Thursday, March 23, 2006

The Coming Pandemic

Three years ago I purchased a DVD recorder – a must for every serious watcher of The Soprano’s (HBO’s) and Swiss Tony (BBC). Now the only thing I record religiously is Charlie Rose (PBS) – the best in depth conversation show on television. Rose, a former lawyer, is well read and traveled, genuinely interested in the world and is very engaging. His interviews are in depth, thorough and yet are compelling, most of the time.

Today, he looked at the bird flu (H5N1) threat. He had a range of people, but asked Sir Paul Nurse (Nobel prize winner, President Rockefeller University) to help him push the debate with Peter Palese (Mt Sinai), Julie Gerberding(Director, Cenre for Disease Control), Laurie Garrett, Harvey Fineberg, Michael Levitt (Health Secretary, US Government) and David Nabarro (now senior UN official). Here is what came up:

  • Some 50-75m could die if this thing takes off, though to date just 96 people have died (out of 165 infected) – this is about the same level of death as occurred in the very early stages of the 1918 pandemic (in 1918 50m died, as far as we know, with 700,000 deaths in the US).

  • We don’t know infection rates, death probability or speed of transmission about this new bird-flu virus. If these were the same as 1918, then 150m or more could die under the most optimistic scenario. Right now, though, there has yet to be a case of human to human transfer.
  • Not all bird species react in the same way – chickens die in larger number than ducks, for example.
  • We don’t know if the virus will move to human : human transmission.
  • We don’t have an antidote that is effective against this virus.
  • It may be fast developing in Africa as a killer, given that many have weakened immune systems due to HIV/AIDS (yet, no one with HIV came down with SARS).
  • Don’t get sucked into this being imminent – it could take some time.
  • The key is to build effective surveillance, public health plans and speed up vaccine production and to engender a strong sense of personal hygiene.
  • The economic consequences could be very serious – communities struggling to operate normally, when a significant portion of their peers are ill or dying.

My previous impressions have been that there is a lot of fear mongering going on. This show didn’t do this. It was a serious, calm and not Oprah like exploration of the issues. So now, wash your hands and keep an eye on the news.

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