Estimates of the impact of a future influenza pandemic in China.

Background The next influenza pandemic will create a surge in demand for health resources in China, with its current population of >1·3 billion persons and under-developed medical care and public health system. However, few pandemic impact data are available for China. Objectives We estimated the effects of a future influenza pandemic in China by examining pandemic scenarios of varying severity and described the time distribution of cases during a first wave. Methods  We used a Monte-Carlo simulation model and death rates, hospitalizations and outpatient visits for 1918- and 1968-like pandemic scenarios and data from the literature or experts’ opinion to estimate four health outcomes: deaths, hospitalizations, outpatient medical visits and clinical illness for which medical care was not sought. For each of the two scenarios we estimated outcomes by week using a normal distribution. Results We estimated that a 1968 scenario in China would result in 460 000–700 000 deaths, 1·94–2·27 million hospitalizations, 111–117 million outpatient visits and 192–197 million illnesses for which medical care was not sought. Fifty-two percent of hospitalizations occurred during the two-peak weeks of the first wave. We estimated that patients at high-risk of influenza complications (10–17% of the population) would account for 61–75% of all deaths. For a 1918 scenario, we estimated that 4·95–6·95 million deaths, 20·8–22·7 million hospitalizations and 101–108 million outpatient visits could occur. Conclusion Even a 1968 pandemic scenario will pose substantial challenges for the medical and public health system in China, and planning to manage these challenges is essential. [ABSTRACT FROM AUTHOR]