Credit: AFP
This article is an extract from Panicology by Simon Briscoe and Hugh Aldersley Williams published by Penguin Australia at $32.95.
Face mask fallacy
Shortly before the Cellardyke swan made its final landfall in Scotland, a German cat was found to have contracted the disease; cat-owners were told to keep their pets indoors. One British newspaper was on the point of demanding that the government distribute face masks to the population until it was pointed out that they would actually be useless against the spread of the virus.
So, why such expansive coverage for a disease that had killed a little over a hundred people around the world in three years – about a quarter of the number who die annually in England from resurgent tuberculosis?
The main reason may be what the media habitually refers to as the 'spectre' of the influenza pandemic that struck at the end of the First World War, perhaps infecting as many as a billion people and claiming 60 million lives.
There have been human flu pandemics since – in 1933, 1950, 1957, 1968 and 1977 – but none as virulent as in 1918. Add to this the vague, residual fear that what we sloppily call 'flu' may not be simply the common cold that happens to be heavy enough to allow us to claim a few days off work but something altogether more serious.
Of course, the media thrives on the unrealised threat of mortal disease that could wipe out entire, well, readerships. Bird flu is just the latest of these – after SARS , MRSA and HIV/AIDS. But in the case of H5N1 flu, august public health officials have added fuel to the flames, pronouncing that a killer pandemic is "inevitable."
Epidemiologists merely use the word 'inevitable' to mean that 'there were several serious flu epidemic/pandemics in the 20th century, the virus is able to evolve into new forms against which we have no effective vaccine or natural immunity, and so there is no reason to think that the 21st century will be different'. Or, as the U.K.'s Independent newspaper shrieked, "We face a century of viral pandemics."
"Century of viral pandemics"
Now it is possible – just about – to make out that the twentieth century was a 'century of viral pandemics', although few would define it in those terms despite the devastating advent of HIV. There is no reason to think that earlier centuries fared better, and so none to think that the twenty-first century should not have its share of viral outbreaks too. The question is whether outbreaks will be more frequent or more severe to earn the century this label.
This kind of language is symptomatic of an old tendency to blame ourselves for visitations of pestilence. But here it has a modern dressing of anticapitalism. For author, Mike Davis, SARS and HIV were the "deadly by-product of a largely illegal international wildlife trade, intimately connected with logging and deforestation, which mortally threatens human health as well as regional biodiversity," while avian flu has prospered "in ecological niches recently created by global agrocapitalism."
The Independent's columnist Johann Hari echoes him, saying we will be "plagued by pandemics because of the new virus-friendly ecology we have created across the world." So it's all our own fault, then. It's our affluent lifestyles, our travelling, our migration to the cities that's doing it.
But it is clear that modern life is not mainly to blame. It is quasi-rural backyards with small flocks of chickens where people catch bird flu, not intensive poultry sheds. On the whole we enjoy better food and personal hygiene and experience less risk of picking up an infection from a non-human source than in the past. Even where the risk is still high, the solution through measures such as clean water supply is within our grasp if we are prepared to pay for it.
It is true that an outbreak today is more likely to be global. But sheer geographic spread does not mean that the virus responsible is uncontainable. The pneumonia-like Severe Acute Respiratory Syndrome (SARS) emerged in November 2002 Over eight months, it spread to 26 countries. In all, more than 8,000 people were infected, of whom 774 died.
Dangerous Journalism
This article "Bid Flu: A Dead Duck?" makes several points that lack proper evidence and, as presented as fact, prove dangerous journalism for anyone considering preparation for this disaster scientific experts deem as inevitable.
"The SARS episode now provides an exemplary case study of how a powerful virus spreads – and may be contained. For although SARS did rapidly kill three times as many people as avian flu has done, it was contained relatively efficiently by isolation and quarantine of those infected."
This article fails to note that SARS is not flu. SARS has 10 day incubation period where the victim cannot shed virus. Inversely, influenza only incubates for 3 days before showing symptoms. Worse, the virus can be spread before the end of the incubation period (without any visible symptoms). For this reason, planning for a severe flu pandemic must be vigilant not to rely on overconfidence from past successes.
