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John Barry is a historian and author, who up until 2004, was best known for his book Rising Tide: The Great Mississippi Flood of 1927 and How It Changed America.
In 2004, however, he would publish a book that would change the way the world looked at pandemic influenza, and help drive national and international policy.
His 2004 book The Great Influenza: The Epic Story of the Greatest Plague in History became a New York Times Best Seller, and was on the reading list for President George Bush during his summer vacation.
That simple twist of fate propelled the United States down the road of pandemic preparedness.
Today John Barry has a lengthy article in the Washington Post on what can, and can’t, be done about the H1N1 pandemic.
Highly recommended.
A hat tip to Indigo Girl at allnurses.com for this link.
Pandemic Reality Check
What Can Be Done -- and What Can't -- To Protect Against H1N1
By John M. Barry
Tuesday, June 23, 2009
This month, the World Health Organization finally declared that the new H1N1 virus has become pandemic. Yesterday it reported a big jump in cases and fatalities since Friday. How many people this virus will sicken and kill depends, ultimately, on three things: the virus itself; the impact of what are known as "non-pharmaceutical interventions," or NPIs; and the availability and effectiveness of a vaccine.
The virus will be the most important factor. Influenza is one of the fastest-mutating organisms in existence, which makes it unpredictable, and a virus newly infecting the human population is likely to be even more unpredictable as it adapts to a new environment. There have been four pandemics that we know about in some detail: 1889-92, 1918-20, 1957-60 and 1968-70. All four followed similar patterns: initial sporadic activity with local instances of high attack rates -- just as H1N1 has behaved so far -- followed four to eight months later by waves of widespread illness with 20 to 40 percent of the population sickened. (In a normal influenza season about 10 percent of the population gets sick.) Subsequent waves followed as well.
In all four pandemics, lethality changed from wave to wave -- sometimes increasing, sometimes decreasing. It's impossible to know what will happen this time, but in 1999 the Centers for Disease Control and Prevention modeled a moderate pandemic in the United States, including a vaccine in its calculations, and concluded that the death toll would probably be 89,000 to 207,000. If the virulence of this virus does not significantly increase -- and right now there is no reason to think it will -- something close to the lower number looks probable.
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