If Occam’s Razor ceases to exist a year from now, it will not be because I will have lost interest. It will be because I am dead. Dead of avian flu, the bird flu that is wreaking havoc in Southeast Asia, has already infected humans and now has migrated to Turkey.
Until today, I was concerned but not really on edge. I can read terrible stories about massive death and destruction but still feel relatively safe in my cocoon. Hurricanes happen to people along the coast. At most, those of us who live here in Northern Virginia have to worry about flooding from a hurricane. Earthquakes like those in Kashmir that killed tens of thousands of people? It could happen here, but it is not very likely. I am far away from major fault lines. Could I become a victim of terrorism? Possibly, but it is not very likely. I do not work in Washington D.C. anymore. I do not take the Metro. I either hop in my car or bike the three miles to work. As gruesome as it sounds, if suitcase nuclear bombs were to go off downtown, at least I am outside of the likely blast zone.
Yes, I could contract cancer, have a stroke, die suddenly in a car crash, or develop some other terrible disease that could fell me early. While I would not wish an early death on myself (or anyone), I would feel better about dying from something conventional like a deadly heart attack than from contracting a virulent form of the avian bird flu.
The Washington Post, perhaps American’s scariest newspaper, printed this article on page A-2 of today’s newspaper. Many of us have heard about the 1918 flu that killed millions of people in this country. As awful as that was, this avian flu could be much, much worse. How much worse?
“This is a nation-busting event!” warned Tara O’Toole, CEO of the University of Pittsburgh Medical Center’s Center for Biosecurity. Speculating that 40 million Americans could die — that’s about one in eight — she warned: “We must act now.”
“We and the entire world remain unprepared for what could arguably be the most horrific disaster in modern history,” inveighed Gregory A. Poland of the Mayo Clinic and the Infectious Diseases Society of America. Somebody in the audience sneezed, and Poland added: “The clock is ticking. We’ve been warned.”
It was hard to top that, but Constance Hanna, an occupational health specialist, tried. “Let me paint you a little picture,” she began. “Twenty to 30 percent of your employees don’t show up to work . . . schools are closed . . . transportation systems are curtailed or shut down . . . Critical infrastructure will or may fail: food, water, power, gas, electricity.”
If that is not enough to get your heart to skip a beat while sipping that café latte, it only gets worse:
“Suppose the pandemic comes next year,” she said, and “a year and a half from now, next winter, you’re thinking about today. You were one of the lucky ones: You got sick but you recovered and now you have immunity against the pandemic strain. But one out of four Americans was infected, one of four people sitting here today, and half of them died.” Some people looked around: There were about 200 in the room, so about 50 would get the bug, and 25 would die.
“Death rates approaching this order of magnitude are unprecedented for any epidemic disease,” contributed O’Toole.
This was difficult to top, but Poland tried. “I want to emphasize the certainty that a pandemic will occur,” he began. “When this happens, time will be described, for those left living, as before and after the pandemic.”
Humans have already caught the Avian Flu. Of those who caught the Avian Flu, the mortality rate has been over fifty percent. What has kept it from turning into a pandemic is that the virus has not mutated into a virulent form that easily infects humans. However, this virus has already mutated into many deadly forms. It would not be surprising if it did mutate into a form that kill millions or billions of us.
What to do? Clearly we need to develop a vaccine, produce it in mass quantities and give it to every man, woman and child in the country. There is one big problem. The vaccine we develop for today’s version of the flu, if we can make it at all, may be ineffective on a newer, mutated, virulent form of the flu. In addition, there is another problem. The cost of the vaccine would be $5-$16 billion. That is not exactly pocket change.
Our president thinks he is on top of the situation. He is pondering using the military to quarantine parts of the country that might pick up the disease, an option that is probably illegal under current law and probably impossible to enforce. Moreover, he has our public health officials talking with international health officials to come up with strategies for dealing with the threat. These are necessary steps, but they should have been done years ago. Instead, as usual, we largely ignored the problem.
What we have not seen so far is much understanding from our public officials acknowledging the seriousness of the threat. Imagine what life would be like if we lost ten percent of our population. Imagine if one in eight Americans died from this pandemic. Imagine if you survive at all, whether your spouse or children would survive. Imagine trying to get them to a hospital to find that they are overwhelmed with flu cases. Just like in New Orleans, when you need help there may be none available.
For the survivors, the world would be changed dramatically. Not only would millions of people die, it is not even clear if survivors could maintain their current lifestyle. A flu of this magnitude would effect everyone. Would there be enough doctors and nurses left to care for the living? Would food be able to get to market? Would there be enough people to keep refineries working? Would civilization as we know it collapse? Would we devolve into a brutish anarchy?
I am no public health expert but it is long past time to blow the claxons. We need to sober up our elected officials very quickly, and we need them to act intelligently. We should be developing a vaccine to protect against the current form of the disease. It may or may not work against a virulent form of the flu, but it is better than doing nothing. It might cut the mortality rate. In addition, of course we need to monitor the spread of the disease carefully and its mutations.
Even if we had perfect knowledge, there are no guarantees. The virus will likely be able mutate faster than we can develop strategies to deal with it. We cannot trust to luck, but we may have to. There may be no place on earth untouched by this pandemic. If we do not know how the citizens of New Orleans or Kashmir feel then we may all soon have similarly profound experiences.
Up next, Isaac Weisfuse, the New York City deputy health commissioner, provided some logistical fears to add to the medical ones. “We’ll be inundated,” he said. “We have no [antiviral] Tamiflu. We have no vaccine. . . . There is no cache of respirators.”
There was little left unsaid for speakers lower in the program. Jeffrey Levi of George Washington University prophesied a panic of “millions and millions of people” trying to get antiviral prescriptions filled. Hanna struggled for superlatives: “We haven’t even begun to conceive of, to understand, to comprehend what that may mean for our workplace.”
That was ominous, but it did not approach O’Toole’s apocalyptic fervor: “uniquely virulent . . . hospitals will be quickly overwhelmed . . . this time of peril . . . quarantine is not going to work.”