Last January, as new H1N1 flu infections were trailing off in the Northern Hemisphere, accusations began to fly that the World Health Organization’s declaration of a pandemic in the spring of 2009 had served mainly to line the pockets of pharmaceutical companies making vaccines and the drug Tamiflu. By June, a report in the British Medical Journal concluded that the WHO had exaggerated the threat.
“That’s a 20/20 hindsight point of view that’s unacceptable,” says Lone Simonsen, a flu expert at George Washington University in Washington, D.C., who cautions it could have been much worse. Early signs of H1N1 indicated similarities to the 1918 flu that killed 60 million people worldwide. But H1N1 changed as it spread, and by the time it reached Japan it was mild, killing mostly the immunocompromised elderly, says Hiroshi Nishiura, an epidemiologist at the Japan Science and Technology Agency.
A recent study of data in the United States measured the impact of H1N1 on years of life lost. By that measure, H1N1 seems more similar to the 1968 pandemic, which killed 1 million people globally, than to the outbreak in 1918. Simonsen notes, however, that the H1N1 battle may not be over, pointing out that “the last five pandemics in history have all come in waves.”