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What Are We Waiting For?

In the 1918-1919 influenza pandemic, the mortality rate was 3 percent, which seems merciful in comparison with the 50 percent mortality rate of today's highly pathogenic H5N1 avian flu. In just the past 18 months, avian flu has caused the death or destruction of more than 140 million birds in 11 Asian nations. And, most alarming, in four of those nations, H5N1 has taken the worried jump from birds to infect humans.

Should the virus shift and human-to-human transmission become sustained, the cost in human lives could be substantial -- especially when vaccine would not become available, at best, until six to nine months after the outbreak of a pandemic. And even then, the vaccine would not be available to every American. Nor do we have enough of the only effective anti-viral agent Tamiflu stockpiled to treat more than 1 percent of our population.

To meet this threat, I propose an unprecedented effort -- a "Manhattan Project for the 21st century" -- not with the goal of creating a destructive new weapon, but to defend against destruction wreaked by infectious diseases such as H5N1 and biological weapons.

Such a project would include substantial increases in support for fundamental research, medical education, emergency capacity and public health infrastructure; the unleashing of the private sector and unprecedented collaboration among government and industry and academia; and the creation of secure stores of treatments and vaccines and vast networks of distribution.

But, above all, I speak of action -- without excuses, without exceptions -- with the goal of protecting every American and the capability to help protect the people of the world.

Many benefits other than survival would follow in train. We will come to understand diseases that we do not now understand and find the cures for diseases that we cannot now cure. It will add to the economy both a potent principle of organization and a stimulus like war, but war's opposite in effect. It will power the productive life of the country into new fields, transforming the information age with unexpected rapidity into the biotechnical age that is to come. Recombinomicsquotes Senator Bill Frist

More of Frist's concerns and hopes for fighting infectious disease, from a speech delivered at Harvard Medical School, June 2005, can be read here.

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Comments

I think, my friend, that this flu is becoming an obsession with you and that, in itself, is an infectious disease :)

I don't think you are overreacting at all.
The other part of the process Fred is to stop factory high intenisve farming that drive the preconditions for aninmal illness and hence the risk to uss.

Doug - a bit of history - nearly all plagues have involved the domestication of animals and the cross over of pathogens from them to us.

Now with high intensive farming an dglobaal markets were incredibly exposed. Recall that about 90% of the indigenous population of the New World died within 50 years of first contact with urban and agricultural westerners

It is going to happen to us - the only variable is when

It would be very unpopular to say that people are the problem, but that's what I'm saying. People create the conditions for epidemics simply through population growth and behavior. In the absence of war, disease, and suicides (suicides kill more than wars), population would get even further out of control. Are epidemics natural population stabilizers? Would the post-apocalyptic population be better off as they are left with more resources? I know this view won't win any Nobel Peace prizes or warm fuzzies but it is the flip side to a catastrophe.

Good point! If we went from 6 billion to 2 and cut off the trajectory to 8, our species and the biosphere would be better off for sure. What a lesson too!

But it would not be lot of fun living through such an event. At least I live in a place where we can grow food. Imagine being a resident of a lrge city when all this occurs?

Sorry but I have a couple of problems with this doom scenario, not the least of which is using Sen. Bill Frist as a source. This is the same Bill Frist who led the Congressional intrustion into what should have been the private tragedy of the Teri Schiavo case (the one where he offered a "diagnosis" from the floor that she was not brain dead even though those who actually treated her said she was and an autopsy later proved). Frist is a leader of a political party that depends on scare tactics to promote its political agenda.

Secondly, I worry when the mainstream media (which I was a part of for 40 years), jumps on a bandwagon. The Baltimore Sun over the weekend said: ""Officials are preparing as though the virus is the heir apparent to the 1918 international flu pandemic, which killed more than 40 million."

In 1986, a similar media feeding frenzy existed on AIDS. Newsweek predicted that, by 1991, AIDS ""will have spread to between 5 million and 10 million Americans." AIDS peaked at 1.5 million Americans.

It's vital to inform and to warn but we must be careful of hysteria. There's a big difference between being alarmed and being an alarmist.

Fred tells me he will give me his 30-minute lecture on avian flu. I'm ready to listen but I'm not yet convinced that I need to start stockpiling canned food.

yes. echo, echo, echo mr. paterson & jim. it's exactly what i've been saying all along, only trying to be nice & respectful like a good southern lady. glad to see i'm not the only voice in the dark re: we are what we did. we have a great saying in the land use planning world, with apologies to Pogo: we have met the enemy, and it is us.

Doug, the mainstream media has treated this as a backpage story for six months, when some responsible journalism (it happened but was rare) and responsible governance last fall might have made for a more gradual introduction of this immensely relevant news topic to the American public. Now, we risk panic or boredom, depending on the spin. The reality hasn't changed. This is the biggest health threat to come along in my lifetime--potentially.

