Marc Siegel repeats a number of myths in his article about Bird Flu.
1.) The myth that the below-average number of pandemics we have seen is somehow related to reductions in squalor or other advances in public health. Former WHO Director of Plague Control, Carlo Cipolla, demonstrated that the incidence of plague is not related to these man made factors.
2.) The myth that ignoring a potential epidemic is the best way to prepare for it. This is particularly unwise since the Bush administration maintained this same view for too long, leaving not enough time remaining to stockpile sufficient antivirals and vaccine, in the event of a H5N1 pandemic.
3.) The myth that "the current H5N1 avian influenza virus has not mutated into a form that can easily infect humans." The re-sequencing of the 1918 flu virus has revealed that: the H5N1 virus is both very similar to the 1918 virus; and needs only minor changes to facilitate high transmissibility from person to person. The 1918 bird virus was so very deadly precisely because it was not very similar to flu virus more commonly seen in humans.
Viral reproduction is very sloppy, essentially buying millions of new lottery tickets every day. It seems highly plausible that a winning virus will be found within the next couple of years, at the outside.
If H5N1 becomes a pandemic Marc Siegel will write a new-improved article claiming that the millions of deaths which resulted from an insufficient supply of vaccine and anti-viral drugs was unfortunate but "unforeseeable" -- well at least unforeseeable by some.
It is now clear that the 1918 virus was seeded through out the world during the five or more years which preceded the pandemic. Two years before the pandemic, a small number of people around the world died of "extreme poor health" or "pneumonia". A number of these deaths have now been confirmed as early 1918 flu deaths, based on sequencing preserved pathology samples. After these early deaths, the pattern of death suggest that the virus mutated into a highly transmissible form -- in several different locations around the world, within a short period of time.
The history of H5N1 since the first human case in 1997 has, not surprisingly, followed this same pattern.
I assume the chance of a Bird Flu pandemic is higher than 5%. Based on this I found it wise to purchase Tamiflu, the only influenza anti-viral currently in short-supply. If Relenza, Amantadine or other anti-virals begin to experience supply problems, I will purchase those as well.
. |
