The Migration Of Bird Flu

The H5N1 bird flu virus

 

The H5N1 strain of bird flu has spread across Europe, Africa and parts of Asia and killed nearly 100 people worldwide and infected about 180 since it re-emerged in 2003. Scientists fear it could evolve into a mutating virus, and gain the ability to jump easily from human to human, at which point it could trigger a pandemic, resulting in millions of deaths world-wide.

All influenza viruses mutate easily, and H5N1 appears to be no exception. We are unprepared, to say the least. Food health and safety (quarantine) barriers will loom larger than ever in world trade this year thanks to fears about the spread of this and other epizootic diseases.

The health care system is close to breaking point and we have no vaccine for the pandemic, which will bring us to that fateful breaking point. Besides, how are you going to immunize 185 million people, you can't do it! And the reason for having only two producers is that the regulatory burden has squeezed out most other producers

Spread of epizootic disease such as bird flu represents an enormous threat to markets because few governments manage them in a rational way based on a cost-benefit assessment of risk mitigation strategies. If this happens, which is likely by late 2006, we really are royally.....and even Iran and their crazy Thug-In-Chief President Mahmoud Ahmadinejad, nuclear threat will fade into insignificance. Well perhaps not quite....

The worries about bird flu are past the realm of "could be a threat" and have entered the phase of the ticking time bomb. Whilst we cannot see the time marker, nor do we know when it will go off in the USA, I am betting on Fall 2006, but it could come much sooner.

"The only reason nobody is concerned the Emperor has no clothes is that he hasn't shown up yet" Harvey V.Fineberg, President of the National Academy of Sciences' Institute of Medicine said recently of the world's efforts to prepare for pandemic flu. "When he appears, people will see he is naked".

The President @ a Press Conference in October last year:

I am concerned about avian flu. I am concerned about what an avian flu outbreak could mean for the United States and the world. I am -- I have thought through the scenarios of what an avian flu outbreak could mean. I tried to get a better handle on what the decision-making process would be by reading Mr. Barry's book on the influenza outbreak in 1918. I would recommend it. The policy decisions for a President in dealing with an avian flu outbreak are difficult.

One example: If we had an outbreak somewhere in the United States, do we not then quarantine that part of the country, and how do you then enforce a quarantine? When -- it's one thing to shut down airplanes; it's another thing to prevent people from coming in to get exposed to the avian flu. And who best to be able to effect a quarantine? One option is the use of a military that's able to plan and move. And so that's why I put it on the table. I think it's an important debate for Congress to have. I noticed the other day, evidently, some governors didn't like it. I understand that. I was the commander-in-chief of the National Guard, and proudly so, and, frankly, I didn't want the President telling me how to be the commander-in-chief of the Texas Guard. But Congress needs to take a look at circumstances that may need to vest the capacity of the President to move beyond that debate. And one such catastrophe, or one such challenge could be an avian flu outbreak.

Secondly -- wait a minute, this is an important subject. Secondly, during my meetings at the United Nations, not only did I speak about it publicly, I spoke about it privately to as many leaders as I could find, about the need for there to be awareness, one, of the issue; and, two, reporting, rapid reporting to WHO, so that we can deal with a potential pandemic. The reporting needs to be not only on the birds that have fallen ill, but also on tracing the capacity of the virus to go from bird to person, to person. That's when it gets dangerous, when it goes bird-person-person. And we need to know on a real-time basis as quickly as possible, the facts, so that the scientific community, the world scientific community can analyze the facts and begin to deal with it. Obviously, the best way to deal with a pandemic is to isolate it and keep it isolated in the region in which it begins.

As you know, there's been a lot of reporting of different flocks that have fallen ill with the H5N1 virus. And we've also got some cases of the virus being transmitted to person, and we're watching very carefully. Thirdly, the development of a vaccine -- I've spent time with Tony Fauci on the subject. Obviously, it would be helpful if we had a breakthrough in the capacity to develop a vaccine that would enable us to feel comfortable here at home that not only would first responders be able to be vaccinated, but as many Americans as possible, and people around the world. But, unfortunately, there is a -- we're just not that far down the manufacturing process. And there's a spray, as you know, that can maybe help arrest the spread of the disease, which is in relatively limited supply.

Aside from pledging $334 mil in the Global Fight Against Bird Flu, you can check here, as to what else the President is doing about it.

One of the important issues is how do we encourage the manufacturing capacity of the country, and maybe the world, to be prepared to deal with the outbreak of a pandemic. In other words, can we surge enough production to be able to help deal with the issue?

And the issue is of course so much more important acute today than in 1918 because of population dynamics. Whilst the President suggests reading Barry’s book, in 1918, the majority population lived on farms; now 80% of the population live in urban areas. Viruses of course love that, as they spread from person to person. Air-travel is also a huge contributing factor for causing earlier epidemics and more and more all year round incidents due to frequent travel crisscrossing the globe.

