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Study: Lax response spurred England's late, severe H1N1 spike

Lapses in health measures during the second season that the 2009 H1N1 flu virus circulated in England probably contributed to a heavier disease burden—marked by more deaths and hospitalizations—than during the 2009-10 pandemic, researchers reported today.

The authors said the pattern is worrying, especially because the health community and the public knew about the possible impact of the virus and that a vaccine against the new strain was available. The group from the University of Oxford and Imperial College published their findings today in Eurosurveillance.

England had two seasons of high 2009 H1N1 activity, one in 2009 and 2010—the pandemic year—that saw summer and fall waves, and one from 2010 to 2011 that consisted of a short but sharp rise in flu activity in December and January.

During the pandemic year, England launched an intensive public health campaign that featured a program to provide early access to antivirals and an awareness campaign that featured the slogan, "Catch it. Bin it. Kill it." The emergence of pandemic infections in England and the country's early response to it garnered widespread, and sometimes sensationalized, media coverage.

When public health officials found that the virus was somewhat milder than originally thought, some politicians in England strongly criticized the country's pandemic response and its vaccine procurement as a waste of public money. The criticism echoed throughout Europe, culminating with hearings at the Council of Europe that led to a critical report of the pandemic response of the World Health Organization (WHO) and other European governments. However, formal reviews of the WHO and England's pandemic responses defended the steps they took.

The authors reported that, before the start of the second 2009 H1N1–dominated season, national public health bodies were generally reassuring in their tone, and officials decided not to launch their usual advertising to encourage seasonal flu vaccination, which that season contained 2009 H1N1 as one of the three strains. When the number of severe infections and deaths spiked that winter, government officials were criticized for complacency.

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