"There are other reasons to worry less about bird flu. The media has repeatedly said that a pandemic is 'overdue' or even 'long overdue'. This claim is not based on any virological dictum, but simply on the historical pattern of outbreaks – one every 10 to 15 years or so from 1918 to 1977 and then a pregnant pause until now. But in fact the longer H5N1 'tries', the less likely it is to succeed in adapting into a human-transmissible type.
Some scientists now believe H5N1 has had its chance. A virus is not like a volcano, where pressure may build up gradually, leading to an eventual eruption. And a continued non-outbreak doesn't make a future outbreak more likely or more deadly. "
It would be helpful to readers to hear the scientific basis of this argument. Because non of the "experts" referred to earlier in the article as calling a flu pandemic "inevitable" have EVER said that "the longer H5N1 'tries', the less likely it is to succeed in adapting". This shows no understanding of viral mutation and even less respect for the journalistic obligation to inform the public truthfully about pressing current events.
I apologize if this seems harsh, but the duty of journalists to report earnestly on this issue is far too often pushed aside for soothing accusations of scaremongering against the international medical community and others who work to prepare our world for an inevitable public health emergency.
Sincerely,
Justin Kamen
jbk2108@columbia.edu
www.StudentsPrepAmerica.org
H5N1 -prepare for panflu year
This article seems to overlook both the facts that the individual cases, and, human clusters are being fought, (on more than one continent) however sloppily, at great expense, (including animal cull zones, movement restrictions, biohazard Level 3 PPE, and, major donations of Tamiflu - seemingly the only treatment keeping H5N1 from being 100% fatal, and, only if given rapidly at, or, for close contacts, before symptom onset, at higher/longer doses than for seasonal flu, because H5N1 replicates so fast and is so virulent) and, that nations are more and more turning to hiding their cases, in order to not increase those "official" statistics (and to avoid economic or travel consequences of reporting an outbreak)(especially in this Olympic year).
Indonesia, for instance, has been claiming people must test positive three times before being an "officially confirmed" H5N1 case; if they don't get Tamiflu in time, people die - but if they are on Tamiflu for about 3 days, it confuses the test, and people who tested positive on arrival but negative after treatment aren't added to the numbers. (There may also be pressure to report cases/deaths as other diseases with symptoms similar to H5N1.)
Many nations have figured out it is easy to not find anything by not looking for it, or, by doing the wrong test at the wrong time.
(What sorts of things get labelled "state secrets" when they have the "economic and political" consequences an H5N1 confirmation does?)
Remind readers to read the Individual's page under the plans/preparedness sidebar on the US pandemicflu.gov site that's been up since Oct 2005. Search out the "US State Dept H5N1 factsheet" that has said, since July 2006, that travellers should know they risk being stranded (by international or local movement restrictions, put in place by other nations, or, the US itself,) when pandemic breaks out anywhere, and, that the US embassies will not be providing any aid to citizens in the event of pandemic.
"Outsourcing" of essentials has created a huge national security risk, as Dr.Osterholm tried to bring to Congress' attention.
As Dr.Nabarro of the UN said, systems of trade, finance, and workplaces are interconnected, "and will not survive" the impact of pandemic on workforces.
We were all supposed to be making workable local preparations, since 2006, with every community having a Pandemic Preparedness Coordinating Committee, including "all" stakeholders in the process!
H5N1, like HIV, is not going away.
It is on so many continents, in so many bird and mammal species, it will keep mutating, and, swapping with other flu virii.
Each human H5N1 case they only know isn't pandemic start after they apply containment measures and see cases don't continue to appear.
We've already had our months of warning; once you know for sure pandemic has started, preparation time will have ended.
Take care of yourself; the state pandemic flu summits with HHS back in 2006 have not resulted in the feds/state/nor locals making any provision for you during a year or more of infrastructure disruptions, and something deadly and contagious before symptoms.
It is not true, as too many officials have said in private; "we can't tell the public, because there is nothing they can do".
For Community Pandemic Mitigation to be possible we need to be proactive, and use the warning science has given us, and, the time Tamiflu has bought us.
See GetPandemicReady.org and try not to be part of the problem.
We'd finally be better prepared for all other disasters and emergencies (which will still occur during panflu year, with far less aid possible) by trying to be better prepared for pandemic year disruptions.
The people back in 1918 were better prepared at home than the public is today. Let's go back as a society to valuing family preparedness.