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Thinking Ahead: Anticipating an HINI Swine Flue Pandemic

The unfolding of the H1N1 pandemic will be an enormously complex and uncertain event, driven by the on-going iteration between the local experience of the disease and the global perception and response to the unfolding pandemic:

Each will affect and influence the other — local events will shape global perceptions and drive global responses, while global perceptions and responses in turn, will shape and influence the character and experience of local outbreaks. Moreover, both the local and global levels will arise through a complex interaction and integration of three principal dimensions of the event:

  1. Physical spread of the virus and the disease. Like the weather, the character of disease is always experienced locally. The H1N1 virus is continuously changing and evolving. Single strand RNA viruses (like influenza) are notoriously sloppy in replicating themselves (they have no self-checking and correcting mechanism) and enormously variable. Each infected cell within the trillions of cells making up a human body can produce on the order of 100,000 copies of the virus prior to bursting, with no two copies of the replicated virus being exactly alike. At the same time, we know that the evolving virus will affect different populations of people, with different genetic, socio-economic and cultural contexts — differently. As a result, monitoring the characteristics of local disease outbreaks can be an important “early warning” of how the virus may be changing, and how local perceptions of the degree of threat posed by the virus may be changing. For example, we already know that local disease outbreaks in Manitoba native communities are resulting in a much higher incidence of severe disease. It is likely that this is due to particular genetic and cultural factors associated with native Inuit communities, and not because of a specific change in the genetic makeup of the virus. Local severity of the disease can be expected to heighten local fears, but in this case, the heightened local fear within the Inuit community is probably not likely to heighted global perceptions of fear significantly.

  2. Perceptions of threat. We know that perceptions of the degree of threat (fears) posed by the disease can(1) vary widely from location to location and over time, (2) spread much faster and in advance of the actual disease, and (3) cause tremendous economic impacts and disruption. The degree of fear — provoked by local outbreaks, rumors, misinformation, and facts — can resonate and amplify (or not) through global media and the reactions and responses of other institutions. Monitoring, analyzing, and reporting on perceptions and fears of the disease — at both the local and global level — especially as they are associated with local disease outbreaks — will be critically important for anticipating the unfolding pandemic, and for understanding how economies and markets are likely to be affected. For example, we have already had reports of fear in Buenos Aires overwhelming public health capacity in advance of the arrival of the disease (click here).

  3. Institutional Responses. The evolution of the H1N1 disease event (and the fears provoked), will drive responses from both private and public sector actors. Moreover, the actions taken will have significant consequences for the future trajectory of the disease event, and the economic and market impacts. Quarantines, school closures, curtailment of trade and travel, curfews, seizure of countermeasure stockpiles — all are possible (if not likely) actions—which will be taken by governments and other institutional actors as the disease event progresses. Early warning on such actions, and their potential consequences — is an important component of the system we are proposing.

Systematic monitoring, analysis, and synthesis of emerging developments across all three of these aspects of the emerging pandemic — from the local to the global level — is crucial for providing businesses with actionable insight into developing events.

Conceptual Overview of “Thinking Ahead” H1N1 Pandemic Early Warning System