WHO guidance on pandemics then and now

We’re about a year into Worldwide Coronapanic. Let’s make sure that we’ve been following expert advice. How about checking out Pandemic Influenza Preparedness And Response, A WHO guidance document to see what #Science had figured out regarding a respiratory virus after 100+ years of study. This 2009 document is an update of previous work and the update is a result of five task forces laboring for years. There were 139 experts who participated substantially and another 428 folks who commented.

We are reminded that viruses can kill us:

Influenza pandemics are unpredictable but recurring events that can have severe consequences on human health and economic well being worldwide. Advance planning and preparedness are critical to help mitigate the impact of a global pandemic.

(also that the only thing worse than a pandemic is a global pandemic)

The case fatality rate can be as high as 2-3% (page 13).

Page 43 is about “Reducing the Spread of Disease”.

In other words, do not close borders unless you’re on an island with no undocumented inbound migration (“in rare instances where clear geographical and other barriers exist”). Do not take all of your money and spend it on Clorox wipes. Do not wear a mask unless you’re sick or treating someone who is sick.

Aside from the above, the 64-page document contains only one other use of the word “mask”:

If medical masks are available and the training on their correct use is feasible, they may be considered for symptomatic persons and susceptible caregivers in household settings when close contact can not be avoided.

The document is silent on the disease-preventing effect of a bandana that has been hanging from the rear-view mirror for months.

6 thoughts on “WHO guidance on pandemics then and now

  1. Reversing themselves on both short and long term horizons. And yet…. Google (YouTube) unironically aggressively removes any video that contradicts their omniscience.

  2. That was 11 years ago when the Obama Administration was in power, and in April of 2009 was battling the H1N1 “swine” flu crisis. Maybe it was important at the time to align the guidance and the #Science with the Administration’s capabilities so as not to embarrass or overwhelm them just as they were getting into the saddle, so to speak. Certainly much has changed in the knowledge of airborne respiratory viruses since then, especially because Donald Trump was President, and his hostility to the WHO and their Chinese Communist Party paymasters had to be punished!

    After all, the H1N1 flu is also known as the “Spanish Flu” – previously the deadliest pandemic in the world! But the WHO wasn’t about to make the Obama Administration’s response look bad, especially right at the beginning of his enormously promising first term!

    The WHO declared H1N1 a Global Pandemic in June of that year. And as everyone knows, especially in hindsight, the Obama Administration and Joe Biden did a fantastic job with it!

    https://www.politico.com/news/2020/05/04/joe-biden-contain-h1n1-virus-232992

    • I mean, if you read that Politico article (which doesn’t mention the word “masks” or “sanitizer” or “decontaminate” anywhere – in any place!, only mentions the word “borders” in contrast with the Hated Orange Man, and of course doesn’t mention “shutdowns” or “lockdowns” or even “quarantine!”), ultimately History as Written by Politico will judge the Obama Administration’s performance during H1N1 thus:

      “They listened to the scientists. They got Congress on board. They put experts out in front of the public. And they righted messaging, adopting an acronym that would serve as a linchpin in averting future snafus: PTFOTV — Put Tony Fauci on TV.”

      And so perhaps it’s not surprising that the WHO guidance from the same year comports perfectly with that.

  3. This reminds me of the “time reversal heuristic” of Andrew Gelman (a highly respected statistician at Columbia) for reasoning about conflicting scientific studies.

    The idea is to reverse the temporal order of the studies and consider the effect that would have had on their public acceptance.

    What we have now is that first there was a long, thorough study representing years of effort reviewing data from all around the world that concluded masks should not be worn by the general public. That was followed in the spring of 2020 by a sequence of small studies showing that in laboratory conditions cloth masks can reduce airborne viral transmission. The conclusion has been broad acceptance that masks are effective and should be worn.

    What if these had happened in opposite order? Imagine if in 2009 there had been a sequence of small studies showing that in laboratory conditions, cloth masks reduce airborne viral transmission. Then in 2020, there was a multi-year analysis from hundreds of researchers analyzing data from countries all over the world who found no benefit to having the general public wear masks. What conclusion would we draw? Seems pretty obvious to me!

    See https://statmodeling.stat.columbia.edu/2016/01/26/more-power-posing/ for an interesting discussion of the heuristic in the context of a study that was once accepted as Science but is now seen as having been noise.

  4. You’re looking at a document about influenza and saying that this is relevant to coronavirus. Why?

    There’s much less a/pre-symptomatic transmission with the flu, for two reasons. Tranmission starts 1 day before symptoms (per https://www.cdc.gov/flu/about/disease/spread.htm), and asymptomatic transmission is relatively less common (https://academic.oup.com/cid/article/64/6/736/2733100).

    But with coronavirus both asymptomatic and pre-symptomatic spreading is _much_ greater, both in terms of duration, and the fact that there are a lot more asymptomatic cases.

    The fact the the WHO “does not encourage the use of masks by in the community by well persons” makes sense, *in the context of influenza*.

    Or in summary, different diseases are different. News at 11.

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