Psychological Barriers By Helen Branswell

[Guest guest]

Psychological Barriers Getting in the Way of Pandemic Preparations:

Experts By Helen Branswell

Distributed by 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 phines —

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 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

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. 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. "

http://www.psandman.com/articles/branswell.htm