Appendix 4: Pandemics

Introduction

A pandemic is a global disease outbreak. A pandemic can start when a new virus or virus subtype emerges in humans that is capable of causing severe disease (and death) and transmits easily and rapidly between humans.²³

Whilst Acquired Immunodeficiency Syndrome (AIDS) is an example of an ongoing pandemic, it is the emergence of a highly infectious and virulent disease for which there is little or no natural immunity in the human population that presents the worst case scenario. An example is Severe Acute Respiratory Syndrome (SARS) that emerged suddenly in 2002-2003, demonstrating that in the 21st century a pandemic virus could spread rapidly across borders with major health, social and economic impacts. Another example is an influenza pandemic.

Influenza pandemics have occurred at irregular intervals throughout history. In the twentieth century, the world experienced three influenza pandemics:

Spanish Influenza (1918-1919) – this pandemic caused the highest loss of human life. Worldwide, at least 50 million people are thought to have died, with over 10 000 Australians losing their lives. Most deaths occurred in young, previously healthy people, aged between 15 to 35;

Asian Influenza (1957-1958) – this was milder than Spanish Influenza, with most deaths occurring in the young and the elderly; and

Hong Kong Influenza (1968-1969) – this was the least severe of the three influenza pandemics of the twentieth century. Deaths were primarily in the over 65 age group.²⁴

Since 2003, the World Health Organization (WHO) has reported outbreaks of H5N1 avian influenza (bird flu) affecting birds in countries in south and central Asia, Africa and Europe. Between December 2003 and December 2008, the WHO has confirmed there were 391 human cases of H5N1 influenza infection with 247 deaths.²⁵ While the virus has not yet developed the capacity to transmit efficiently from human-to-human, the widespread nature of H5N1 in birds has increased the risk of an influenza pandemic occurring in humans.

Further, in 2009 we are seeing the spread of swine influenza A (H1N1). At the time of publishing this guide, the WHO was coordinating a global response to human cases of swine influenza, and monitoring the corresponding threat of an influenza pandemic.

It is not possible to predict when pandemics will occur, how severe it will be, or how long it will last. The WHO reports that the world is moving closer to a pandemic, and history supports the fact that it is ‘more likely than not’ that a pandemic will occur. It is estimated an influenza pandemic could last from seven-to-ten months in Australia,²⁶ with impacts on the health system, the economy and society potentially lasting longer. At the peak of the pandemic, staff absences may be in the range of 30-50 per cent²⁷ due to illness, travel restrictions, or the need to care for family. Reduced staffing levels may coincide with a surge in the demand for services from agencies that are involved in the response to the pandemic and may also affect an agency’s ability to service and maintain its physical infrastructure.

In addition, transport systems may be disrupted, communications systems may be overloaded, schools may be closed, and suppliers of goods and services may close. There is likely to be widespread uncertainty and panic in the community.

Therefore, it is important that entities at all levels of Australian government have appropriate management plans in place in advance of a pandemic to minimise the impact of a business disruption event caused by a pandemic, and to expedite recovery.

²³ _{United Nation and World Health Organization influenza sites - http://www.un-influenza.org and http://www.who.int/csr/disease/avian_influenza/en [accessed 16/1/2009].}

²⁴ _{Australian Health Management Plan for Influenza Pandemic, 2008, Department of Health and Ageing and Business Continuity Guide for Australian Businesses, Appendix C – Background on previous pandemics, 2006.}

²⁵ _{World Health Organization, Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO, http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_09_10/en/index.html [accessed 14/10/2008].}

²⁶ _{National Action Plan for Human Influenza Pandemic - Working Draft, Council of Australian Governments. Working Group on Australian Influenza Pandemic Prevention and Preparedness, 2008, p. 4.}

²⁷ _{Australian Health Management Plan for Influenza Pandemic, 2008 Department of Health and Ageing, 2008 p. 16.}