The WSJ ran an Op-Ed piece last week by Dr. Larry Brilliant. Dr. Brilliant has an incredible pedigree: a physician, epidemiologist, and humanitarian, Dr. Brilliant was a major steward of the WHO’s polio erradication program, is co-founder of the SEVA foundation which restores sight to people in undeveloped countries, Chairman of the National Biosurveillance Advisory Subcommittee, the former head of the Google Foundation and newly appointed President of the Skoll Urgent Threats Fund, part of the Skoll Foundation. He writes there is good news, bad news and worse news to report.

Good News

Compared with a just a short time ago, overall the world is better prepared to deal with pandemic influenza. At virtually every level of government and business there has been widespread training, tabletop exercises, and preparedness drills. WHO members have agreed on a set of regulations that require all members to report the status of diseases of global significance within their borders. At least for now, there are two effective antiviral drugs. There have been some progress to reduce the time required to get effective vaccines into the field, and there is even a small chance that last year’s seasonal vaccine will help protect lives from H1N1. In the U.S. at least, influenza surveillance has improved.

Bad News

Dr. Brilliant paints a bleak picture by stating that we remain underprepared for any pandemic or major outbreak, whether it comes from newly emerging infectious diseases, bioterror attack or laboratory accident. He ticks off a list of weaknesses. We are lacking:

  • The best general disease surveillance systems
  • Sufficient “surge” capacity in our hospitals and health-care facilities.
  • Enough beds, respirators or seasoned public-health staff (many of whom, because of the financial meltdown, ironically got pink slips from their state and county health departments days or even hours before WHO declared we are at a Phase 5 alert, one step short of its highest global level).

He goes on to say that we not only need to retain the public-health people we have, but quickly train a new generation of 21st-century workers who know both the old diseases and have mastered the computer and other digital technologies and genomic advances to keep them ahead of the newest emerging threats.

There is Worse News?

The 2009 swine flu will not be the last and may not be the worst pandemic that we will face in the coming years. Indeed, we might be entering an Age of Pandemics.