Leading article: Keep calm and carry on

Sunday 26 July 2009 00:00

As any pedant knows, the "Keep Calm and Carry On" poster was printed in 1939 but never displayed – at least, not until 2005, when it became the latest equivalent of "You Don't Have to Be Mad to Work Here ... But It Helps". One of the reasons for its popularity may have been that it offers such a multilayered rebuke to the tendency of today's media to overreaction and panic.

The swine flu pandemic is the starkest recent example of the difficulties we have as a nation in dealing with the concept of risk. The Government, the media and the general public have all struggled to make sense of the threat that arose in April when cases of swine flu were first reported in Mexico. Partly because of the scare over Sars in China and Canada in 2003, and partly because officials had been so well-prepared for the possibility of a bird flu pandemic, public opinion was already sensitised to the possibility of a new strain of flu virus spreading quickly around the world and killing hundreds of thousands of people.

An early sense of urgency was justified, therefore. But by 3 May, this newspaper was already reporting that the outbreak, which had by then spread to 16 countries, "may not be as bad as initially feared". It was quickly established with a reasonable degree of certainty that this H1N1 strain was both highly infectious, but also unusually mild.

As with any strain of influenza, it can kill; but compare it with normal seasonal flu, which kills 6,000-8,000 during most British winters, and which killed about 21,000 in the worst recent season, that of 1999-2000. To date, the death toll from swine flu in Britain is 30, of whom only five appear to have been free of any underlying condition that contributed to their illness. And most authoritative predictions are that the incidence of the disease in this country either has peaked already or will do so in the next couple of weeks.

Of course, nothing can diminish the loss and the pain of the families of those who have died, and it may sound heartless to use words such as "mild" of a virus that can be deadly. But, for the population as a whole, a sense of perspective is supplied by comparisons, not just with seasonal flu but with other causes of death. Last year, 2,538 people were killed in road accidents and about 5,000 people died of hospital-acquired infections – although they would have had, by definition, what are now known as "underlying health issues".

Perhaps the most telling thought experiment is this: if we had not known about the existence of swine flu, would we have noticed that anything unusual was happening? Many adults have felt ill in the past two months; some might even have had swine flu. Many of us have children who have been sick and run a high temperature for a few days. Had we not heard about pandemics from the media and NHS information campaigns, we might have used words such as "flu" and "stomach bug" loosely, and carried on.

Instead, we have besieged first NHS Direct and now the dedicated National Pandemic Flu Service, mostly to ask for advice that has already been provided or to ask for antiviral drugs that we do not need.

Thus one of the more pressing public policy issues to arise from the outbreak of swine flu phobia is that of ensuring that drug companies are restrained from profiteering, as we report on page 14.

There remains, of course, the issue of the coming winter. If another wave of infections should coincide with cold weather, the number of deaths could rise significantly. Professor Sir Liam Donaldson, the Government's chief medical officer, is planning for a worst-case scenario of 65,000 deaths. The figure has been widely reported, but it is difficult to convey its low probability, which is as important as its alarming scale.

Even in places where it is winter on the other side of the world, the death toll has been mercifully low: 165 in Argentina; 40 in Australia. There also remains the abiding risk that this virus or a bird flu virus could mutate to a more aggressive form – but that threat is no greater now than it has been for many years.

All in all, the Government has a good record of preparedness – despite predictable complaints that it has been too slow or put out "confused messages"; and despite the likely kneejerk response to our report today of priority for drug addicts. Britain has better stocks of antiviral drugs and better plans for coping with a pandemic than most other countries. In any case, the threat from this virus falls some way short of a national emergency. This is not 1939: we wish all our readers a calm and reasonably healthy summer holiday.

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