Pandemic? What flu pandemic?

First we were told swine flu could kill 65,000 Britons. Now the death toll is unlikely to top 1,000

The 2009 swine flu pandemic may turn out to be the weakest in history. It is spreading more slowly than expected and the latest figures show a flattening, or even a dip, in new infections. It is mild in most people but severe in a few and, while it readily infects children, it appears to spare the elderly. With the vaccine being rolled out, its impact should be further curbed.

So far in the UK, 154 people have died from the virus, around half of whom were under 45. In addition, 1,431 were admitted to hospital with swine flu last week. But in comparison with previous pandemics – or even seasonal flu epidemics – this is a relatively low toll.

In July, shortly after the World Health Organisation declared the first flu pandemic for 40 years, Britain's Chief Medical Officer, Sir Liam Donaldson, published a worst-case scenario suggesting the country should plan for up to 65,000 deaths. That planning assumption has since been revised downwards twice. In September the "worst case" was cut to 19,000 deaths, and in October it was cut again to 1,000 deaths. This compares with an average annual toll of 4,000 to 8,000 deaths from seasonal winter flu.

Previous pandemics have had higher death tolls. In 1918 Spanish H1N1 flu claimed an estimated 230,000 lives in Britain and up to 50 million worldwide. In 1957-58, Asian HN2 flu caused 1.5 to 2 million deaths worldwide and 33,000 in Britain. That was followed by Hong Kong H3N2 flu in 1968-69 which caused one million deaths worldwide of which 30,000 were in Britain. So far, 2009 "novel H1N1" flu has caused 6,394 deaths worldwide, of which 154 have been in the UK.

Doctors say the key difference with seasonal winter flu is that it does not normally kill the young. Swine flu is worst among the under-fives, whose hospitalisation rate is four times higher than in older age groups. Pregnant women are also vulnerable.

Doctors have also been dismayed by the unpredictable ferocity with which it attacks some people. The biggest concern is the number in critical care which has risen sharply in recent weeks. In England, of 848 patients in hospital on 4 November, 172 were in critical care.

Dr Steven Field, chairman of the Royal College of GPs, said: "I thought the original predictions for the number of deaths were incredibly high. Hospitals are coming under pressure but, because the care is so good, fewer people are dying."

Dr Laurence Buckman, chairman of the British Medical Association's GPs committee said: "The original government masterplan was for a maximum of 250,000 dead. But that was based on avian flu. It became clear that swine flu did not pose the same risk. Compared with those earlier assumptions it is looking pretty tame."

The H1N1 swine flu virus that emerged in Mexico last April was the first novel flu virus seen for more than 40 years. But it has since become clear that H1N1 virus is not quite as novel as it appeared. Unlike seasonal flu, swine flu has spread much less among the over 60s, leading scientists to speculate that they have some immunity.

Flu viruses are, however, notoriously unpredictable. The 2009 H1N1 swine flu strain proved its capacity to surprise early on by triggering the first serious flu outbreak in summer in living memory last July, when cases peaked at over 110,000.

But it could yet hold more surpises in store. John McCauley, director of the World Influenza Centre at the National Institute of Medical Research in Mill Hill, north London, said: "Of the three pandemics in the last century it is nothing like 1918 Spanish flu and it may well be milder than 1957 Asian flu or 1968 Hong Kong flu. But it is too early to tell. In the pandemic of 1968-69 we had more illness in 1969."

Professor John Oxford, a flu expert and director of Retroscreen Virology Ltd, said: "So far, this pandemic is the weakest. But the paradox is it could be worse next year. We cannot let up our guard."

Professor Angus Nicoll, head of the influenza programme at the European Centre for Disease Control in Stockholm, said: "It is a potentially manageable pandemic but there will certainly be a number of deaths among younger people that we don't normally see. For that reason I would be resistant to saying it is the weakest pandemic, especially if that were used as a reason not to be immunised."