I've been reading on this topic daily for 10 months, from the most reliable sources I can find (not newspaper front pages tho I've posted links to some because but links to the medical sites offers more jargon than the average person can wade through.)

The fact that Frist has made some poor calls in the past does not necessarily diminish the clarity with which he, as a physician before politiician, has assessed the economic, political, sociological and cultural risk of a pandemic ignored. He is in a very small minority among his largely silent and motionless colleagues.

Yes, figures for potential infection rates and mortality are all over the map. We don't know how this organism will evolve in coming months. At present, its lethality is hovering around 50%. The 1928 flu had a mortality rate of about 3%. Truth is we don't know what, when or how many. But the consensus is that if it's not the current strain of H5N1 bird flu, we are looking ahead at a future where infectious disease is a certainty compared to terrorists strikes, which for the time being, couldn't come close to the devastation of a pandemic organism for which we have no plan in place.

As another reader has suggested, perhaps this is just the planet's way of returning to a balance of planetary abuse vs repair. Something has to change. Would that it were in human minds and hearts. If not, it will be in their respiratory systems, in empty homes in empty villages across a silent landscape. To some degree, the choice is ours. Our government has said in effect, 'bring 'em on.' Then done very little, very late.

For those genuinely interested in this topic, I've posted links before. They are not hard to find. I'm backing away from thinking I can raise awareness or effect change anywhere but here on Goose Creek. Then at other times, my staying silent while there's a very sick elephant in the room seems an irresponsible and cavalier attitude compared to the day to day blahblah I post on Fragments.

For starters, NewsNow newsfeed on bird flu will show you what's going on worldwide in this area.
http://www.newsnow.co.uk/newsfeed/?name=Bird%20Flu

A more science and public health based source is Effect Measure and links from there.
http://effectmeasure.blogspot.com/

Don't read the local paper and make judgements of this one. The public by and large has only seen the shadow of the tip of this iceberg. And we can still have that 30 minute discussion. Lunch Friday?

Sorry Fred but if Bill Frist told me the Capital of the United States was Washington, DC, I'd second source it. I know the man. I've interviewed him on numerous occasions and worked with him on some projects. I wouldn't trust him to treat a bunion.

The media is starting to buy into the story (as witnessed by the Sun article over the weekend and other reports I've seen). But will they inform or spread hysteria? That remains to be seen.

We have a difference of opinion here. It doesn't mean either of us is right or wrong. It's just that we see the situation from different points of view. You may convince me after I get your 30-minute lecture but from what I've read on the subject so far (and that includes the links you've posted), I'm not yet convinced. But then I'm a professional skeptic :)

Doug

Doug, you're a tough sell.

But then I've been watching biology for all the years you were watching DC politics, world conflict and SI Swimsuits, so that would make for a different perspective. Let's talk.

You should tape that conversation and release it as a podcast. I'm sure it would be fascinating!

BTW,consider this my request that you keep posting the Avian Flu news.

Susannah and others who profess the 'we're getting what we deserve' point of view:

Here's the conundrum:

Yes, we (the too-many we) have fouled our nest, pun not intended, by placing efficiency and profit ahead of public health considerations in high-density poultry management practices we have now exported across the planet. We've underestimated the role of wild fowl in spreading bird flu. We've created a system whereby a localized pestilence on one side of the world can appear the next day on the other--a mere jet flight away.

Yes, the opportunity for this mindless microbe (not even a microbe) to wipe out millions has more to do with the state of things in our times than malice on the part of the virus. We are the enemy, in that sense.

But as this great leveler of population (perhaps) approaches, is our choice to lay down our weapons, dig our own graves, crawl in and wait? Because if we do that with this one, we (those who remain) will be that much farther away from coping with the next one that WILL come, and the next. Population thinning is one thing, and not a pleasant one. Population extinction is yet another. I'd hoped we'd hang on for a few more generations, myself.

It's easy to have a 'bring 'em on' attitude (and also politically in vogue) from this distance in time (we think) from the potential misery some seem ready to passively accept. When the rubber meets the road, I fear we're going to be casting blame all over the place. Let's hope some of those pointing fingers don't turn back to us. My grandchildren's children could hang in the balance, and that sort of weighs heavily on me.

Remember that in 1918 most folks seldom traveled more than a day's ride from home. The morality was contained by distance and isolation. Now nations are inter-connected by air and thousands of trucks criss-cross the US, Canada & Mexico daily delivering fuel, food and dry goods.

Like the 8.0 earthquake that is statistically inevitable on the San Andreas fault at the bottom of my hill, there's not a whole lot I can do about it. I wrote and called everyone who could and they are only interested fattening their campaign warchests. Fat chance.

So I'll just have to do "Scarlett" and think about it tomorrow and hope indeed that tomorrow is another day.;^)

bj

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