We also need to boost vaccine production. Unfortunately, I am told it's not so easy as to just ‘make more.’ This stuff has to be grown in egg whites for approximately 18 months for it to be a viable vaccine. Not to mention running into the problem we had in 2004, where the FDA only allowed vaccine produced by 2 different companies. It's not like “Generic Biotech INC.” can just start making flu vaccine. This is an instance where regulation shoots us in the foot.

As far as military quarantine, I think that with bio-terrorism, things like Ebola, and H5N1 flu, we seriously need to have quarantine plans in place that utilize absolutely all of our assets. But of course none of this will be in place until it’s too late to organize it in a civilized manner.

CDC is a Government site, where you can get a lot of information on the avian flu, also try Avian Flu What We We Need To Know, which is a daily blog and very informative giving a lot of links to information as well as updates, and lastly The Poultry Site, which also has a lot of the latest on the subject.

The Economist View and (no surprise here) ‘Avian Flu What We Need To Know’ authored by Tyler Cowen, Professor of Economics at George Mason University. Hugh Hewitt has been dutifully following all the information tracks and so has Glenn Reynolds @ Instapundit who gives constant updates. Another recommended read is the NYT's Has America finally woken up? There would of course be a Flu Wiki Blog!

Well that's five blogs out of, let's see 50 000 000. What do you think Tyler, impressive ratio? Give me another statistic please I am drowning here.

What is the Blogosphere waiting for? The update on the President's recommended read "Mr. Barry's book on the influenza outbreak in 1918"? Oh yeah......

Comments

[Washington]

Whilst it would be a disaster if a pandemic happened I just don't see it. I recall about five years ago there was an intense worry among scientists about the spread of Ebola, Marburg, et al because of airline travel.

It is part of the scientific paranoia that pervades our society. Global cooling-then global warming. Eggs, no eggs. Run, don't run. Take this drug-but wait!

Here in the states we legislate to death-OSHA is king. Kids riding bicycles look as if their off for war. It's an approach to life that prohibits risk-and one mention of bird flu, chicen flu, or a Wham! reunion and people get worried.

[gringoman]

Pandemic? One is here already: the pandemic of chatter. It's escalated far beyond a year ago when your gringo blogman posted a Russian doctor's assertion that bird flu may kill one billion people (alarmist enough?) (www.gringoman.us /10/28/04 ). The chatter pandemic has affected a billion of us already. It's much more evolved than it was even on February 02 this year(2005) when we posted The Specter of Bird Flu(www.gringoman.us )

Is this chatter pandemic un-founded, or ill-founded?......

from the early part of a gringo article posted last October, "Bird Flu: Why Panic?" (Clickable at sidebar for 'Other Posts.'

[Alexandra]

Jeff,

That's really great stuff there, do you have a post you wrote on this?

[Jeff Durkin]

For those who are interested in tracking H5, I would recommend the following sites:
WHO's AI site: http://www.who.int/csr/disease/avian_influenza/en/index.html
Flu Information Centre/Flu In China: http://www.flu.org.cn/
VLA Weybidge (Europe's main AI reference lab): http://www.defra.gov.uk/corporate/vla/
FAO (UN Food and Agriculture Organization): http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/special_avian.html

By the end of the month, the DoD is supposed to come out with its H5 reaction plan. If it is anything like what has come out of the UK (in which the military is pretty much assumed to be taking things over if the disease gets into the human population) or Australia (where they plan to seal the continent off) than I would assume that NORTHCOM will be taking control of response efforts fairly early on.

And, keep in mind, that H5 is already a serious global problem. The poultry and feed industries are losing billions of dollars and could be crippled. Poultry provides about 33% of global protein production and is a main source of protein and income for hundreds of millions. And, as was warned by the UNEP (http://www.unep.org/Documents.Multilingual/Default.asp?DocumentID=471&ArticleID=5235&l=en) the current pandemic could cause severe problems for the global biosphere.

In the event of a mutation into a form that is easily passed from person-to-person, whatever the mortality rate, chances are that the global economy will come to a halt for a six month plus month period, as vaccine development and production is ramped up. How long can US industries last without parts from overseas? Without oil from outside of North America? And, if we (the US, Europe, Japan, China, a few other places) only begin serial production at a minimum of six moths from the initial outbreak, how much longer for other areas of the world to start receiving vaccines? And how will the "developing" world handle being cut off from trade, food aid, and so forth for an extended period of time?

The cascade fatalities (from famine, civil disorder, the collapse of infrastructure support, the collapse of health care infrastructure. Our own government is projecting a 30 - 60 period, in the even of a widespread plague, before our health care system begin to fail. How much worse in countries where healthcare is marginal to begin with?) could outnumber those from the flu.

