CHICAGO—Did government health officials “cry swine” when they sounded the alarm on what looked like a threatening new flu?

The so-far mild swine flu outbreak has many people saying that the talk about a devastating global epidemic was just fear-mongering hype. But that’s not how public health officials see it, calling complacency the thing that keeps them up at night.

The World Health Organization (WHO) added a scary-sounding warning Thursday, predicting up to 2 billion people could catch the new flu if the outbreak turns into a global epidemic.

Many blame such alarms and the breathless media coverage for creating an overreaction that disrupted many people’s lives.

Schools shut down, idling even healthy kids and forcing parents to stay home from work; colleges scaled back or even canceled graduation ceremonies; a big Cinco de Mayo celebration in Chicago was canned; face masks and hand sanitizers sold out—all because of an outbreak that seems no worse than a mild flu season.

Two weeks after news broke about the new flu strain, there have been 46 deaths—44 in Mexico and two in the United States. More than 2,300 are sick in 26 countries, including about 900 US cases. Those are much lower numbers than were feared at the start based on early reports of an aggressive and deadly flu in Mexico.

Time to relax?

Public health authorities have acknowledged that their worst fears about the new virus have not materialized. But no one’s officially saying it’s time to relax. And experts worry that people will become too complacent and tune out the warnings if the virus returns in a more dangerous form in the fall.

“People are taking a sigh of relief too soon,” said Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention.

In an interview Wednesday, Besser said the outbreak in the United States appeared to be less severe than was first feared. But the virus was still spreading and its future potential as a killer was not clearly understood.

Measures

“The measures we’ve been talking about—the importance of handwashing, the importance of covering coughs, the real responsibility for staying home when you’re sick and keeping your children home when you’re sick—I’m afraid that people are going to say, ‘Ah, we’ve dodged a bullet. We don’t need to do that,”’ Besser said.

“The thing that’s keeping me up right now is that feeling of dodging the bullet,” he added.

Peter Sandman, a risk communication specialist, said on his website that reminding people the risk was real and warning them in the future if a pandemic was imminent “will be extremely difficult.”

“Swine flu looks to be an extremely mild pandemic if it goes pandemic at all, despite WHO warnings that it may ‘come back with a vengeance’ in the fall. People are going to be very, very skeptical,” Sandman wrote.

Crybabies

That concern was shared by infectious disease specialists. But elsewhere, especially online, talk of hype was rampant.

“Adults are acting like a bunch of crybabies in a B-rated science fiction germ-outbreak movie, wringing their hands, whining about what to do next,” Dallas Morning News reader Mark Thompson wrote in a letter to the editor posted online on Wednesday.

Whether the media overhyped or accurately reported the dangers is a toss-up, according to a USA Today/Gallup poll published Thursday on Americans’ views of the media’s flu coverage.

The May 5 poll also found that concern about the flu peaked a week ago. But even then, only 25 percent of Americans said they worried about getting the virus.

Dangers of complacency

In Geneva, the WHO warned against complacency over swine flu saying one in three people may be infected worldwide if there is a pandemic.

“It is critical for countries to maintain their alertness and monitoring so this evolution can be followed as closely as possible,” said Keiji Fukuda, WHO’s acting director general, on Thursday.

He warned the disease could become more virulent later in the year with the onset of the northern hemisphere’s winter flu season.

“Complacency is the greatest danger,” said Fukuda. “It does appear to be a period where the virus may be seeding itself in various parts of the world … What we are seeing now is milder than in 1918 (when up to 50 million people died of the Spanish influenza pandemic). But 1918 started mild in springtime and became more severe in winter.”

2 billion could be infected

Fukuda said up to 2 billion people could be infected by swine flu if the current outbreak turns into a pandemic lasting two years.

“If we do move into a pandemic, then our expectation is that we will see a large number of people infected worldwide,” he said. “If you look at past pandemics, it would be a reasonable estimate to say perhaps a third of the world’s population would get infected with this virus.”

With the current total population of more than 6 billion, that would mean an infection total of 2 billion, he said, but added that the world has changed since pandemics of earlier generations, and experts are unable to predict if the impact will be greater or smaller.

“We don’t really know.” said Fukuda. “This is a benchmark from the past. Please do not interpret this as a prediction for the future.”

He added that it was impossible to say if the current strain of swine flu would become severe or mild, but that even with a mild flu, “from the global perspective there are still very large numbers of people who could develop pneumonia, require respirators, who could die.”

A mild outbreak in wealthier countries could be “quite severe in its impact in the developing world,” Fukuda said.