Scott McPherson's Web Presence

A blind man could see it in a minute: the World Health Organization, after a series of good moves and sound decisions, has blown the non-call on its reluctance to move the world to Phase 6 swine flu H1 status.

Why not Phase Six?  A technicality:  According to Helen Branswell of the Canadian press, Chile is in the WHO's North American reporting region.  Now, that is like saying Japan is in the European region.  But apparently the WHO is not too keen on Southern Hempsihere geography, else they would have a separate reporting schema for South America.  factor in Chile, and presto!  You have a Phase Six tripwire.  According to Branswell, however, if Britain or Australia show community spread (and they will, no doubt about that), the WHO has no choice.

Therefore, functionall there can be no doubt -- no doubt at all -- that the world is in the beginning (yes, the beginning) of a real, honest-to-God influenza pandemic. Yet for the WHO and for so many nations whose preparations wholly centered around a killer avian flu with a severe death rate, they failed to take into account one small detail.

What if the pandemic isn't all that lethal?

First answer: Excellent! We'll take a 1957 or 1968-type pandemic over 1918. Or 1830. Or even 1946's near-miss.

Second question: Why couldn't these best and brightest conjure up a scenario that would involve just what we are facing right now?

Second answer: Because public health professionals are not distinguishing themselves well as emergency managers or homeland security planners. It is amazing to see the number of nations who never planned for a minor pandemic, and now are crying to the WHO to loosen the protocols.  Heck, even the WHO itself has flirted with a rewrite of the protocols, although they just announced this week they will not do so.  Good call, Dr. Chan.

For a moment, I want to give some props to the Bush Administration.  The Obama Administration has admitted it is using the Bush playbook for this swine pandemic, and even President Obama has thanked the former president for his leadership in providing a roadmap to management of this crisis. And yes, it is a crisis.  ANY flu pandemic is a crisis-in-the-making.  We won't know just how bad of a crisis it is until many days from now.

Part of that playbook includes the ingenious move by HHS/DHS to classify pandemics according to a kind of Saffir-Simpson intensity scale.  As fans of the Weather Channel and residents of any state within 250 miles of a coastline know, the Saffir-Simpson Scale measures hurricane intensity.  What HHS/DHS did was take that metaphor and apply it to pandemics.

HHS/DHS have been using that Saffir-Simpson scale to measure response and move resources since Day One of this crisis.  It is so simple and easy to understand, more mainstream media attention should be placed upon it.  And I dare say if the other nations of the world had also applied it, or something similar to it, there would not be so much angst and political pressure applied to stifle a Phase Six declaration.

Look at the charts below to understand the United States' approach to this problem.

I frequently refer to this master chart as the "Saffir-Simpson" scale for pandemic lethality.  For those nations lobbying to slam the door on the WHO's desire to declare a pandemic, let me ask: has your planning taken the following items into account? See below.

The way I read it, we are currently somewhere between Category One and Category Two pandemic status in this country.  However, and despite the mainstream media's decision to ignore what is happening all around them, this virus is killing far more Americans now than it did thirty days ago.  It is being reported in the surviving hometown daily newspapers in each edition.  This means the virus is circulating freely in our communities and continues to attack and, sometimes, kill.  It is not going quietly away; it is continuing to spread, which of course is also what we are seeing across the globe.  At last count, some 64 nations had the virus, and no nation is declaring itself virus-free.  Except maybe North Korea, and that nation has collectively lost its mind anyway.

It is almost worthless at this point to try and track numbers of infections strictly by swabbing throats and noses.  We now have to assume, as the New York health officials have assumed, that any case of influenza is now swine flu.  Any case of summer flu (which is unheard of in seasonal flu, by the way) should, by definition, be considered the pandemic strain by default.

My Blackberry is going off multiple times a day with reports of confirmed H1N1 swine flu deaths across America.  Chicago: A 20-year-old pregnant woman dies after giving birth.  Deaths now reported in many states.

People say:  No biggie, it's not a killer, so what's the big deal? 

In Egypt, recent news reports talk of a village with a confirmed H5N1 human case ( a 4-year-old) and some 39 suspected follow-on infections.  A person is testing positive for H5N1 in Egypt at the rate of one every three days.  And we don't have any idea of the number of human H5N1 infections in Indonesia; the Health Ministry adopted a policy of only releasing human H5N1 cases every few months.  the only inklings of what is occurring in Indonesia come from news accounts, many of which are quickly denied by the government.

As swine H1 takes its victory lap around the planet, it will invariably create local versions of itself.  And it will (if it has not done so already) eventually and inevitably be introduced to H5N1 avian flu, either in the respiratory tract of a pig or a human.  How those viruses behave together, only God can predict. 

So let's go to Phase Six, remind nations of the excellent chart and methodology of HHS/DHS, and begin planning for an unpleasant autumn flu season.