In blatant defiance of the White House Press Corps tradition of asking nothing but questions which they ought to already know the answer to over and over again, one reporter at yesterday's press conference actually brought up a timely and important topic, the threat of Avian Flu.
President Bush was ready with an exhaustive answer - he's just finished meetings with the United Nations and World Health Organizations on this issue, and has been extensively briefed on the subject. He's also preparing to host an international conference on the Avian Flu crisis later this year, so the subject is very much on his mind.
The specifics of the president's response to the question have led to some negative reaction because he suggested the use of the US Military to impose a quarantine within our borders in violation of Posse Comitatus. This has raised concerns for some, but it does seem to be a logical outgrowth of the inability of local authorities to respond to recent major crises like hurricane Katrina, a situation which would be accentuated by the interstate character of the outbreak of a major flu epidemic.
For years concerned commentators like Ralph Nader have been complaining that the administration was not taking the threat of Avian Flu seriously enough. Now that they are apparently taking it seriously, the proposed solutions are stirring up accusations of fearmongering.
Yet the more we learn about the threat of Avian Flu the more alarming it seems. The context in which all epidemics are assessed is the Spanish Flu of 1918, which is now believed to have originated as a bird flu. That virus infected about 25% of the population of the world and had a fatality rate of about 20%, ultimately killing millions of people world wide - about 3% of the total world population or 50 million people. In comparison the Avian Flu has yet to spread far, but it has a fatality rate of as high as 70%. All it would require would be for the virus to break out of the areas in Asia where it is currently contained and begin to pass from one human host to another and it would become an epidemic of unprecedented proportions. The World Health Organization has estimated a potential death toll of as many as 150 million people.
Article comments
— go to most recent comments1 - Lumpy
Isn't it possible that when it mutates into a contagious form in a new host it will be less lethal than it is when caught directly from a bied?
And what about migratory birds bringing it direct to the US. Scary.
lumpster
2 - RJ
As with just about everything in biological science, we just don't know the answers to the important questions.
Perhaps this strain will never mutate to infect human populations, via human-to-human transmission.
Perhaps it will, but in doing so it will become much less deadly.
Or perhaps it will mutate to human-to-human transmission in just a few days, and will kill hundreds of millions of people, even in deeloped countries like the US.
We just don't know what will happen. But we DO need a plan for the worst-case scenario...
3 - RJ
"deeloped" = developed...
4 - Cerulean
I remember the Swine Flu thing as not happening. People got sick from the vaccine that they urged on us, but I don't remember serious outbreaks. Does anyone else remember them?
This whole thing bird flu thing feels like fear mongering. They are always trying to traumatize us with this but it doesn't feel real to me. It feels like another thing to panic about. As Louis Pasteur said,
"The microbe is nothing, the territory is everything."
But what did he know?
5 - Dave Nalle
The original Swine Flu outbreak in 1976 was real and was the worst flu epidemic since 1918. Subsequent reappearances have not been as bad as expected, at least partially because of resistences built up during previous visits from the bug.
The key thing with Avian Flu is not the combination of inevitability - it will eventually spread to humans - and the unpredictability - it could be nothing or it could be more deadly than the Spanish Flu. And right now the cases we do have suggest high mortality. The combination of inevitability and unpredictability means we have to prepare as soon as possible and stay prepared for as long as necessary.
Dave
6 - Nancy
It won't matter; when/if this thing finally develops & starts spreading, there will be no time to develop a vaccine, let alone get it to a huge population pool, especially in poorer, overpopulated countries in asia. I can pretty much guarantee that here in the US, what vaccine there will be - if any - will be very limited, 'secret' (so as not to cause rioting when word gets out it's restricted), and restricted only to VIPS & the very rich; the rest of us will have to fend for ourselves. Actually, probably the only even minimally effective drug that may be available will be something like Ribavirin, & it will only blunt the virus, not surmount it.
