As this article in the Washington Post makes clear, there’s probably nothing that can be done to avoid what could turn out to be the most calamitous event in American history; the coming Bird Flu pandemic:
Public health officials preparing to battle what they view as an inevitable influenza pandemic say the world lacks the medical weapons to fight the disease effectively, and will not have them anytime soon.
Public health specialists and manufacturers are working frantically to develop vaccines, drugs, strategies for quarantining and treating the ill, and plans for international cooperation, but these efforts will take years. Meanwhile, the most dangerous strain of influenza to appear in decades — the H5N1 “bird flu” in Asia — is showing up in new populations of birds, and occasionally people, almost by the month, global health officials say.
If the virus were to start spreading in the next year, the world would have only a relative handful of doses of an experimental vaccine to defend against a disease that, history shows, could potentially kill millions. If the vaccine proved effective and every flu vaccine factory in the world started making it, the first doses would not be ready for four months. By then, the pathogen would probably be on every continent.
Am I being an alarmist? Am I overstating the potential for unmitigated disaster?
I wish I was. What the article makes clear and what international health officials have been saying for months is that it is only a matter of time before the strain of flu currently infecting millions of birds mutates into a pathogen not only with the ability to jump from birds to humans, but more catastrophically, a mutation that would enable it to leap from human to human via casual contact.
This would bring about a social and economic catastrophe the likes of which this country has never seen.
Other measures would go well beyond the conventional boundaries of public health: restricting international travel, shutting down transit systems or nationalizing supplies of critical medical equipment, such as surgical masks.
But Osterholm argues that such measures would fall far short. He predicts that a pandemic would cause widespread shutdowns of factories, transportation and other essential industries. To prepare, he says, authorities should identify and stockpile a list of perhaps 100 crucial products and resources that are essential to keep society functioning until the pandemic recedes and the survivors go back to work.
In order to contain the outbreak, the federal government will have to assume enormous powers, ordering the closing of schools, office buildings, factories, malls - anywhere and anyplace that large numbers of people congregate. The simple chore of shopping for food will become a nightmare as strict limits will be placed on the number of people that will be allowed in a store at any one time.
Every time you walk out of your house, you’ll have to think is this trip worth the risk of getting sick?
The strain on the public health system will be overwhelming. Hospitals will be filled to capacity. Workers on the front line of the epidemic - doctors, nurses, and other health care workers - will be hardest hit straining the ability of hospitals to deliver even basic services.
How do we know this? Because the US and the rest of the world went through a flu pandemic before; the Spanish Flu outbreak in 1918. That worldwide calamity killed more than 30 million people, 675,000 in the United States alone. By contrast, on average 36,000 deaths are attributed to flu each year in the United States.
Given the massive change in population density worldwide plus the advent of international air travel the World Health Organization is estimating that a Bird Flu pandemic could kill 300 million worldwide. Even their pie-in-the-sky best case scenario where the world is given another year or two to prepare places the number of dead at 7 million.
We may not have that long.
So what makes this version of the flu any different than the disease that strikes the US every winter?
Pandemic influenza is not an unusually bad version of the flu that appears each winter. Those outbreaks are caused by flu viruses that have been circulating for decades and change slightly year to year.
Pandemics are caused by strains of virus that are highly contagious and to which people have no immunity. Such strains are rare. They arise from the chance scrambling and recombination of an animal flu virus and a human one, resulting in a strain whose molecular identity is wholly new.
The reason Bird Flu has flared up in Asia is because of the close proximity of people and birds. This closeness has been seen throughout history as a prerequisite for viruses making the jump from animals to humans.
What has international health officials especially worried is that this particular flu’s mortality rate doesn’t moderate once it makes the jump to humans. Where the disease might have a mortality rate of 70% in birds, that number would be expected to fall precipitously once making the jump to humans, dropping to less than 10%. The reason is the simple evolutionary strategy of the bug. In order to survive it must keep infecting humans. To do that, it has to keep the host alive long enough to infect someone else. This gives our own body’s defenses time to marshall its immune forces to do battle with the invader.