Flu deaths: the numbers

65,000

Number of deaths in worst-case scenario for Britain published in July



19,000

Revised worst-case scenario outlined in September



1,000

Revised worst-case scenario last month



154

Number of deaths in Britain so far



4-8,000

Average annual death toll in Britain from seasonal winter flu

Life and Style
Customers can get their caffeine fix on the move
food + drink
Life and Style
techCould new invention save millions in healthcare bills?
Sport
David Moyes gets soaked
sport Moyes becomes latest manager to take part in the ALS challenge
Voices
Mosul dam was retaken with the help of the US
voicesRobert Fisk: Barack Obama is following the jihadists’ script
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Arts and Entertainment
Loaded weapon: drugs have surprise side effects for Scarlett Johansson in Luc Besson’s ‘Lucy’
filmReview: Lucy, Luc Besson's complex thriller
Arts and Entertainment
Jamie T plays live in 2007 before going on hiatus from 2010
arts + entsSinger-songwriter will perform on the Festival Republic Stage
Life and Style
food + drinkThese simple recipes will have you refreshed within minutes
News
peoplePamela Anderson rejects ice bucket challenge because of ALS experiments on animals
Arts and Entertainment
tvExecutive says content is not 'without any purpose'
News
A cleaner prepares the red carpet for the opening night during the 59th International Cannes Film Festival May 17, 2006 in Cannes, France.
newsPowerful vacuum cleaners to be banned under EU regulations
Sport
sportLeague Managers' Association had described Malky Mackay texts as 'friendly banter'
Arts and Entertainment
tvSpielberg involved in bringing his 2002 film to the small screen
News
peopleCareer spanned 70 years, including work with Holocaust survivors
News
people
Travel
Flocking round: Beyoncé, Madame Tussauds' latest waxwork, looking fierce in the park
travelIn a digital age when we have more access than ever to the stars, why are waxworks still pulling in crowds?
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Generalist HR Administrator, Tunbridge Wells, Kent - £28,000.

    £25000 - £28000 per annum: Ashdown Group: Generalist HR Administrator - Tunbri...

    Head of IT (Not-for-Profit sector) - East Sussex

    £45000 - £50000 per annum + 5 weeks holiday & benefits: Ashdown Group: Head of...

    Supply Teaching jobs in Thetford

    £21588 - £31566 per annum: Randstad Education Cambridge: Randstad Education ar...

    KS1 teachers needed in Peterborough

    £110 - £125 per annum: Randstad Education Cambridge: Randstad Education are ur...

    Day In a Page

    Air strikes? Talk of God? Obama is following the jihadists’ script

    Air strikes? Talk of God? Obama is following the jihadists’ script

    The President came the nearest he has come yet to rivalling George W Bush’s gormless reaction to 9/11 , says Robert Fisk
    Ebola outbreak: Billy Graham’s son declares righteous war on the virus

    Billy Graham’s son declares righteous war on Ebola

    A Christian charity’s efforts to save missionaries trapped in Africa by the crisis have been justifiably praised. But doubts remain about its evangelical motives
    Jeremy Clarkson 'does not see a problem' with his racist language on Top Gear, says BBC

    Not even Jeremy Clarkson is bigger than the BBC, says TV boss

    Corporation’s head of television confirms ‘Top Gear’ host was warned about racist language
    Nick Clegg the movie: Channel 4 to air Coalition drama showing Lib Dem leader's rise

    Nick Clegg the movie

    Channel 4 to air Coalition drama showing Lib Dem leader's rise
    Philip Larkin: Misogynist, racist, miserable? Or caring, playful man who lived for others?

    Philip Larkin: What will survive of him?

    Larkin's reputation has taken a knocking. But a new book by James Booth argues that the poet was affectionate, witty, entertaining and kind, as hitherto unseen letters, sketches and 'selfies' reveal
    Madame Tussauds has shown off its Beyoncé waxwork in Regent's Park - but why is the tourist attraction still pulling in the crowds?

    Waxing lyrical

    Madame Tussauds has shown off its Beyoncé waxwork in Regent's Park - but why is the tourist attraction still pulling in the crowds?
    Texas forensic astronomer finally pinpoints the exact birth of impressionism

    Revealed (to the minute)

    The precise time when impressionism was born
    From slow-roasted to sugar-cured: how to make the most of the British tomato season

    Make the most of British tomatoes

    The British crop is at its tastiest and most abundant. Sudi Pigott shares her favourite recipes
    10 best men's skincare products

    Face it: 10 best men's skincare products

    Oscar Quine cleanses, tones and moisturises to find skin-savers blokes will be proud to display on the bathroom shelf
    Malky Mackay allegations: Malky Mackay, Iain Moody and another grim day for English football

    Mackay, Moody and another grim day for English football

    The latest shocking claims do nothing to dispel the image that some in the game on these shores exist in a time warp, laments Sam Wallace
    La Liga analysis: Will Barcelona's hopes go out of the window?

    Will Barcelona's hopes go out of the window?

    Pete Jenson starts his preview of the Spanish season, which begins on Saturday, by explaining how Fifa’s transfer ban will affect the Catalans
    Middle East crisis: We know all too much about the cruelty of Isis – but all too little about who they are

    We know all too much about the cruelty of Isis – but all too little about who they are

    Now Obama has seen the next US reporter to be threatened with beheading, will he blink, asks Robert Fisk
    Neanderthals lived alongside humans for centuries, latest study shows

    Final resting place of our Neanderthal neighbours revealed

    Bones dated to 40,000 years ago show species may have died out in Belgium species co-existed
    Scottish independence: The new Scots who hold fate of the UK in their hands

    The new Scots who hold fate of the UK in their hands

    Scotland’s immigrants are as passionate about the future of their adopted nation as anyone else
    Britain's ugliest buildings: Which monstrosities should be nominated for the Dead Prize?

    Blight club: Britain's ugliest buildings

    Following the architect Cameron Sinclair's introduction of the Dead Prize, an award for ugly buildings, John Rentoul reflects on some of the biggest blots on the UK landscape