TORONTO - The pandemic that hit like a cyclone but mellowed to a cool breeze could still take the world by storm.
That's why it's crucial, in the relatively present calm, to soak up lessons from the on-going H1N1 flu situation, say speakers at a disaster management conference taking place in Toronto this week.
"There's a belief we missed the bullet, which is a little unnerving," said Regina Phelps, founder of San Francisco-based consulting company Emergency Management and Safety Solutions.
"That says to me people are thinking 'Gee, we're done, we missed it, we lucked out, it wasn't bad and life is going to continue on as it is.' Which could be a huge mistake."
If seasonal flu strikes this fall as expected, there's also potential for a more vicious second wave of illness and deaths related to the new H1N1 virus. It's something everyone should prepare for, Phelps said.
"We're in a situation that is evolving and that is highly fluid and if anyone tells you they know what is going to happen they're totally fooling themselves, because no one actually does."
Dr. Allison McGeer, a Toronto-based flu expert, agrees that more planning is necessary.
"I'm really happy to see all the work that's been done has paid off, but we're still a long way from what would have been an ideal response," she said.
In Canada that would include improved co-ordination of a national response that specifically fills the biggest gap, she said, which is co-ordinating primary care.
The virus first reached public view in mid-March, sweeping from Mexico through the U.S. and Canada, and then to Europe, Asia, the Middle East, Australia and South America.
It was declared a global pandemic, the first since 1968, by the World Health Organization in early June.
Yet after initial panic, the cancellation of Mexico's Cinco de Mayo celebrations, quarantine of travellers in China and shuttered schools across the world, the announcement was anti-climactic - especially as the WHO stressed pandemic rankings refer to geographic spread and not severity of the illness.
By last week, infections had been confirmed in nearly 45,000 people in more than 90 countries and 180 deaths had been attributed to the virus. With the majority of cases mild and far fewer deaths than are caused by seasonal flu, public attention in North America has waned.
Phelps believes this pattern parallels the Spanish flu epidemic of 1918. A bug, unknown to anyone at the time and seemingly lenient, suddenly emerged and spread across the globe. It too attacked young people with greater frequency than the rest of the population.
Yet so far it stands in contrast to H1N1 flu because, by its end, it had killed millions.
As North Americans release the grip on the backs of their seats, they could easily return to complacency and that's the wrong attitude to take, Phelps warned.
"The first lesson we have learned is that we haven't learned," she said.
"I don't want people to be scared, I want people to be worried and concerned to a significant enough level that they do something."
She recommends all people, from CEOs to parents, create a pandemic plan because "the planning we've done has paid off, but we're not done."
She also suggests the strengthening of health-care systems, the continuation of steady information flow, that school boards probe the impact of closures and create better responses to a crisis and that HR departments write policy for workers who become ill.
McGeer added that ongoing education is paramount, without which people may view H1N1 flu with the same indifference as seasonal flu - a killer of 4,000 Canadians every year that people "completely ignore," she said.
"Influenza is very difficult for all of us to get our heads around ... (because) even in a catastrophic situation, most illness is mild," she said.
"It's hard to respond to disease in which risk is relatively low for each individual patient, but risk to the community is high."
Whether H1N1 flu takes a nasty turn and explodes into something much worse, or even if the next flu season is just rougher than usual, the impact will be much worse without plans in place, she said.
"It's not often we have the potential and that much advance notice to get prepared for something that could be significant."
