When is a pandemic not a pandemic?

When the World Health Organization says so. With the virus spreading in Australia, where there's been a four-fold increase in cases in a week, it might seem surprising that global health officials have not yet moved from the current Phase 5 to 6, which would mean that a pandemic had been declared.

Predictions are a mug's game - but, on BBC TV and radio this evening, I stuck my neck out and said that a pandemic declaration was likely within days, or possibly weeks at the outside.



The reason for this was that listening to the WHO's assistant director general Dr Keiji Fukuda in the weekly media briefing, it seemed to me that the WHO was holding back from declaring a pandemic for political reasons.

I'm not suggesting anything underhand, but simply that member states and scientists have advised the WHO that it must prepare the ground before making the move to Level 6. The WHO can't ignore the surge in cases in Australia, and, to a lesser extent, the leap in cases in the UK and Chile.

Dr Fukuda said that he feared "a blossoming of anxiety" - in other words, panic - if they suddenly declare a pandemic. It's true that the word "pandemic" sounds scary. But it simply means a global epidemic of an infectious disease.

It is not a signal that the virus is getting more virulent; it has nothing to do with severity; rather, it is a measure of geographical spread. And we must remember that the vast majority of people who get H1N1 swine flu have a mild illness.



Dr Fukuda said that it was fair to say that we are "really getting close" to declaring a pandemic, but that the WHO wanted to avoid or reduce the sort adverse actions that had happened when it last raised the threat level, such as the culling of pigs, unnecessary concerns over pork, trade embargoes, travel restrictions and concerns about travellers from certain areas.

"These are the kinds of potential adverse effects you can have if you go out without making sure that people understand the situation as well as possible.

"In earlier pandemics, we have often seen that people who are worried, but not particularly sick, have over-run hospitals and led to a dsyfunction in the health system because so many are going to emergency rooms, adversely affecting people who really require emergency care. We'd like to minimise the risks of that."

Listening to that, it does seem sensible that the WHO first prepares the ground before moving to Phase 6. The media must play a part here, emphasising the facts about this virus and not over-reacting.

Governments, too, have a big role to play, ensuring that their pandemic plans are in place. And businesses must prepare for the coming of a virus which, even if it is mild, will cause huge numbers of absences from work.

Remember, though, that when a pandemic is declared, it won't make any difference to most of us. Different countries will experience local epidemics at different times. What matters is when H1N1 begins to spread rapidly within your community, way beyond schools and unrelated to travel.

Only then might the virus make a tangible difference to your daily life.