However, this strain of Bird Flu has shown a 34% mortality rate. And while there’s a chance that figure will go down in any pandemic, compared to the 1-3% mortality of ordinary flu worldwide the numbers would still be catastrophic.
As for the economic effects, there would not be a parallel in American history. The reason goes to the heart of what globalization means to our economy and how economic activity in the United States is truly the engine that drives the economies of the world.
If the kinds of draconian quarantine measures contemplated by the government were initiated, the economy would deflate like a punctured balloon. Even if the CDC were able to contain the epidemic quickly - say, as quickly as a modern industrialized Hong Kong was able to contain the recent SARS outbreak, we’d still be looking at a period of about two months of government mandated reduced economic activity.
What would that mean for the economy?
The only comparable event we have to go on would be the economic impact of 9/11. And while there are as many estimates for that as there are economists, the GAO did a round-up of estimates that would seem to indicate that the attacks cost the US economy upwards of $165 billion in direct costs with a loss of perhaps as many as 175,000 jobs. Indirect costs that are still being felt today could be 3 times that much.
That was one attack in one city. The flu would hit several cities almost simultaneously and cause massive economic dislocation due to the virtual halt in economic activity in those and perhaps most regions of the country. I wouldn’t want to contemplate what that would mean over a two month period but given that imports and exports would be massively affected due to probable restrictions on loading and unloading of ships, I daresay that the entire world would be plunged into an economic nightmare that would overwhelm the ability of most third world government to deal with the crisis.
I really hope I’m wrong in all this. But seeing how the WHO has been scrambling for the last 18 months to try and contain each and every outbreak of human to human contact, I’m not very optimistic. And the CDC is taking the possibility very, very seriously.
As I said back in May when this story first started to percolate, I’m going to keep a close eye on the far east news services. I would suggest you do the same. Given the incompetence of the MSM, by the time they start reporting this story in earnest, the epidemic will be upon us and it will be too late.
I’m also going to make some common sense plans including purchasing a good supply of surgical masks and stock up on canned goods and other non-perishables.
I hope a year from now everyone can call me an old goat who panicked over nothing.
UPDATE
I thought that this would be a story tailor made for the Shadow Media but at the moment, only 9 blogs have linked to the WaPo article.
One of them is Fragments of Floyd:
We (global mankind, science and public health) have not adequately anticipated and prepared for such a scenario, even though we could have seen it coming for a decade or more. If we could turn back time 15 years and know with certainty the pathogens we would face in the future, would there have been any better cooperation between continents? Would we have wasted so much talent, wealth and technology (ostensibly) to protect our people and way of life from acts of terrorism if we’d accepted that it was emerging infectious disease that posed by far the greater threat to our economy and to our very survival?
It seems we may be very near the moment of truth. Is it too late to turn our swords into vaccines?
I don’t buy the argument but he has a point (we would have to face both - there’s no “either, or” - much like our dilemma at the outset of WW II: Germany or Japan?)
His point about cooperation is spot on. Read his post for how that pandemic might be nipped in its infancy with an international pooling of resources.
UPDATE II
It appears that most of the other A-list bloggers don’t find this story worth their time with the exception of Glenn Reynolds, who thinks we should be worried “a bit” and John Cole who at least has the common sense to share a small degree of my concern:
This isn’t going away, it can’t be negotiated, so we better start preparing. Just as a curious side note, the the late night crazies at Art Bell’s Coast to Coast have been fretting about this for years.
What next! Will a Yeti walk out of the woods and show up in a bar in Yakima?
UPDATE 8/1
The Maryhunter has posted his learned and fascinating response here.
8:01 am
[...] this morning about what appears to be the unavoidable catastrophe of a Bird Flu pandemic. Tell me if I got carried away a little… Said Ric [...]
7:02 pm
Rick I think this could have a devasting effect if it spreads. Much like many other nasty germs, this disease could become a worldwide epidemic that no one is prepared to deal with. Like small pox, this stuff could become the next plague. Good article.
