Non-pharmacological interventions may be as important as—or even more important than—drugs and vaccines in fighting pandemic flu, speakers at a conference in Barcelona said last week.

The international conference on health technology assessment heard from James LeDuc, a professor at the University of Texas who until recently helped to lead the US national strategy for responding to pandemic flu, how St Louis did much better than Philadelphia in the 1918 pandemic—long before effective drugs and vaccines were available. St Louis had its first cases on 5 October 1918, and on 7 October it took a range of measures, such as closing schools, theatres, and dance and pool halls and banning public gatherings, including funerals. In contrast, Philadelphia …