- The theme of the person awaking from a deep sleep or
coma to find a world utterly changed is a popular one in science fiction.
From John Wyndham's book The Day of The Triffids through The Omega Man
to the recent film 28 Days Later, the trope of the man arising from his
hospital bed to find that nothing is as it was has become well-worn.
-
- That's fine - as long as it remains just a story. But
if - when - a flu pandemic comes, and millions of people die around the
world over a period of months, the reality will be one of two alternatives.
It's either going to be like those films, with videoconferencing suddenly
all the rage, local farm produce making a big profit, empty supermarket
shelves (you have to ship the oil, and distribute the fuel, but can the
Armed Forces really do all that?), tumbleweed blowing in the streets, a
medieval attitude to anyone not from "around here".
-
- Or else governments will impose a police state that will
make all the ID cards and airport checks look like a tea party. You'd not
be allowed to move anywhere without showing off a vaccination certificate.
(Sure, you'd get those on the black market, and they'd cost more than £300,
but would you really want them? If you're not vaccinated would you really
want to travel among people who might be carriers?) Or it might be both
at once.
-
- One more thing. You might well be one of those millions
who die in such a pandemic. If you travel to work on public transport;
if colleagues in your company travel by air to Asia; if you're travelling
abroad through a busy airport. You'll probably touch someone or share air
with someone who's infected. The premise of Terry Gilliam's Twelve Monkeys
will become reality.
-
- You may think this is overblown. But discussion of the
possibility of a flu pandemic has fallen out of the news. And as the security
consultant Bruce Schneier says: "One of the things I routinely tell
people is that if it's in the news, don't worry about it. By definition,
'news' means that it hardly ever happens. If a risk is in the news, then
it's probably not worth worrying about. When something is no longer reported
- automobile deaths, domestic violence - when it's so common that it's
not news, then you should start worrying."
-
- The risks posed by an outbreak of flu passed from chickens
in the Far East, in coutries such as Vietnam and Thailand, burst into the
news in February. But now they've passed out of the news. Since then we've
had more important things, like the Crazy Frog ringtone, to concern us.
-
- Time to worry. And the scientists are. In fact, they're
edgier than I've seen them since the BSE outbreak was in its earliest days
and people were wondering if it might pass to humans. Quite a few scientists
stopped eating beef at that point. Oh, you didn't know?
-
- Now, their reaction is to write papers and watch what's
happening, very closely. If you read the scientific journals (we do, so
you don't have to) the articles are piling up. Last week the journal Nature
pulled together an entire online resource on the threat of avian flu.
-
- That's the trouble with scientists. They get an idea
into their heads - CFCs and ozone, carbon dioxide emissions and the greenhouse
effect, the transmission of BSE to other species such as humans - and they
worry away at it until they determine what the answer and the mechanism
is.
-
- Here's what's they're worrying about now. The First World
War killed seven million people. But the strain of flu that followed it
- incubated, experts reckon, in pigs that were kept near the front lines
to help feed the troops - killed up to 100 million, helped by the movement
of troops returning home from the war.
-
- Pandemics come around, on average, about every 70 years
or so. There were small ones in 1957 and 1968/9, when "Hong Kong flu"
- strain H1N1 - spread around the world, and one million died. That was
tiny by pandemic standards. The scientists reckon we're overdue for an
infectious, fatal strain of flu, one which can pass from human to human
by the usual methods - sneezing or contact.
-
- There's already a deadly strain of flu around - "chicken
flu", better known to the scientists by the strain of flu virus that
causes it: H5N1. But it only passes from chickens to humans, not from from
person to person. If it could do that, it would have the potential to turn
pandemic.
-
- But maybe it already can. There have already been a couple
of cases of deaths from H5N1 where the only logical pathway is human-to-human.
The UK government announced in February that it will buy in thousands of
doses of Tamiflu as part of the UK Influenza Pandemic Contingency Plan.
-
- Too bad - the latest results suggest that Tamiflu isn't
effective against H5N1. And anyway, New Scientist reports, the UK's order
for 14.6 million five-day courses of Tamiflu treatment will take its patent
owners Roche two years to fulfil. The company is still trying to develop
ways to synthesise it from scratch.
-
- The consequences of a really big, fatal flu epidemic
on modern society are hard to imagine, partly because they're so enormous.
Air passengers would be the first vector of infection, followed by the
people who travelled with them in the train or Underground train or coach
from the airport, followed by the family and friends of those people. Give
it a few days and people would be falling ill, then over the next weeks
dying.
-
- If the strain is new and unexpected, there wouldn't be
time to produce enough vaccine to treat it. According to a New England
Journal of Medicine article by Dr Michael Osterholm of the University of
Minnesota in Minneapolis - who is also director of the Center for Infectious
Disease Research and Policy - titled "Preparing for the Next Pandemic",
the 1950s-era methods of producing vaccines means we would need (ironically
enough) one chicken egg per person to produce the vaccine, plus six months
to culture it.
-
- "The global economy would come to a halt, and since
we could not expect appropriate vaccines to be available for many months
and we have very limited stockpiles of antiviral drugs, we would be facing
a 1918-like scenario," notes Dr Osterholm, who calculates that given
current technology, we could vaccinate about 500 million people, tops -
about 14 per cent of the world population.
-
- Of course, most of those will be in the developed world.
But are you sure you'd be one? Are you in the Armed Forces? Do you or your
business count as an essential service? If you're not involved with the
electricity, water, fuel distribution, phone or gas industries, then probably
not. "And owing to our global 'just-in-time delivery' economy, we
would have no surge capacity for health care, food supplies, and many other
products and services," Dr Osterholm adds.
-
- Let's have some more numbers from Dr Osterholm, just
to encourage you. He writes: "It is sobering to realize that in 1968,
when the most recent influenza pandemic occurred, the virus emerged in
a China that had a human population of 790 million, a pig population of
5.2 million, and a poultry population of 12.3 million; today, these populations
number 1.3 billion, 508 million, and 13 billion, respectively. Similar
changes have occurred in the human and animal populations of other Asian
countries, creating an incredible mixing vessel for viruses. Given this
reality, as well as the exponential growth in foreign travel during the
past 50 years, we must accept that a pandemic is coming - although whether
it will be caused by H5N1 or by another novel strain remains to be seen."
-
- All this has been noted by virologists and disease experts
around the world. But what can we do? For one thing, listen to what they're
saying, and put some pressure on the politicians who are ignoring this
threat, in the hope it will go away. Climate change may be a greater threat
than terrorism, but a flu pandemic is a more immediate threat than either.
-
- Or, as Canada's deputy chief public health officer, Dr
Paul Gully, put it to the Toronto Star: "Frankly the crisis could
for all we know have started last night in some village in Southeast Asia.
We don't have any time to waste and even if we did have some time, the
kinds of things we need to do will take years. Right now, the best we can
do is try to survive it. We need a Manhattan Project yesterday."
-
- Let's hope they got started. Now, where's the number
of that forger for my vaccination certificate?
-
- © Copyright 2005
-
- http://www.theregister.co.uk/2005/06/02/bird_flu/
|