Frankly I totally doubt the US (i.e. the administration, FEMA, WHO, CDC, et al) will be any better prepared to respond to a pandemic than they were/are to a hurricane or terrorist attack. As far as Bush's vaunted "quarantine" idea goes, the Chinese have already amply demonstrated with the SARS epidemic that people simply ignore it & do what they want; especially in other parts of the world there is too much corruption for the various governments to guarantee tight enforcement of same. In the US, there is too much laxness due to overconcern with 'rights' to roam in & out of the country, not to mention the inevitable SNAFUs created by the bureaucracies, federal, state, & local. If we can't control millions of illegals pouring over our borders, I'd be interested to hear how Bush thinks he's going to control refugees from the flu, unless perhaps he's prepared to create "dead zones" & shoot to kill anyone who enters without authorization? (which I doubt).
7 - David R. Mark
Wouldn't there just be large-scale distribution of the medicines we now use to treat viruses?
Every year, there's a new flu that emanates from somewhere in Asia and that we don't have the appropriate vaccine for. And every year we turn to the wide variety of available drugs and as a nation survive the scare, no?
Didn't we just go through a scare last winter -- with not enough vaccines, the wrong vaccines, etc.? How many deaths came from that?
8 - Cerulean
I think it takes a year (?) for flu vaccines to get made and distributed from a new form of flu. It's at least six months. I don't especially believe in flu vaccines and "anti-virals" anyway. I guess there's other things they could do but they seem draconian and inhumane. I think if we work with nature, that is the best way. This seems like some big scare party for the usual suspects to garner attention, media, CDC, etc.
9 - David R. Mark
Perhaps to take our minds off other things in the news ...
10 - Silas Kain
We've flown the coop and have chosen to wag the chicken.
11 - DJRadiohead
Regardless of any chicken wagging, we should be proactive about something (and this something in particular) once in awhile rather than always playing catchup.
12 - JR
David R. Mark: Didn't we just go through a scare last winter -- with not enough vaccines, the wrong vaccines, etc.? How many deaths came from that?
Yeah, we also went through a scare last year when Hurricane Ivan, headed straight for New Orleans, veered off through the Florida panhandle.
Maybe this is our lucky year.
13 - Dave Nalle
>>Actually, probably the only even minimally effective drug that may be available will be something like Ribavirin, & it will only blunt the virus, not surmount it. <<
There's actually a drug like Ribavirin called Tamiflu (Oseltamivir) which is specifically designed for treating flu, but it's expensive, not produced in sufficient volume, and there's virtually no back supply of it as I understand the situation. Plus we don't really know how effective it is, though there is one major study which had pretty positive results.
>>Frankly I totally doubt the US (i.e. the administration, FEMA, WHO, CDC, et al) will be any better prepared to respond to a pandemic than they were/are to a hurricane or terrorist attack.<<
That's why I wrote the article. But at least Bush is attempting to address the situaton with this conference.
>> As far as Bush's vaunted "quarantine" idea goes, the Chinese have already amply demonstrated with the SARS epidemic that people simply ignore it & do what they want; especially in other parts of the world there is too much corruption for the various governments to guarantee tight enforcement of same. In the US, there is too much laxness due to overconcern with 'rights' to roam in & out of the country, not to mention the inevitable SNAFUs created by the bureaucracies, federal, state, & local. If we can't control millions of illegals pouring over our borders, I'd be interested to hear how Bush thinks he's going to control refugees from the flu, unless perhaps he's prepared to create "dead zones" & shoot to kill anyone who enters without authorization? (which I doubt).<<
Yep, a quarantine is of dubious value. But we have been successful in controlling Mad Cow disease by going after the infected livestock. We need to do the same thing here and really aggressively go after the poultry.
Dave
14 - Dave Nalle
>>I think if we work with nature, that is the best way. <<
The best way to have 100,000 dead in the US alone.
>>This seems like some big scare party for the usual suspects to garner attention, media, CDC, etc.