And, also keep in mind that if H5 moves into the human population, it will not remain a "static target." From what I have read, we could be hit with waves of H5 , each genetically unique, over a period of years.

Some of this is, obviously, a worst case projection. However, even the best case (a global avian flu, which causes mass die-offs and leads to the mass culling of birds) is going to have substantial economic effects and could lead to many more human deaths than the actual disease. This disease really requires a global effort, one that is still lacking.

In my humble opinion, of course.

[RL]

a good, helpful, and informative posting concerning the much-hyped avian flu over at the Cranach blog today,

cranach.worldmagblog.com/cranach/

it is my sincere hope and prayer that Mr. Yoshihiro Kawaoka and his team of scientists' research is right concerning this serious matter (jsonline.com).

consumerfreedom.com : )

[MarcH]

Alexandra,

Here are a few thoughts about this important and under-publicized issue (well done of you to write about it today).

1. Lielks summarizes (in his usual entertaining manner) a few realistic steps ATB readers can take to prepare for a possible pandemic @ http://www.jewishworldreview.com/0306/lileks.php3.

2. I don’t think that it is entirely accurate to suggest that the flu vaccine shortage of 2004 was due to FDA regulations preventing all but two companies from producing the vaccine (perhaps I misunderstood your point?). IMHO a bigger cause of the problem is that the regulated price structure for flu vaccines made it unprofitable for more companies to go through the FDA approval process. Also, I believe that at the conclusion of all recent flu seasons including 2004, excess vaccines were returned to manufacturers.

3. The problem of traffic in unapproved, counterfeit or otherwise contraband pharmaceuticals is a fascinating and serious trans-national crime problem which is only beginning to impact the U.S. There are publicly reported organized crime and terrorist connections. Acquisition of pharmaceuticals from outside of the U.S. regulatory system entails some risk.

4. I want to bang my head against a wall rather than write the following, but David Byron is correct in some of his comments on this issue. A more robust public health system would aid significantly in containing the damage in any future pandemic. (sigh) A broken watch is accurate twice a day.

[Darrell]

"American healthcare is far more expensive than comparable healthcare in other countries."

David, there is no comaparable health care in any other country. The only problem with the American health care system is the Socialism that has crept into the system, and the enormous cost of litigation. If Capitalism had a free hand, the US would have the lowest cost of advanced health care in the world. Absent litigation costs and price-fixing/anti-competitive edicts by the AMA, lawmakers, and other players in the market, American-trained Indian doctors are setting up advanced clinics in India, using refurbished American technology(MRIs, CT-Scanners, etc.) and delivering services at 1/30 the cost of their US practices. Maybe as a Brit, David, you can travel there and finally get that MRI without the 5-year wait from your NHS. No human being can ever match the decision-making capability of the Capitalist marketplace: We all make the correct decisions at the speed of light with every purchase we make and the market sets all the rest.

[Laurel]

Again David show me the facts. As a former military person the job of the military is to defend the United States not every individual collective. There is no way the military can defend every man, woman, and child. Again, personal responsibility.

US medicine is far from socialized. If you're talking about poor people going to the emergency room for care that can't pay for it - how is this socialized? Again, facts. I've been in the German health care system. Pretty good, but not the utopia you make it out to be. Again, facts.

It's apparent you believe socialism is better than capitalism. In reality it's only the people who make these 'isms work that decides if they are good or bad. And what socialistic country may we look at to guide us?

[DavidByron]

To depend on any type of government to "take care of you" during times of crisis is ridiculous.

Does that criticism apply to the military also?

Fact is many issues can only be dealt with collectively. In this sense capitalism is simply unworkable and all governments have to be socialist. Indeed if the issues could be solved without collective responsibility why bother having a government at all?

Now if you look at the old testament as a model here you see a system that was incredibly anti-centralised government but that didn't mean a lack of collective responsibility.

The nation of Israel was to have no king and no standing army. How "small government" can you get? No army and no chief executive. Instead local "states" (tribes) maintained militias which were led by "judges" who were apointed to take charge of the nation's armed forces only when a conflict demanded a national response.

But the nation had social security administered localy and funded by taxes (tithes) which were collected nationally (federally). The religious duties were also administered "federally".

In America the pretense at avoiding socialist solutions ends up just being an inefficient way of solving the same problems federally. It's just a way to ignore incompetency by the government. American healthcare is far more expensive than comparable healthcare in other countries. In America as with other countries you can get emergency healthcare even if you can't pay. But Americans love to pretend that isn't socialised healthcare. The difference is the American charade is inefficient and full of holes because nobody organises the collective response adequately.

That's not individuals taking responsibility; it's society being scamed and over-paying for a worse service compared to a better organised system.

