A US expert says that the public health measures taken in response to swine flu may be seen as alarmist, overly restrictive, and unjustified.
Peter Doshi, a doctoral student at the Massachusetts Institute of Technology, argues that any plans for pandemics need to take into account more than the worst case scenarios.
Writing in a paper published on bmj.com, he even calls for a new framework for thinking about epidemic disease.
He points out that pandemic preparations have focused on responding to worst-case scenarios over the past four years, which is why the H1N1 outbreak was responded to as an unfolding disaster.
While some countries erected port of entry quarantines, others advised against non-essential travel to affected areas and some closed schools and businesses.
Doshi insists that pandemic A/H1N1 is significantly different than the pandemic that was predicted.
According to him, pandemic A/H1N1 virus is not a new subtype but the same subtype as seasonal H1N1, which has been circulating since 1977.
He stresses that a substantial portion of the population may have immunity against it.
Doshi further argues that actions in response to the early H1N1 outbreak were taken in an environment of high public attention and low scientific certainty.
He says that the perceived risk was amplified by the sudden emphasis on laboratory testing for H1N1 in the first weeks of the outbreak.
He has even highlighted the fact that the World Health Organisation has revised its definition of pandemic flu since the emergence of A/H1N1.
The wisdom of many of these responses to pandemic A/H1N1 will undoubtedly be debated in the future, he writes.
Public health responses not calibrated to the threat may be perceived as alarmist, eroding the public trust and resulting in the public ignoring important warnings when serious epidemics do occur, he warns.
The success of public health strategies today depends as much on technical expertise as it does on media relations and communications.
Strategies that anticipate only type 1 epidemics, severe disease affecting many people, carry the risk of doing more harm than they prevent when epidemiologically limited or clinically mild epidemics or pandemics occur, he concludes.