Monday, October 3, 2005

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Things that keep me up at night

The Independent's Jeremy Laurance reports that the World Health Organization is trying to calm people down about avian flu:

The World Health Organisation has moved to play down a cataclysmic warning by one of its own officials that a pandemic caused by the bird flu virus ravaging poultry flocks in the Far East could kill as many as 150 million people.

The prediction came from David Nabarro, a senior WHO expert on infectious diseases, who was appointed on Thursday as UN co-ordinator for avian and human influenza. He said the next pandemic could claim from five million up to 150 million lives....

While he did not say the 150 million prediction was wrong, or even implausible, he said it was impossible to estimate how many could die. But he reiterated the WHO calculation that countries should prepare for 7.4 million deaths globally, arguing that was "the most reasoned position". (emphasis added)

Well, I feel much better now.

Even more calming is this report from Christine Gorman:

If, like public health authorities in the U.S. and many other countries, you're counting on the anti-viral drug Tamiflu (generic name oseltamivir) to save you should bird flu become pandemic, you may have to think again. A Hong Kong expert told Reuters on Friday that a strain of the H5N1 virus isolated in northern Vietnam this year is resistant to Tamiflu. More common human flu viruses have also recently been shown to be developing a resistance to another set of antivirals called adamantine drugs.

If the Vietnam report proves true, the implications will be particularly worrisome for public health programs to combat bird flu: Many governments have made stockpiling Tamiflu the centerpiece of their planning for a possible pandemic. U.S. Health and Human Services Secretary Michael Leavitt wants to create a big enough stockpile to treat 20 million Americans, and about $3 billion of the $4 billion the U.S. Senate last week proposed allocating to the Centers for Disease Control and Prevention to prepare for bird flu is to be used to buy Tamiflu. Never mind the fact that Tamiflu is produced in only one facility in the world, which is unlikely to produce enough to fill everyone's stockpile for several more years.

What this tells you is that the medical, private and public sectors had better have more than one big idea on how to deal with a potential pandemic of bird flu among humans. Debating as a number of health experts have done recently over whether a pandemic would kill 2 million or 150 million people is kind of beside the point.

posted by Dan on 10.03.05 at 01:04 AM


Just what did W learn from his vacation read?

The lack of urgency astounds.

Or, is there much more happening that we do not know about since knowing about it would create panic (although the projected death of 150 million is sobering indeed -- assuming we can begin to comprehend that magnitude of catastrophe)?

Or, and this seems likely to me, have we no solution in the timeframe required?

posted by: Greg on 10.03.05 at 01:04 AM [permalink]

Woe is me. My own country (Ireland) hasn't even started stockpiling anything...and a flu pandemic is invevitable. Maybe I should buy my own antivirals.

posted by: Gavin on 10.03.05 at 01:04 AM [permalink]

I remember swine flu and the Do Something Now buttons. Or was that Whip Inflation Now? Swine flu will mess you up. Or was that the vaccine that messed people up?

posted by: Max on 10.03.05 at 01:04 AM [permalink]

SARS is coming for all of us. Until it hits modern hygiene and medicine. Yawn. Lemme know when the sky hits the ground.

posted by: Mark Buehner on 10.03.05 at 01:04 AM [permalink]

Given the response of the political authorities on all levels in New Orleans it strikes me as silly to keep pooh-poohing these possible events. The cronyism in the appointment of officaldom at the Federal level under Bush and its incompetence is staggering(Michael Brown, John Roberts, Julie Myers and for more see Michelle Malkin). To expect that these people can respond to an evolving organic event is reason to be concerned.

posted by: Robert M on 10.03.05 at 01:04 AM [permalink]

Major catastrophes deserve that title in part because the expenses associated with preventing or even substantially mitigating the damages of such disasters make it almost impossible. We'd spend billions and billions to avoid bird flu (which might never even hit) and instead be struck by WMD, earthquakes, power outages or another type of WMD.

The lawsuits and hearings after 9/11, the response to Hurricane Katrina, and the immediate outrage over the recent boat flipping in upstate New York show that we're great at reacting to tragedy ("Someone must be to blame!"), but unwilling to do much to prevent it.

And realistically, unable to do much.

posted by: Brian on 10.03.05 at 01:04 AM [permalink]

The U.S. has the advantages of plentiful capacity, readily available modern therapies (IVs) and better than most in terms of hygiene and etc.

Still, the very young, the very weak, the very elderly, and the compromised (diabetics for example)would be at great risk.

How to prepare? There probably is no "silver bullit" preparation program.

posted by: healthcarethinktank on 10.03.05 at 01:04 AM [permalink]

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