One Year Later: 5 Lessons from the H1N1 Pandemic

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Luis Acosta / AFP / Getty

Mexicans protect themselves from the swine flu virus at the Mixcoac health center in Mexico City

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Some evidence also suggests vaccines may not even be as effective against flu viruses as advertised. A review of the scientific literature by Tom Jefferson, an epidemiologist at the Cochrane Collaboration in Britain, finds little scientific data to support the effectiveness of flu vaccines in reducing infection or death. Jefferson told TIME in February that "we don't know what protection, if any, [flu] vaccines offer."

Jefferson's work should at least remind health officials that the focus on vaccines must not blind them to other cheap and effective means to blunt the spread of a new virus — especially if we're still making vaccines the slow, old-fashioned way.

5. It all boils down to communication and trust.

The main concern going forward should not be the way health officials responded to the last pandemic but how we will respond to the next one. And that may prove worrisome: the perception that officials overhyped and overreacted to the H1N1 pandemic may make the public less inclined to react appropriately the next time around. The fact that vaccination rates in the U.S. were still fairly low during the latest flu season — Harvard researchers estimate that 6 out of 10 adults were not vaccinated — indicates an abiding skepticism toward public health. But while we got off relatively unscathed this time, next time we may not be so lucky.

The only way to defuse public skepticism is for health officials to communicate better what they know about an outbreak — and even more important, what they don't know about it. Washington officials did an admirable job putting out information in the early days of the H1N1 pandemic, but they were less successful at putting that information in context. There wasn't enough explanation of what a "pandemic" really meant: that it referred only to the transmissibility of the new virus, not its virulence.

Leaving interpretation of the data to the media, whose coverage tends to swing between extremes, is not a good idea. In an age of Twitter and transparency, there's no substitute for official honesty. "Communication in 2010 is a really tricky situation," says Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases. "This was the first pandemic done in the age of the Internet." Chances are it won't be the last — but if we learn from H1N1, at least we'll be prepared.

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