WHO – Doctor Fukuda statements May 1st 2009

CP Exclusive: WHO says prepping for a bad pandemic has to be considered

http://www.google.com/hostednews/canadianpress/article/ALeqM5j1PQOzI0HN6NoxZzXVvpgsJvklfg

TORONTO — The world may not know for quite some time how the outbreak of swine flu will play out, the scientist leading the World Health Organization’s response to the situation warned Friday.

And given that the future path of the virus is unknowable and the possibilities run the gamut from fizzling out to causing a global outbreak of severe disease and death, preparing is the prudent course of action, Dr. Keiji Fukuda told The Canadian Press in an interview.

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Fukuda defended the WHO’s call to arms, saying the world cannot know at this point what this new virus has in store.

“And so if we go ahead and we spend a fair amount of time getting ready and it remains mild and not so many people die or get seriously ill from it, then we are lucky and we should just be happy,” Fukuda, the WHO’s acting assistant director general of health security and environment, said from Geneva.

“If on the other hand it turns very severe and we have simply stopped preparing and we haven’t pushed ahead with the preparations . . . that would really be the worst of all possibilities.”

“To have had an opportunity to really do something and then to have lost it and then to have a significant number of people get really sick and to die – that would really be the worst of all possibilities.”

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In many ways, this virus is acting like a garden variety flu – and not a very bad one at that. The problem is, there is virtually no way to gauge its future behaviour by its present actions, Fukuda said.

Influenza is notoriously unpredictable. The RNA viruses mutate continuously. Flu dogma is constantly being rewritten. People who’ve spent years studying the virus marvel at its ability to confound; this out-of-left-field emergence of a swine flu outbreak serves as a perfect example of that.

“It’s just amazing how often you are so completely taken by surprise by flu,” Fukuda said with wonder in his voice.

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“There’s no way we can predict it, no way we can know, even if it disappears, that it’s not going to reappear later on,” Fukuda said. “So it really takes a significant amount of time to know whether that would happen or not.”

-The virus could cause a mild pandemic.

Too little is yet known about the dynamics of flu viruses for anyone to be able to predict which of these possibilities is most likely, though given the efficiency of spread to date Fukuda thinks fizzling out is unlikely.

That uncertainty is what is driving the WHO and governments to respond with such aggression to this outbreak.

“We are trying to sound a note that the situation is serious, but there are things that you can do and we ought to do them,” Fukuda said.

“We are not trying to present an overblown picture about the dangers or anything. But you know, we are very mindful of the historical patterns in the past and the different effects in different populations and the ability of this virus just to change for reasons we don’t understand or in ways that we can’t predict.”

He said he doesn’t worry about the public seeing this as a “crying wolf” situation, should the outbreak fizzle out or cause only a mild pandemic.

“If you explain things in the right way, this situation can be understood,” he insisted.

“And so it’s really: How do we convey the situation in a way which people can understand there’s a lot of uncertainty in it, and there are definitely choices to be made about how we approach things?

“But there are also some very serious considerations that have to be taken into account. And that is one of the things that we are wrestling with to steer the right course for this.”

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