The Legacy of H1N1

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As we watch swine flu through the rear view mirror, and our concerns begin to fade, it is easier to see it in a more proper context. I tried to do just that in my opedin USA Today.

Even as we turn our attention to the southern hemisphere, and watch via the World Health Organization FluNet tracking system for the extent of the virus over the winter, I can't help but comment on the WHO handling of the Pandemic Alert System as it applies to the swine flu outbreak.

The problem is that the current alert system was put in place in 2005 in reaction to the Avian Flu scare. Of course a tracking system in response to a scare has a built in tendency for overreaction. I don't have a problem with the notion that level 5 involves sustained transmission of a new flu strain from person to person in 2 countries in the same region. Nor do I have a problem with the idea that a full pandemic (a scare term which is too vague to be descriptive) involves a sustained outbreak in different regions of the world. What I do have a problem with is the lack of statistics -number of cases and number of deaths don't factor in. So it is possible to have a pandemic with only a few thousand cases. Where would the Bubonic Plague or the Spanish Flu, diseases which killed many millions of people, fit on a pandemic alert scale where a relatively small outbreak of Swine Flu is already listed near the worst possible ranking?

Not only that, but these pandemic alerts are used by the U.S. and other countries as a justification to divert needed health resources from other essential medical problems to the fear of pandemics. Sometimes that is justified, but often it isn't. Keep in mind that Tamiflu and vaccines (which are stockpiled and then mobilized in anticipation of a pandemic), are perishable. We have already discarded hundreds of thousands of doses of unused smallpox and anthrax vaccines. How much excess expensive Tamiflu will we also discard when it expires?

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of "False Alarm: The Truth About the Epidemic of Fear"and "Bird Flu: Everything You Need to Know About the Next Pandemic." Read more at