TELL ME project suggests a new integrated Pandemic Threat Index

Many experts talk about pandemics and about the importance of preparedness but, based on the previous experience with the 2009 A(H1N1) swine flu, the issue of what a pandemic is and when it has to be declared is still under debate.

In 2009 A (H1N1) pandemic, the 2005 WHO Global pandemic six-phases threat index, set following H5N1 bird flu and SARS crises, showed its own limits. By focusing only on the geographical spread of the outbreak and using a professional language, it contributed to produce misunderstanding among international organizations, the media and the general public, with a backfire effect on public trust towards health authorities.

Learning lessons from past experience was one of the main tenets of the EU-funded TELL ME project; at the end of its research, it provided a new, integrated Pandemic Threat Index, designed to combine the features of other three currently used systems: WHO revised pandemic phases (2013), CDC Pandemic Severity Index (2007) and Sandman’s risk Scale (2007). Though each threat index is comprehensive, considering the practical tools they offer, their alert phases are very much oriented to different aspects. Namely, the WHO’s risk assessment of influenza virus with pandemic potential is based on the geographical spread of the threat, CDC pandemic index is severity-based and Sandman’s communicational phases emphasize public perception of the risk. Subsequently, these three phase systems do not overlap but rather complement each other.

The WHO declaration of a global flu pandemic on June 11, 2009, raising the alert level to phase 6, did not imply severity and only pertained to the wide geographic spread of the new strain of flu virus. It was not meant to cause alarm, but was then necessary to start the implementation of preparedness actions (like the production of vaccines). Media and the public, however, interpreted it as a declaration of an impending catastrophe. The milder than expected evolution of the pandemic was taken by many as a proof that the declaration had been driven by economic interests.

Most people discovered that the criteria by which WHO declares a phase 6 pandemic had little relevance to their daily routine.  In the end, the lack of accessibility and relevance of the six-phase index to the intensity of the level of public concern led growing mistrust towards health authorities at general and WHO particularly.  Therefore, to better define when a pandemic should be declared is not just an academic issue, but a key point in order to rebuild trust and improve preparedness.

This case-study led the TELL ME Project to recommend the integration of the three pandemic risk communication scales into a TELL ME integrated threat index based on their three main aspects, namely the geographical threat, severity and public risk perception. A policy brief was drafted and sent to relevant policy makers and stakeholders at international, European and national level, in the hope that it will be viewed as a positive and helpful contribution to the current debate about preparedness to wards future pandemic.

MMLAP and other EU Projects

Health system analysis to support capacity development in response to the threat of pandemic influenza in Asia
Making society an active participant in water adaptation to global change
Public Participation in Developing a Common Framework for Assessment and Management of Sustainable Innovation
Engaging all of Europe in shaping a desirable and sustainable future
Expect the unexpected and know how to respond
Driving innovation in crisis management for European resilience
Effective communication in outbreak management: development of an evidence-based tool for Europe
Solutions to improve CBRNe resilience
Network for Communicable Disease Control in Southern Europe and Mediterranean Countries
Developing the framework for an epidemic forecast infrastructure
Strengthening of the national surveillance system for communicable diseases
Surveillance of vaccine preventable hepatitis
European monitoring of excess mortality for public health action
European network for highly infectious disease
Dedicated surveillance network for surveillance and control of vaccine preventable diseases in the EU
Modelling the spread of pandemic influenza and strategies for its containment and mitigation
Cost-effectiveness assessment of european influenza human pandemic alert and response strategies
Bridging the gap between science, stakeholders and policy makers
Promotion of immunization for health professionals in Europe
Towards inclusive research programming for sustainable food innovations
Addressing chronic diseases and healthy ageing across the life cycle
Medical ecosystem – personalized event-based surveillance
Studying the many and varied economic, social, legal and ethical aspects of the recent developments on the Internet, and their consequences for the individual and society at large
Get involved in the responsible marine research and innovation
Knowledge-based policy-making on issues involving science, technology and innovation, mainly based upon the practices in Parliamentary Technology Assessment
Assessment of the current pandemic preparedness and response tools, systems and practice at national, EU and global level in priority areas
Analysis of innovative public engagement tools and instruments for dynamic governance in the field of Science in Society
Public Engagement with Research And Research Engagement with Society
Computing Veracity – the Fourth Challenge of Big Data
Providing infrastructure, co-ordination and integration of existing clinical research networks on epidemics and pandemics
Promote vaccinations among migrant population in Europe
Creating mechanisms for effectively tackling the scientific and technology related challenges faced by society
Improve the quality of indoor air, keeping it free from radon
Improving respect of ethics principles and laws in research and innovation, in line with the evolution of technologies and societal concerns
Investigating how cities in the West securitise against global pandemics
Creating a structured dialogue and mutual learning with citizens and urban actors by setting up National Networks in 10 countries across Europe
Identifying how children can be change agents in the Science and Society relationship
Establishing an open dialogue between stakeholders concerning synthetic biology’s potential benefits and risks
Transparent communication in Epidemics: Learning Lessons from experience, delivering effective Messages, providing Evidence