The public health measures taken in response to swine flu may be seen as alarmist, overly restrictive, or even unjustified, a US expert has claimed.

In a paper published on bmj.com, Peter Doshi, a doctoral student at the Massachusetts Institute of Technology, argues that our plans for pandemics need to take into account more than the worst case scenarios, and calls for a new framework for thinking about epidemic disease.

Swine Flu Latest: Pandemic Planning Flawed

Over the past four years, pandemic preparations have focused on responding to worst case scenarios. As a result, we responded to the H1N1 outbreak as an unfolding disaster. Some countries erected port of entry quarantines. Others advised against non-essential travel to affected areas and some closed schools and businesses.

“Pandemic A/H1N1 is significantly different than the pandemic that was predicted,” says Doshi. “Pandemic A/H1N1 virus is not a new subtype but the same subtype as seasonal H1N1 that has been circulating since 1977. Furthermore, a substantial portion of the population may have immunity.”

The Government has warned that a ‘second wave’ of swine flu cases are likely to hit the UK in the autumn as the weather deteriorates and the traditional flu season arrives.

Swine Flu Latest: How severe a pandemic could it be?

If the 2009 influenza pandemic turns severe, early and enhanced surveillance may prove to have bought critical time to prepare a vaccine that could reduce morbidity and mortality.

But, Doshi argues, if this pandemic does not increase in severity, it may signal the need to reassess both the risk assessment and risk management strategies towards emerging infectious diseases.

Doshi suggests that future responses to infectious diseases may benefit from a risk assessment that broadly conceives of four types of threat based on the disease’s distribution and clinical severity.

For example, the 1918 pandemic was a type 1 epidemic (severe disease affecting many people), while SARS was a type 2 epidemic (infecting few, mostly severe disease), and the H1N1 pandemic may prove to be type 3 (affecting many, mostly mild).