t particularly impressive once the medical professions knew how to recognize it and stop its spread.

Pandemic influenza will be far more contagious. And unlike SARS, a person infected with flu can spread the disease before knowing he or she is ill.

“In some ways there is this mindset: even when it was really, really, really bad, we fixed it. So I think that we have to fight that,” says Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

The head of the World Health Organization’s global influenza program agrees that people may believe modern medical science is capable of conquering nearly every challenge it faces.

“In our society we currently believe that everything is controllable. You’re getting sick, you take a drug. You get more sick, there’s a surgery possibility,” Dr. Klaus Stohr says.

“It’s not a given that because we are further advanced in our knowledge that we will be prepared. We have to use what we have the best way, otherwise the best technology will fail to reduce death and disease.”

There are tools to help weather a pandemic – anti-viral drugs and, some months after the pandemic starts, it’s hoped there will be vaccine for a portion of the world’s population.

But unless critical changes are made to production systems now, countries with no vaccine makers within their borders will go without, experts warn.

All authorities are assuming governments will nationalize drug companies within their borders, meaning supplies of anti-virals and antibiotics needed to treat secondary infections will dwindle.

Vaccine expert Dr. David Fedson uses Switzerland as an example. That country imports flu vaccine from Australia for its population of 7.4 million people. During a pandemic, Australia would likely suspend that contract.

But Switzerland has the world’s only factory for Tamiflu, an anti-viral drug that works against the strain of influenza that experts fear may cause the next pandemic.

“So Switzerland will find itself without any domestic vaccine supply and will do the only thing that it’s possible to do if you happen to be Swiss, and that is it will nationalize its Tamiflu production,” Fedson predicts.

“And that means if a country doesn’t have supplies already and hasn’t stockpiled it, boy it’s going to be a long time before it’s going to get any.”

Copyright © 2004 by Canadian Press

My complete response to Helen Branswell’s email asking for my comments on the psychology of pandemic preparedness is on this site.

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