Swine Flu - Lessons Learnt in Australia

In this Medical Journal of Australia (MJA) editorial, Peter J. Collignon asks the question: What did Australia do well in the first year of pandemic (H1N1) 2009, and what can we do better? He begins by noting that the new H1N1 influenza strain that presented in Mexico in April 2009 appeared to be associated with a high mortality rate, which fuelled fears that a highly virulent virus would quickly spread internationally. By mid-May, Collignon notes, Australia had in place the following: accurate polymerase chain reaction (PCR) testing for swine flu, improved public awareness of infection control, and good public health surveillance. By September of that year, Australia was among the first countries with a vaccine available.

Reflecting on this history, Collignon reviews several lessons learned, some of which are communication-related. For instance, noting the fact that people who are sick should not be at work, school, or travelling on public transport, Collignon argues that "[d]isproportionate fear generated by media reports resulted in many people presenting to emergency departments or medical practices when they had mild illness and should have stayed at home to recover on their own. However, we do need the ability to quickly assess those in risk groups or those whose condition deteriorates. This may require a phone triage system. Health care workers would then only need to directly assess the much smaller numbers of patients who may need antimicrobials or hospital admission or who are severely ill."

He also suggests that front-line general practitioners and other clinicians faced "extreme difficulties because of deficiencies in implementing parts of the pandemic plan" - one of which was related to a lack of clear communication about policy changes as the situation progressed. Collignon proposes learning to adapt better as circumstances change and improving consultation with front-line clinicians in any future planning.

In a final communication-related argument, Collignon highlights the fact that the core components of current pandemic planning are influenza vaccination and antivirals. He says that "[t]his may not be the best approach. Simple infection control measures such as hand hygiene and barrier methods (gloves, masks, isolation) reduce the spread of respiratory viruses..." This implies that, to prevent deaths, strategies to communicate simple behaviour change messages should be a core element of pandemic plans.