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article imageH1N1: $1 billion spent, no pandemic, no third wave Special

By Lynne Melcombe     Nov 27, 2009 in Health
Dr. Richard Schabas, Ontario's former chief medical officer, "shakes his head" about money spent on the global H1N1 panic because it fails to meet pandemic criteria for illness and deaths. And there will be no third wave, he said.
Now public health officer for Prince Edward and Hastings in Ontario, Schabas said in a telephone interview that, "I was critical of calling it a pandemic in May, and I still am, because the whole reason for defining [an influenza strain] as pandemic is that it will cause higher levels of morbidity and mortality than the seasonal flu.
"When H1N1 appeared, the WHO moved very quickly to call it a pandemic and promptly issued all kinds of ominous warnings, but there was good evidence very early on that it wouldn’t be serious enough to be called a pandemic."
A pandemic has specific characteristics, such as out-of-season outbreaks and strain replacement (ie, replacing the usual seasonal flu strains), which we have seen, he said. However, H1N1 is not causing the high levels of illness and death that would be expected of a pandemic as compared with seasonal flu.
"There is a culture of catastrophe at the WHO that has spread through public health agencies in many countries, including Canada, and there’s a whole corporate empire built around this that encompasses many of our public health agencies, and even the CDC," he said.
"[These bodies] have built a tremendous pandemic response capacity and there is a need for them to justify the money invested. Three years ago, the Public Health Agency of Canada received $1 billion to build pandemic response capacity, so a lot of people are invested in demonstrating that capacity."
Pharmaceutical companies have also profited, Schabas said, "but I don’t think we can put the most of the blame at their feet. This crisis was delivered to them by public health officials. They are the ones who created this panic, and the pharmaceutical companies have been only too happy to profit from it."
Asked why no one is questioning the pandemic label, Schabas said, "I don’t know. I shake my head. Mine is not the only voice questioning it, but there are not many. I’ve tried to base my opinion on evidence of what we’ve seen."
When H1N1 first broke out in Mexico, he said, there was potential for alarm, but within a week it was clear that what we were not seeing the tens of thousands of deaths associated with a pandemic. This was confirmed when it hit Australia in what was their flu season but did not cause any more illness or death than seasonal flu would have.
"It seemed obvious to me that it was not following the classic pandemic model," he said.
In fact, said Schabas, one of the ways H1N1 is different than seasonal flu outbreaks is that there have been significantly fewer deaths because older people are not getting it. In a pandemic, there would be a 25-35% death rate and that hasn't occurred, but public health officials seem to be "invested in overstating its seriousness, and resistant to seeing that the peak is over."
Schabas also said that a third wave is "inconceivable."
"Most cool heads are saying that [a third wave] is absurd, there is no precedent," he said. The likelihood of an outbreak is calculated on the basis of levels of immunity. It usually requires around 40% immunity to prevent an outbreak and to date, between immunizations and exposure, more than 50% of the population is immune. Referring to result of an as-yet unreleased study, he said, "it’s inconceivable that there will be a third wave."
It is still reasonable for people with medical risks and pregnant women to get immunized, as having an underlying chronic disease increases risk 20-fold, he said. But for the general public, it’s a waste of public money.
"The money for the vaccines has already been spent," he said, "but we need to recognize that money has not only been spent on vaccines." Every shot costs money in terms of clinic hours, a lot of money has been spent on extra Tamiflu and ventilators that won’t be used, and a lot has been spent on planning.
"When you put all the costs together, a huge amount of resources has gone into this," Schabas said -- expenditures that will likely be rolled into into federal and provincial deficits, and rack up interest.
"I think the recurrent issue here is one of the failure of public health officials to give people an accurate portrayal of where we stand," Schabas said. "Dr. David Butler-Jones [Canada’s medical health officer] said yesterday that the pandemic is plateauing, but that’s not accurate. Flu outbreaks rise and fall. They don’t plateau unless they’re over. And this outbreak is, for all intents and purposes, over.
"If people get the vaccine now, they need to know that it’s not going to give then any protection against the second wave of H1N1, because it’s already come and gone," he said.
Asked whether the response to H1N1 in Canada might have grown out of criticism over the way SARS was handled, Schabas that would be "unfortunate" because "it means we haven’t learned the most important lesson from SARS – that we should react to evidence, not to fear." As well, the SARS crisis was in Canada only while the H1N1 panic is global.
More about H1n1, Flu, Deaths, Pandemic, Third wave
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