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The Policy Response to the Biology and Psychology of Flu Pandemics

Every year the flu kills 500,000 on average world wide. Deaths occur typically in the very young and very old because these age groups do not have the immune reposes necessary to combat the disease. Higher death rates also occur in people with chronic illness and those that lack proper nutrition. About three times per century a more deadly form of the flu emerges. While we have not seen a pandemic virus occurring on that cycle recently, (there has not been a major pandemic since the 1968 Hong Kong Flu) if one were to emerge it could kill upwards of 50 million people.

The difference between an annual flu epidemic and a pandemic is the rate a virus is transmitted and mortality ratio. Its novelty is also a factor. In a typical year people will die from a variety of flu strands and many people that contract the virus may have been vaccinated with a similar type of flu or had previously been exposed and thus can combat the virus more easily. Also during a typical epidemic only 0.1% of people that contract the virus will die, whereas a severe virus would kill at least 2% of those infected and possible much more (maybe in the 20+% range). The sign of a pandemic is that vast majority of deaths occur in people 25-45 or 99% of death rate is of people under 65. These people die because of their immune response and the onset of severe mucus in the lungs (pneumonia). This last point is what set of the alert for the current strand of H1N1. As laboratory cases confirmed results of young and middle aged people the WTO became concerned.

Laboratory testing to confirm the strand of influenza takes time. While there is a suspected 2,500 cases in Mexico and approximately 170 deaths, the Secretaría de Salud (Secretary of Health) in Mexico has only been able to confirm 49 cases and 7 deaths which puts the mortality rate at 14% i.e. much higher then a normal year. If you take into account all possible cases it brings the motility rate below 7% in Mexico and just above the normal averages in the United States.

Part of the difference between the death ratio between Mexico and the United States could be due to the fact that developing countries in general have higher death rates. Or it is simply that more people in Mexico have been infected.

In addition researchers are questioning whether the current virus has the proper amino acids to make it deadly. The flu infects by binding to sugars on the surface of epithelial cells which are mainly found in the lungs of human (also the throat and nose). Flu cells need to be able to cleave glycosidic linkages.

Since flu is transmitted by the virus aerosolizing the humidity and temperature of the air influences transmission. Cold and/or wet weather increases the spread. It is generally believed that if the virus can be contained through the summer so a vaccination can be created it will not cause any problem.

The data and the reactions seem to be inconclusive or contradictive. While the scientific community is still out on whether the virus posses any risk policy makers have acted swiftly, mainly because of the chance of it turning into something major.

All school and public places are closed in Mexico City and the commercial district is scheduled to close Friday. This has consequences for the Mexican economy. I am wondering what is the full logic is behind these decisions.

The other issue is how people psychologically handle these situations. The idea of the onset of a pandemic can be very stressful for many people during a time of already concerning economic times. People also become more wary and less accepting of government action if multiple scares seem to be duds.

More extreme action is also very undesirable. If countries begin closing borders, needed supplies are cut of. Additional public stress is created and greater finical consequences can ensue. It is also ineffective since flu does not show symptoms in people immediately and contamination would have already occurred.

Comments

Great Post!!! Its interesting to read it.

Thanks

"The idea of the onset of a pandemic can be very stressful for many people during a time of already concerning economic times."

Could you point us to some articles about large-group stress response (and remove Maurice F. Spammer)?

Hubert H. Humphrey Institute of Public Affairs
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