Moderate pandemic, not many dead—learning the right lessons in Europe from the 2009 pandemic

It could have been very different (Table 1). Although it was clear, from an early stage, that the 2009 influenza pandemic was likely to be less severe than the 1918 ‘Spanish Flu’, which killed an estimated 50 million people,1 there was still much uncertainty among European authorities on how it might develop. View this table: Table 1 Positive features of the 2009 pandemic for Europe Three factors played a role in mitigating its impact. First, many of those in their mid-50s and above possessed cross-immunity from a similar virus that circulated before the 1957 pandemic.2 Hence, older people who account for over 90% of deaths from seasonal influenza were relatively spared. Those who died were mainly children and younger adults; among deaths reported to ECDC, about 80% were >65 years old. Second, along with Japan and China, Europe was the last industrialized region to be affected, enabling it to draw on the experience of North America, temperate countries in the Southern Hemisphere, and the one European country, the UK, that experienced a significant Spring/Winter wave. Therefore, the UK authorities were well placed to advise the rest of Europe what to expect, and what not to do. Its experience endorsed the guidance from the WHO and ECDC not to try to contain the uncontainable. Third, many European countries had worked intensively to strengthen their previously variable degree of pandemic preparedness. As a consequence, there were no disproportionate government reactions such as those in Mexico, Argentina and the Ukraine. The coordinated review mechanisms in some of the European plans also made it possible to adapt responses once the WHO declared the …