Via CIDRAP, Robert Roos has a very good summary of both the CDC report and the immediate response to it: CDC estimate of global H1N1 pandemic deaths: 284,000. Excerpt:
The estimation approach used by the authors received a general endorsement from Marc Lipsitch, PhD, an epidemiologist and director of the Center for Communicable Disease Dynamics at the Harvard School of Public Health.
Lipsitch told CIDRAP News via e-mail that he was not completely independent from the study because he served on a WHO working group that gave the authors some advice, and he cautioned that he had not yet read the full report.
But he said, "I know the broad outlines of their method and think it is a plausible approach to a very difficult problem of making estimates with extremely limited data, where even the available data are really very uncertain.
"I don't know if the number is right, but certainly any reasonable estimate would be far above the WHO number of confirmed deaths," he added. "Confirming flu deaths is not routine (and much less than 100% sensitive) in the richest countries, and would be exceptional rather than likely in much of the world. Thus the disparity from the WHO confirmed number is a good sign, not a red flag."
In a commentary accompanying the study, Cecile Viboud, PhD, and Lone Simonsen, PhD, write, "Future research should focus on obtaining additional country-specific estimates of the burden of seasonal and pandemic influenza in understudied locations through traditional excess mortality approaches or innovative surveys of mortality, and address the lack of estimates of case fatality rates from middle-income and low-income regions."
Viboud works at the National Institutes of Health's Fogarty International Center, and Simonsen is with George Washington University's School of Public Health. The two were part of a team that in March 2010 estimated years of life lost because of the 2009 H1N1 pandemic in the United States.
The authors of the study say their findings point up the need to expand delivery of flu vaccines to Africa and Southeast Asia, since those regions may have borne a disproportionate share of the pandemic mortality burden.