7:18 pm
[...] “>
7/31/2005
Birds and Flu
My blog friend Rick Moran has yet another excellent post -this is about Bird Flu pandem [...]
8:07 pm
The 1918 influenza made an impression on those that survived. So much that their stories passed down to the next generation. Stories of strapping big farmers that got sick, laid in bed a day or two, went out to work in the fields or the dairy barn or what have you, and dropped dead. Stories of people who closed up their shop because they felt ill, went home, laid down in bed and were dead by nightfall.
Stories of healthy young soldiers in excellent condition who took sick in barracks, were carried to the fort hospital, and died during the same night.
Businesses were closed. Schools and universities sent the students and faculty home. Families stayed home, nursed their sick, buried them if need be, avoided going out much.
These weren’t made up stories. They were real things that happened, and even those that were merely children of 5 or 8 years remembered them decades later.
Statistically this world is due for another nasty new influenza bug at least as dangerous as the one that swept around in 1968. But we could be due for one as bad as 1918.
What price “just in time” and “fully interconnected” economies, if nobody wants to go to the factory, the port, Wall Street, the bank, the mall, and other places?
9:08 pm
Anyone who doubts the impact of such a pandemic should read “The Great Influenza: The Epic Story of the Deadliest Plague in History”, by John M. Barry. The potential of this current Bird Flu is frightening.
9:45 pm
[...] ge article titled “World Not Set To Deal With Flu” about which Rick wrote at Rightwing Nuthouse, and my take on the potential for a d [...]
5:37 am
[...] ge article titled “World Not Set To Deal With Flu” about which Rick wrote at Rightwing Nuthouse, and my take on the potential for a d [...]
7:41 am
my concern for this potential pandemic is somewhat mitigated by some differences between 1918 and today. Among those is that people in the developed countries are much healthier by comparison to those of 1918. Advances in medical care and preventative medicine has increased 1000-fold in the past 100 years. Every year, we are scared by reports of the “next deadly flu outbreak” that never materializes.
I don’t mean to belittle the legitimate concerns made in the article, but it’s just a bit too alarmist for me. It’s seems that most of the deaths occur in underdeveloped or rural areas, where access to proper medical care is not readily available.
6:12 pm
Yours is a valid point, Rightismight. My concern though is that too much thinking this way by The Powers That Be could result in not enough attention to the threat… and that third-world countries already saddled with high AIDS infection rates and general ill health could be devastated by a pandemic that still dinks the first world mightily. (whoops, I showed my soft spot for the third world and health issues… evil Conservative that I am)
Then, what happens when we’re asked to bail out the developing countries when we have our own serious health issue to deal with? (ah, atta boy, Conservative Principles arise)
Actually I would love to see some data that correlate a country’s per capita wealth with death rates for flu, any flu. From the death rate in “young healthy adults” (data about which I am still dubious) I am beginning to wonder just how indescriminate a killer modern flu pandemics are from a socioeconomic standpoint. The 1918 data probably hold some clue (even tho dated), since if I recall, generally the death rate per capita in the US was far lower than less industrialized countries. I just haven’t had time to investigate this.
Rick, did I miss something painfully obvious?
6:43 pm
For some background on flu bloggers, see my article “Blogging the Pandemic” in The Tyee (http://www.thetyee.ca/Mediacheck/2005/06/01/BloggingPandemic/). My own blog “H5N1″ offers links to some extraordinary sites with both current news and expert analysis.
As for differences between 1918 and today: In 1918, many people had experienced the 1890 flu pandemic and had antibodies that protected them somewhat. We have zero immunity to H5N1 because until 1997 it was strictly a (rather harmless) fowl virus.
As for the disproportionate death rate of young, healthy persons in 1918, that was attributable to the strength of their own immune systems. A strong system, faced with a serious attack, launches what is called a “cytokine storm” to destroy the infection. The damage is catastrophic. In effect, the immune system kills the individual it’s supposed to protect.
