American Enterprise Online | 11.29.05
By Alan Dowd

If the experts are right, it’s only a matter of time until a new strain of avian flu known as H5N1 mutates into a virus that is easily transferable to humans and spreads like a wildfire across the planet. Because it is a new flu strain, humans have little or no immunity built up against it. And because we live in an increasingly borderless world, it has the capacity to make its way around the globe rapidly, far more rapidly than any flu strain we have known.  

Together, these factors serve as the key ingredients for a pandemic that could claim 2 to 7 million people, according to the World Health Organization.  

“This is a nasty little beast,” as Dr. Sarah Archer explained during a recent roundtable at Sagamore Institute for Policy Research (SIPR). Archer, who is a public health expert and an associate fellow at SIPR, notes that previous influenza pandemics have claimed millions, including hundreds of thousands of Americans. A 1968 outbreak killed 34,000 Americans and 700,000 worldwide; a 1957 flu claimed 70,000 Americans and some 2 million worldwide; and of course, the worst of them all, the 1918 pandemic, killed 40 million people, including half-a-million Americans. President Bush has noted that even typical flu strains annually kill up to 36,000 people, hospitalize another 200,000 and cost $10 billion—in the United States alone.

This new strain, first discovered in 1997, has infected just over 130 people; but it has killed about half of those infected. Moreover, it has decimated bird populations, causing “the largest and most severe outbreaks in poultry on record” according to the World Health Organization.  In other words, this is no typical 24-hour bug.

The good news is that public health experts around the world are more prepared than ever before—and have been far more effective at convincing policymakers of the seriousness of H5N1. The twin facts that cases are being reported quickly and that governments are seeking ways to collaborate to head off a super-flu are evidence of global readiness. Indeed, for all its gaps, the global early warning system for diseases is acting in ways unimagined prior to previous pandemics. For example:  

• The US government is investing $7 billion in prevention and preparedness. To brace America for this new flu, Bush is activating a multi-pronged strategy that includes a nationwide information campaign, beefed-up detection, better coordination between US agencies such as HHS and the Agriculture Department, better information sharing with multilateral organizations such as trade associations and UN sub-agencies, development and stockpiling of antivirals, mass-vaccinations for “frontline” personnel, and early intervention overseas to prevent a rapid spread inside America. (Even in the war on viruses, there’s a place for preemption.) Bush is also calling on local governments and the private sector to establish “an ethic of infection control at the workplace,” including ways to ensure that work functions and business activity continue even if workers cannot report to the workplace. Plus, the CDC is developing special contingency regulations to monitor and, if necessary, quarantine incoming travelers with avian-flu symptoms.
• The Thai government has enlisted some 800,000 village-level volunteers—one for each community—to watch for signs of the new flu in animals and humans.
• Even the Chinese government, after a pathetic response to SARS in 2002-2003, is dutifully reporting outbreaks of the flu among its poultry populations. By mid-November, Beijing had confirmed and reported its first human cases.
• Leaders from the Asia-Pacific Economic Forum (APEC) put avian flu at the top of their November summit agenda. Likewise, EU leaders have huddled for emergency meetings on how to handle and control an outbreak.
• The WHO is serving as a clearinghouse for incoming information on cases and outgoing information on preparedness and best practices. 

Even so, there is a fine line between pandemic preparedness and pandemic panic. As BusinessWeek reported this month, avian-flu panic is spreading across Europe. One British newspaper headline promised that “Bird flu will hit Britain and kill 50,000.” France has ordered 200 million medical facemasks. Poultry sales have dropped off by as much as 40 percent in Europe. Italy has blocked poultry imports from the Balkan region; other countries could follow suit. Britain is weighing a permanent ban on all bird imports other than poultry. The EU is banning birds and poultry from any country where bird flu has appeared. (That includes, by my unscientific count, China, Kuwait, Vietnam, Indonesia, Russia, Mongolia, Thailand and Cambodia, plus an avian-flu variant recently found in Canada.)  

“The answer is not panic,” according to Archer, “but preparedness.” In other words, this is no time to cocoon ourselves at home. Yet Archer and other public health experts concede there is not much a typical American can do to prevent or prepare for this looming pandemic.

The best we can do, it seems, is what our parents taught us: wash our hands, get plenty of rest, take our vitamins and eat right. But even though the experts say H5N1 can’t be spread via cooked poultry, I suspect my doctor will understand if I pass on the chicken-noodle soup this winter.