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Now that every swan with a snuffle is guaranteed international celebrity status as a harbinger of a global flu pandemic, we can turn with confidence to the ‘information pack’ distributed, with remarkable foresight, to every GP in the country in October 2005.1 In addition to a 50-page guide from the chief medical officer, entitled Explaining Pandemic Flu, the pack also includes a ‘fact sheet’ providing ‘key facts’ about ‘pandemic flu’ for members of the public requiring larger writing — this is particularly welcome to ageing doctors like myself who now require reading glasses. Regrettably, there is no comic book version for children, although there is a ‘pandemic flu’ poster to brighten up our waiting rooms.
The strange thing about the current extraordinary mobilisation of public health resources and national anxieties is that there is at present no flu pandemic, nor any imminent prospect of one. It is well known — among those who care to find out — that the A/H5N1 flu virus is not easily acquired by humans and, if acquired, not easily passed on.2 It is therefore highly unlikely to cause a human pandemic.
A key quotation recurs throughout the Department of Health's pandemic flu propaganda (it features on the cover of the Explaining Pandemic Flu guide from the chief medical officer): ‘most experts believe that it is not a question of whether there will be another severe influenza pandemic but when’. The origin of this statement is another report by the chief medical officer published with negligible publicity some 3 years ago.3 Indeed the government's pandemic flu strategy was first produced in 1997, when it was not felt necessary to promote mass public awareness of the possibility of a pandemic. Most experts have for decades believed that a pandemic will occur at some time in the future. The same experts have no very strong grounds for believing that this is more likely this year than in any year since 1918. Yet this year, it has suddenly become necessary to alert the public to the danger of a flu pandemic.
The origins of the flu panic are not to be found in any antigenic shift in the flu virus, but in the increasingly irrational drift of government health policy. In response to the Sars epidemic of 2003 and the 9/11 and 7/7 events in the US and London, the government has sought to avoid blame for any lack of preparedness in face of biological or terrorist threats by conducting contingency planning in the full glare of publicity. As in many areas of government policy, public relations takes priority over both principle and practicality. The need to popularise the conception of a ‘pandemic’ reflects public exhaustion with mere epidemics: now these have become so commonplace (obesity, bullying and binge drinking) a new term is required to achieve the level of anxiety that the government is seeking to foster around flu. It is important to note that the ‘pandemic flu’ promotion provides no information of any preventive value, and its answers to the question ‘What can I do?’ during a pandemic are the familiar banalities from any self-help guide on dealing with coughs and colds.
In a revealing aside in a recent circular on ‘avian influenza and pandemic influenza’ to all doctors and health authorities, the chief medical officer comments earnestly that, ‘as you can imagine, with the high level of public interest in this subject, things are very hectic in the Department of Health at the moment’.4 When a non-existent pandemic can create such a febrile climate, it is no surprise that the NHS is heading into increasing chaos. Nor is it a surprise that the first death of a child from measles for 14 years — the victim of another health panic — passes with little public comment.5