Think of an army that’s lost the ability to distinguish between invaders and its own civilians. That’s a cytokine storm. It’s sadly ironic that in 1918 so many of the victims were themselves young soldiers, drafted to defend their homelands and dying within days of their enlistment.
3:08 am
Submitted for Your Approval
First off… any spambots reading this should immediately go here, here, here, and here. Die spambots, die! And now… here are all the links submitted by members of the Watcher’s Council for this week’s vote. Council li…
2:38 pm
Winds of Change posted on this with lots of good links. I did an homage of sorts, with stories about my family’s experience, which continues down to the 4th generation now.
Yesteday, my co-blogger, the Baron, did a post on the pig slaughter in Indonesia:
When Pigs Fly
The money quote:
Experts worry that pigs infected with both bird flu and its human equivalent could act as a “mixing bowl,†resulting in a more dangerous, mutant virus that might spread to people more easily — and then from person to person.
I envy the sang froid of your commenters who think we’re too rich and too healthy to be a target of this virus. It killed off the young and the healthy last time…
Please keep ringing this bell.
BTW, Joe Katzman has *excellent* links on his post re this whole mess.
3:10 am
The Council Has Spoken!
First off… any spambots reading this should immediately go here, here, here, and here. Die spambots, die! And now… the winning entries in the Watcher’s Council vote for this week are The Coming Catastrophe? by Right W…
8:36 am
[...] best posts for this week. The top post from the council goes to Right Wing Nut House for The Coming Catastrophe?. The best post in the non-council category was [...]
10:55 pm
Watcher’s Council Results
The Watcher’s Council has voted on this past week’s nominees. Rightwing Nuthouse has taken first place among the members of the Council with The Coming Catastrophe? The Counterterrorism Blog was selected as the winning non-council entry with The Amer…
1:04 am
The Coalition of the Willing
As you may or may not already be aware, members of the Watcher’s Council hold a vote every week on what we consider to be the most link-worthy pieces of writing around… though I don’t actually vote unless there happens…
3:32 am
[...] consideration in the upcoming nominations process. Here is the most recent winning council post, here is the most recent winning non-council post, [...]
7:41 am
Watcher’s Council best posts week ending August 4
The Watcher’s Council selected these best posts from among those nominated last week. The Coming Catastrophe? at Right Wing Nut House was voted best Council post. Two in a row! The post is about avian flu; read it and also check out the Avian Flu blog…
1:46 pm
Now, don’t go bugshit, really, this…ahh hell if I even say the ititials, it’s going to cause apoplexy.
There’s this completely screwed up international group that has a medical department that’s also screwed up, but they are responsible for keeping the asian bird flu in the publid eye and under check so far. They have convinced poor-assed Thailand and Cambodia to eradicate 10s of millions of poultry, due to exposures. They have feet on the ground in Asia that are monitoring human cases, and they are the source of 99% of the information that the CDC and the WaPo have on Asian Bird Flu.
The last good thing they did was about 40 years ago. They led the fight to wipe out smallpox, and get the credit for doing so.
This is a good news - bad news deal. The good news is that we have plenty of warning, and the vaccines are under production, due to their vigilance. The bad news is I’ve been talking about the WHO. *buys two boxes of canned beans and another x-large tuna can of 7.62 x 39*
12:22 am
Watcher Winners
Not late for once, here are this week’s Watcher’s Council vote winners: The Coming Catastrophe? by Right Wing Nut House — Alarming predictions about Bird Flu, if true. The American Islamic Leaders’ “Fatwa” Is Bogus by The Counterterrorism Blog –…
2:29 pm
[...] or the posts of the last week most deserving of recognition. The winning Council post was Right Wing Nut House’s thoughts on the possibility of a Bird Flu p [...]
11:46 pm
[...] phrase might lead. Last week’s contest made a two-fer for the Right Wing Nut House. “The Coming Catastrophe” is an unflinching look at the threa [...]
11:09 am
[...] get=”_blank”>August 5th results: Votes Council link 2 1/3 The Coming Catastrophe?Right Wing Nut House 1& [...]
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