August 9, 2017

Family Science Professor Sandra Quinn explores the implications of a 21st century influenza pandemic in a new essay on the Infectious Diseases Hub website.

Dr. Quinn, who is a senior associate director of the Maryland Center for Health Equity, opens with a nod to Dr. Anthony Fauci, Director of the NIH’s National Institute of Allergies and Infectious Diseases. While others might point to the Zika virus or Ebola as the most frightening in today’s world, Dr. Fauci—and Dr. Quinn—think pandemic influenza should be our biggest concern.

Why now? “Of particular and pressing immediate concern in 2017 is what Michael Osterholm refers to as an ‘unprecedented’ situation, in which there are more avian influenza virus strains circulating on more continents than ever before, increasing the potential for mutations and human transmission.  For these avian influenzas, we can anticipate that they will spread in flocks, through wild bird migration and human contact with birds.  Which strain and when one will emerge as a true pandemic strain is the great unknown,” Dr. Quinn writes.

Dr. Quinn looks at vaccine update from a historical standpoint, considering the H1N1 influenza pandemic of 2009-2010, in which there was relatively low vaccine uptake around the world—though the severity of H1N1 was fortunately not as high as initially anticipated. She addresses the issue of vaccine hesitancy and trust. Quinn writes, “Today’s world is increasingly characterized by distrust in government, and equally importantly, a growing recognition that the public does not understand, and potentially does not value science.” She notes that pharmaceutical companies are the least trusted organizations, and that gaps in understanding are often filled by anti-vaccine groups instead of public health authorities.

Growing inequality and massive urbanization in the world are also factors that would contribute to a pandemic, with risk factors that include crowding, lack of health care access, poor nutrition and, critically, low-wage work that does not include sick leave. The lack of sick leave creates a disincentive for workers to stay home and isolate themselves when they are unwell. In the H1N1 pandemic, research by Quinn and Kumar “not only documented the disparities in risk of exposure, susceptibility and access to care, but literally found that those disparities, particularly in the inability to social distance, contributed 5 million additional cases of influenza-like illness in the general population and 1.2 million cases among Latinos.”

Dr. Quinn suggests that social media, while it can be a source of conspiracy theories, is an important tool for disseminating accurate information. The key, she says, is the quality of the communication. “First, we know public health leaders are more trusted sources than elected officials. Providing crisis and emergency risk communication to public health leaders will strengthen their ability to address the uncertainty of a pandemic, which is critical to communication success and trust.” She goes on to emphasize the importance of transparency in messaging to the public in order to gain trust, and of partnering with organizations to reach minority groups with culturally appropriate communication via trusted channels.  

“We must begin today,” she writes. “An influenza pandemic will happen; that much is a given.  How well prepared we are to communicate with the public, to what extent we have built trust and learned how to effectively communicate in uncertain times, will shape how we respond to the pandemic threat, and ultimately, how many lives we save.”

Article Link: 
21st century challenges in an influenza pandemic
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Sandra C. Quinn