Perhaps to take our minds off other things in the news ...<<
Maybe put aside your partisan paranoia for a minute. This isnt' something Bush made up. This is the #1 threat priority of the WHO which isn't exactly under Bush's control. The fact that Bush is taking it so seriously is a good thing, not a bad thing.
Dave
15 - David R. Mark
Just remind me, though, how many Americans died last year when we didn't have the right vaccine for last year's flu?
I remember that the government had a contract with a British company which didn't produce the right vaccine -- and then there were no back-up contracts, so for a while, there was no good vaccines available.
Anybody remember what happened next?
16 - Cerulean
I remember that problem but I don't know if it did, indeed result in deaths. Flu vaccines are not of the current year's germs. They are a year old or more, I think.
17 - Dave Nalle
>>Just remind me, though, how many Americans died last year when we didn't have the right vaccine for last year's flu? <<
There was more than one flu in circulation last year and the vaccine we had was good for most strains. All told there were about 1000 deaths - which is relatively low. Most years it's higher.
>>I remember that the government had a contract with a British company which didn't produce the right vaccine -- and then there were no back-up contracts, so for a while, there was no good vaccines available. <<
Actually, they produced faulty vaccine which had to be destroyed. It wasn't the wrong kind, it was unsafe.
>>Anybody remember what happened next?<<
Vaccine was rationed so the highest risk people got it and things worked out okay.
But the point is that we got lucky in the fact that more virulent strains like Avian Flu did not pop up last year. That doesn't mean that they won't eventually and it could be any time.
Dave
18 - Cerulean
Why do you think there were fewer people taking flu vaccines and fewer flu deaths? Isn't there supposed to be the opposite correlation?
19 - Dave Nalle
Cerulean, I know you belong to the tinfoil hat club, but let's not even go there. There were only 20 documented cases of flu vaccine causing flu last year, and that's pretty typical. The people who die are NOT the ones who get the vaccines.
Dave
20 - troll
Dave: *Maybe put aside your partisan paranoia for a minute. This isnt' something Bush made up. This is the #1 threat priority of the WHO which isn't exactly under Bush's control. The fact that Bush is taking it so seriously is a good thing, not a bad thing.*
a true nonpartisan statement -!- this particulae H5N1 virus has been working on getting into humans in a big way since the '97(I believe)Hong Kong outbreak -
get a pneumococcal vaccine (usually reserved for the elderly) - the majority of 1918 deaths were caused by pneumonia secondary to influenza
we'll see if Bush & Co come up with a workable response plan or use the threat as another distracting side show
this must be the most unlucky administration ever
troll
21 - Dave Nalle
Troll, one of the concerns with H5N1 is that it isn't killing the elderly with Pneumonia or even babies, it's killing otherwide healthy adults with extreme high fever, which is quite different from most previous flus.
And the Hong Kong flu, like the 1918 flu was also avian in origin, but it wasn't H5N1.
Dave
22 - troll
Dave - the '97 outbreak was H5N1 - check it out
when the virus goes pandemic it is likely that the situation will be similar to 1918 when pneumonia was in fact a major issue
while there might well be no vaccine to protect the population from death by influenza there is a vaccine for pneumonia - not enough doses but what else is new in the middle of a decimated public health system
troll
23 - troll
Dave - you were thinking of the '68 outbreak
troll
24 - Dave Nalle
Weird. If '97 was H5N1, then why are they saying that H5N1 has never been contagious from human to human. And if it was Hong Kong flu, then it's still around as part of the melange of yearly flu already.
Hmmm. Did some research. It looks like the Hong Kong flu that was H5N1 was not whatever people were actually catching in '97, since there were only 18 cases of it with one death. Seems that people were actually catching good old H1N1 and H3N2 and calling it Hong Kong flu because of the publicity surrounding H5N1 - strangely reminiscent of our current situation.
Dave
25 - troll
H5N1 never made it out of Hong Kong in '97 - a massive chicken slaughter and poor person to person transmissibility contained it
my point was that H5N1 has been workin the person to person angle for a while
troll