Thank you so much for posting on my Bird Flu Preparedness blog.

Yes, I have seen the arguments on all sides myself, and perhaps I am being overly optimistic. Having been involved in business continuity myself for over 20 years I understand fully the need to plan and prepare for a worse-case scenarios.

Having said that, unfortunately it is those very same expectations (of CFR’s being 50% or more) which are keeping many businesses from making any preparations at all. The response I get from potential clients who haven’t made preparations is that there is no point to prepare against something which will be so devastating. “It’ll be the end of life as we know it, so what’s the point?”.

If the CFR’s are that high then it will be ‘the end of life as we know it’ and they would be right. But if (regardless of the chances) the CFR’s are like previous pandemics then there really is a point to preparing, and the businesses which haven’t will not be able to prepare retro-actively.

This is made worse by the media of course which loves to propogate the more (headline grabbing) exaggerated claims than the moderate ones. They are unwittingly stopping preparations from getting underway.

Of course I hope I am right and those which expect the worse-case scenario are wrong. I’m sure we all do!

One other point you made that I’d like to comment on is that we must prevent infection at all costs. I agree, however we must also accept the reality that there will be no escaping exposure to the virus, by anyone – except perhaps those who remain in total isolation throughout.

Preventing infection will help by moderating any spiking in the outbreak, spiking which will bring health and regulatory services to a grinding halt. Preventing infection will not reduce infection rates, it will simply spread the load over time. This is not a bad thing as firstly health and regulatory services have a better chance of coping, and secondly, we may come up with a vaccine in time to protect those who manage to escape exposure when the virus first breaks out.

I guess there’s no way of knowing for sure until it happens.

Nigel Thomas
For free references and tools go to Bird Flu Manual Online or, if you need more comprehensive tutorials and templates, consider Bird Flu D-I-Y eManual for business preparedness and survival.

Saw your post on Effect Measure nd just read the above article. I have been researching H5N1 since the beginning and helping my local community in Sydney prepare for a panflu event.

From my investigations, I do not see the same reasons for your optimism that H5N1 will moderate to a CFR of 1-2%. The arguement from history is meaningless, as has been discussed by many virologists. Just because there has not been a widely recognised pandemic with CFR above 2.5%, does not mean it cannot happen. The WHO panel of virologists state this position in their 2007 paper.
New things happen all the time, and nobody I am aware of has made the case scientifically for H5N1 CFR dropping from say 50% (or over *0% in the case of Indonesia) down to 1 or 2 % very convincingly, in my opinion. We just don’t know anywhere near enough about pandemic development/viral evolution to make such claims.
The point being that I think you do a disservice to those engaged in planning/training by putting an overly optimistic CFR position. The qualitative aspects of pandemic planning dependant on severity, such as mortuary services, food supply and distribution etc. will be caught flatfooted if we don’t consider the true worst case scenarios seriously, and plan accordingly. I believe you will find that the military are considering severe CFR scenarios (ie CFR of 10% and above) in their planning, and we woud be wise to do the same in the community mitigation and corporate planning as well.
It becomes starkly obvious that at high CFR’s, the prime objective is to prevent infection in the first place at ALL costs.
For a period of time, it will not be business as usual, and planning that is based upon that asumption will prove disasterous in the event of a high CFR event.