by revere, cross-posted from Effect Measure

We are now almost through the period considered to be the traditional flu season (to the end of March in the temperate northern hemisphere) and so far the amount of documented influenza infection is at a relatively low normal level and pneumonia and influenza deaths are about usual for this time of year. Said another way, there so far has been no big “third wave” of pandemic swine flu. Most flu experts didn’t know what would happen but if they had to bet, probably would have bet on a resurgence. I suppose it could still happen, since the original transmission in the community occurred “out of season” (April to June of last year). But now the odds look to be against it. So what lesson do we draw from this? I hope it’s not the wrong one:

Alberta’s health minister is now calling for a review of the process.”Specifically I asked the Health Quality Council if they would look into the issues of preparedness and response to the H1N1 epidemic and anything else they thing is important to be reviewed,” said Health Minister Gene Zwozdesky.

Alberta Health Services CEO Dr. Stephen Duckett now admits he might have done things differently.

“It’s easy in hindsight to say, ‘well if I had more — the same information now, I wouldn’t have done it in the same way, but you’ve gotta look at what we knew at the time.” (Canadian TV)

Examining response is a good idea. But the idea that because this one didn’t turn out horribly — if in fact that turns out to be the case — next time we should not take it as seriously as we took this one, is terribly wrong headed. Our understanding of the dynamics of influenza is still primitive. A notoriously unpredictable disease is just that: notoriously unpredictable. Past experience is some guide but far from infallible. That’s why we may have gotten the third wave wrong this time. There was a third wave in the otherwise similar 1957 pandemic.

That was based on hindsight, too. And it wasn’t 20-20.