‘Plausible uncertainty’: the negotiated indeterminacy of pandemic influenza in the UK

Policymakers in the UK (and worldwide) are preparing for what is said to be an inevitable and imminent influenza pandemic. However, aside from its inevitability, there is a considerable amount of uncertainty surrounding the pandemic. Public health policy is flexible and ad hoc, and this, the public is told, is a direct result of the natural unpredictability of the influenza virus, This article argues that we should not uncritically accept policymakers’ assertion that the uncertainty surrounding pandemic influenza public health is simply a result of this natural unpredictability. Uncertainty in public health policy must be understood in terms of its socio-political, as well as its scientific, context. Uncertainty is seen to occupy two separate but related levels: basic scientific uncertainty and public health policy uncertainty. This study shows how the former, which to an extent is real uncertainty, is translated into the latter which is (re)constructed and politicised as ‘plausible uncertainty’. The actors are seen to displace accountability onto the influenza virus through a naturalistic account of uncertainty which fails to include a public discussion of those socio-political factors, such as funding and licensing, which also help to shape both scientific research and policy formulation, and which subsequently have an impact on how well prepared we are for coping with a pandemic. The danger, it is suggested, is that the existence of a ‘culture of precaution’ too easily allows for a naturalistic account of uncertainty to be seen as a justifiable solution to a difficult policy problem, in instances where the full social and political context of the issue may not have been openly discussed.