[Darrell]

Poor, poor misguided Euro-Socialist ne'er-do-well, David! Capitalism isn't at fault for any vaccine shortages. The Left has removed profitablity from the equation. Allow a manufacturer to make a profit, and indemnify them against product liability lawsuits, particularly the kind with no basis in scientific fact, and you will have all the vaccine you'll ever need. Madame Hillary(1994 Vaccines for Children Program) took charge of the process in the US, setting prices below costs and refusing to protect manufacturers from future claims. And we are just reaping what she sowed.

[Laurel]

I do find it interesting that we don't have enough companies to produce a vaccine but, I'm interested in what is the plan?

Some questions to ponder are:

In case of a pandemic who gets the vaccine first? Older, younger, first responders, what is the plan?

Will it be like the gas shortage in the 70s? A - M go get your shot on Tuesdays..the rest on Wednesdays?

Are there alternative medicines that can help with the symptoms in order to fight this strain?

There needs to be a plan.

I disagree with David that a socialist government handles this better than a capitalist government. Where are the facts? Remember the heat wave in Europe a couple years back? I do, I was there. Thousand of people died because of heat. Of course this happened during August (European vacation time) so many medical personnel weren't available. Even Chirac didn't end his vacation to handle the problem.

To depend on any type of government to "take care of you" during times of crisis is ridiculous. You have to have some sort of personal responsibility. Of course, socialism doesn't foster any sort of personal responsibility. According to the flu experts, a viable vaccine can't even be made until the virus jumps from person to person.

To compare a flu outbreak with Katrina is also wrong. This was a natural disaster forewarned. The problem was the plan and the people who failed to implement it. You have to have a plan and competent people to implement that plan to save lives. I grew up around hurricanes - there is a natural propensity to stay because you think this one isn't going to be that bad.

[DavidByron]

Off topic: wanted to make sure Alexandra didn't miss this :)

[gringoman]

There are reasons to worry about a pandemic and reasons not to---as with the great coming of Y2K not long ago. gringoman.com laid out an alternate scenario on October 24, 2005. 'Bird Flu: Why Panic?' (Clickable under 'Other Posts'.)

[Michael (van der) Galien]

A week ago this issue was adressed on television here; experts told what the results would be if the variant of the bird flu humans could get, would overwhelm the Netherlands.

They made clear that we do not have enough vaccins. People will undeniably die. Who will receive the vaccin, and who will not receive it is a case of cold hard decisions.

[Semanticleo]

I'm just glad it's not another Muslim conspiracy.

Seriously, the two schools of thought wrangle over
it's similarity to the 1918 Flu and the absence of
antibiotics for the former. It seems the body's
own defense system causes a high proportion of healthy
young people to succumb (unlike the typical U curve where
the very young and very old have most fatalities)because
organ failure. Not that a weak immune system
will help, it's just that a strong one becomes worse than
the disease. That's pure speculation, but the only
explanation for high numbers among the 15-40 year olds.

[DavidByron]

The progressive blogs have covered this for years. Is it not so visible omn the Right? There are few blogs dedicated to it solely of course.

Probably there won't be a major pandemic with this strain ever. But if there is then it's likely to be the weakest link in the chain that fails -- some place like Nigeria maybe where it recently turned up. Some place where they don't have much of a defence. It will spread pretty much regardless of any quarantine attempt. There is no vaccine and no way to manufacture one even if one was invented. Medicine just doesn't deal well with viruses yet.

So this is a time bomb really. If not H5N1 then something else. Keep rolling the dice eventually you'll get snake eyes. But each individual threat is likely to pass without major event, reinforcing the "Oh, well be alright!" attitude.

The expected death toll in America is obviously much higher than any war or natural disaster. Let us pray it doesn't happen on the watch of Bush or some similar Republican administration whose philosophy of government is that the government should be small in competence and big in graft. This would be one thousand Katrinas.

But our odds are good.
For each individual threat.

Makes you wonder, doesn't it, why so many pretend that Iraq was a threat to America when this thing was known to be there and known to be likely to kill millions of Americans and far more people worldwide, possibly precipitating economic collapse as a side effect.

It also shows the failure of the capitalist system. Why is there no manufacturing base for vaccine production? Why are the techniques ones that Edward Jenner would instantly recognise? Because there's no money in vaccines. Capitalism doesn't care about helping people or protecting society. It's just about the bottom line. It's more profitable to be defenceless against H5N1 than to be prepared, so that is why you are defenceless. Socialist Europe is in a much better situation. However desease and pandemics are by their nature a collective defence issue. It will be the weakest link that counts the most and that will be some poor war striken nation perhaps in Africa. Ironically it might even be Iraq --- because their health care has been all but eliminated under the American occupation. Often their water supply is the open sewer. Desease doesn't respect international borders -- far more so than terrorism.