A human influenza pandemic may cost billions, and perhaps trillions of dollars, a top health economist has warned at a meeting of bird flu experts in Singapore on Thursday.
However, Martin Meltzer, at the US Centers for Disease Control and Prevention in Atlanta. Georgia, US, argues that economic models can help governments and healthcare systems to reduce the impact vastly 鈥� keeping key healthcare workers in place and hospitals running.
Analysing the costs of a pandemic, combined with epidemiological information, can help make crucial decisions regarding who should receive the limited supplies of vaccines and antiviral treatments in the event of the outbreak. 鈥淎ssuming you can鈥檛 stop it at its source, you can do a lot to ameliorate it,鈥� said Meltzer.
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If the H5N1 bird flu currently sweeping across the globe becomes a human pandemic strain it could kill one billion of the world鈥檚 population, says a 2005 estimate. This compares with the estimated 2.0 to 7.4 million killed in the relatively 鈥渕ild鈥� 1968 pandemic, and the 40 to 100 million killed in the severe flu pandemic of 1918.
Although deaths are clearly important, 鈥渨hat is really important is how many flu cases are going to turn up at the hospital and doctor鈥檚 surgery鈥�, argues Meltzer.
Conservative estimates
鈥淚 do not believe there鈥檚 a healthcare system in the world that can readily absorb a 1968-type pandemic. And heaven help us if we get a 1918-type pandemic,鈥� he told New 杏吧原创. 鈥淎nd the economic impact is going to be large. It鈥檚 worthwhile spending money on planning.鈥�
According to a 1999 study by Meltzer and colleagues, a flu pandemic where 35% of people are attacked by the virus would cost the US alone a total of $166 billion. A milder 1968-like pandemic, with only a 15% attack rate, would cost the US $71 billion. He notes that these are 鈥渃onservative鈥� estimates and do not account for work days lost due to panic or parents staying home with their children because schools are shut.
However, he points to a recent study by an Australian economist which models the impacts of scenarios from mild to an 鈥渦ltra-1918鈥� type pandemic. In this worst case scenario, the cost to the world could run into trillions of dollars.
However, Meltzer cautions that such macroeconomic models usually do not take into account the epidemiological aspects of a disease 鈥� how long it takes to spread from person to person, for example.
鈥淕ranny and grandpa鈥�
As using economic models to plan how to deploy resources and staff during a pandemic, their use may also help work out how to ration limited vaccines and antiviral treatments, says Meltzer.
鈥淚f you wish to vaccinate those most at risk of death, it鈥檚 granny and grandpa at the head of a plan,鈥� he told scientists at the meeting on flu pandemic preparedness, organised by The Lancet. But if this healthcare decision were to be taken on the basis of economics those of working age, 20 to 65, would be top priority. And especially the high-risk in that group, such as those with asthma. They would be followed by high-risk children, since the young are the economic future.
In fact, in the US, the influenza pandemic vaccine priority list takes account of both. The top tier for receiving vaccines in the event of a pandemic is vaccine and antiviral manufacturers and medical health workers in direct contact with patients. They are then followed by those at high-risk of death over 65.
