Intended for healthcare professionals

Analysis And Comment

Dealing with uncertainty: perspective from primary care

BMJ 2006; 332 doi: (Published 30 March 2006) Cite this as: BMJ 2006;332:791
  1. Anthony Harnden, university lecturer (
  1. 1 Department of Primary Health Care, University of Oxford, Oxford OX3 7LF

    Influenza A (H5N1) is worrying governments and public health experts. Something sinister about the label “bird flu” has also captured the attention of the public and the world media. News footage and stories occur almost daily. Although it seems inevitable that we will have another flu pandemic, many uncertainties remain, most of which will affect primary care. But general practitioners are experts in coping with uncertainty and are well placed to adapt and respond to an evolving public health emergency.

    Dealing with uncertainty

    The biggest uncertainty is the timing of the pandemic, which depends on the H5N1 virus changing so that it can spread between humans. Information will then start to emerge about the virulence and infectivity of the new virus. Clearly, a clinical attack rate of 25% will have a different effect on primary care than an attack rate of 50%. Once human to human transmission has been established, wherever in the world, general practitioners are likely to be the first to identify outbreaks in the United Kingdom. At this stage general practitioners will be on …

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