Lessons from a pandemic that never was

In planning for a possible avian flu pandemic, said Harvey Fineberg, M.D., president of the Institute of Medicine, it is instructive to look at the recent past. Thirty years ago, Fineberg noted, the federal government began planning for a pandemic that never happened. Several people died of complications from a vaccine for swine flu, and that incident, coupled with a flawed outreach plan, bred mistrust of the program.

“That program was considered a fiasco,” Fineberg said, addressing the annual meeting in April of the Associates of the Cushing/Whitney Medical Library. The plan had an unrealistic goal of immunizing 95 percent of the American public, and the inability to attain this target obscured the unprecedented achievement of vaccinating 40 million people, twice as many as in any previous year.

Flu epidemics occur about three times a century, Fineberg said, denying scientists frequent chances to observe them. He called such events “low-likelihood, high-consequence” occurrences.

“They are seriously difficult for experts and for policy-makers,” he said. “If you are a naysayer and you scoff at the prospect of preparation, more often than not you are going to be proved correct. That doesn’t mean it is wise or prudent if you fail to prepare.”