Oms last reported a pandemic in 2009, when influenza A (H1N1), better known as swine fever or swine flu, affected about a billion people in the first six months, causing 600,000 deaths worldwide.
. The influenza virus H1N1, A(H1N1)pmd09, initially referred to as the swine influenza virus H1N1, is a combination of swine, avian and human influenza viruses that spreads easily from person to person. According to research, infection is not acquired through ingestion of pork, but occurs, although very rarely through contact with infected pigs.
The SARS-CoV2 coronavirus is therefore the second pandemic in a globalised world, in which the virus moved rapidly from one continent to another on board aircraft, just as the H1N1 influenza virus did. What made the Coronavirus pandemic (SARS-Cov2) unique was the response from the scientific world, which obtained the genetic identikit of the responsible agent with a speed never seen before.
Deeply different, instead, was the situation at the time of the Spanish pandemic of 1918, which had caused about 50 million deaths, surpassing with its death toll that of the First World War.
According to reports from the Istituto Superiore di Sanità,
about one third of the world population was affected by the Spanish during the 1918-1919 pandemic. The disease was exceptionally severe, with a lethality greater than 2.5% and about 50 million deaths, some speculate up to 100 million.
According to the Centers for Disease Control and Prevention, one of the leading public health control bodies in the United States of America, this is the most serious pandemic in recent history. Caused by an H1N1 virus with genes of avian origin, the “Spanish” owes its name to the fact that the first news about this form of flu was written in the newspapers of Spain which, not being involved in the world conflict, was not subject to war censorship. It is clear that the damage and consequences of a pandemic can be even more damaging than those of a war.
Viruses until the last century travelled across continents much more slowly, as did the pandemic of the
Asian in 1957, which killed 1.1 million people
, and the
Hong Kong in 1968, which killed 1 million people.
According to the Oms definition, a pandemic is the worldwide spread of a new disease and generally indicates the involvement of at least two continents, with sustained human-to-human transmission.
It is not so much the severity of the disease that is the decisive parameter for a pandemic to be declared, but the effectiveness with which a disease spreads.
The declaration of a pandemic implies that each country must draw up a pandemic plan and constantly update it on the basis of WHO guidelines.
Pandemic plans may include measures to reorganise hospital beds, including intensive care facilities, and pathways to lighten emergency care facilities, while other measures may relate to the numbers of healthcare personnel.
The purchase of drugs and the development and large-scale production of a vaccine become priorities, as well as the organisation of vaccination campaigns.
In some cases (as is currently being discussed in Italy) it may also become necessary to make choices regarding access to therapies, an attitude typical of the branch of medicine called “Disaster Medicine”, which applies in emergency situations such as earthquakes, tsunamis, terrorist attacks, etc..
Already in 1999, the WHO published a guide on pandemic preparedness, updated in 2005. Since then, work has continued on the development of response plans and
Oms has repeatedly pointed out that there is now a greater awareness that preparing for a pandemic requires the involvement not only of the health sector, but of society as a whole, with the direct involvement of people.
. Coordination between the WHO and other international organisations also plays a very important role. Finally, at national level, notes the WHO, it is very important to inform the public regularly about the pandemic disease, including how it is transmitted, its clinical severity, prevention and treatment.
According to the latest communiqué issued by the Italian Ministry of Health concerning the “swine” influenza H1N1, the number of victims linked to this influenza has been set at 229, which, in relation to the estimated number of cases (4,391,000 in Italy) corresponds to a lethality of about 0.005 %,
so almost a hundred times less than the past H3N2 flu. At the moment the Coronavirus, according to the totally uncertain data available to us at the moment, presents a lethality between 2 % and 7 %, therefore much worse than the last pandemic that has faced our planet in this millennium.