Friday, February 18, 2005

Pandemic precautions

'Sleepwalking to disaster' screams the UK Daily Mail, shocked to find the UK government has not made preparations for a possible pandemic of bird flu. The disease is becoming endemic among poultry in eight Asian countries and has led to over 50 confirmed deaths in humans. However, new findings suggest that the disease may be even more common in humans, as the symptoms can be more varied than first thought, which means some cases are missed. The danger is that the virus could merge with an existing human influenza virus, becoming considerably more contagious to humans while also proving deadly. Yet the UK government has no plans to buy vaccines or anti-viral drugs.

'Bird flu threatens to be the most serious world pandemic since Spanish flu killed some 50million people around the world in 1918-19', writes the Mail's Geoffrey Lean, arguing that the government's inaction is 'nothing short of a scandal'.

Bird flu has been around for some years now, including a major outbreak in Hong Kong in 1997. Yet it has never resulted in many human cases, and the vast majority of these have been as a result of direct infection from birds to humans, rather than human-to-human. Since most people in the UK do not live in close proximity to poultry, such transmission in this country is almost impossible.

The assumption is that we are 'due' another pandemic. But while it is right and proper for the authorities to monitor the situation in Asia, and to continue attempts to eradicate the infection in birds, whether a new form of virus comes into being is otherwise largely out of our hands. What we can say for certain is that conditions in the UK are very different to those in Asia, and to those that existed in the shattered society after the First World War.

There is no vaccine for this 'super flu' - you can't produce a vaccine for a virus that doesn't exist. The options open to the government are vaccines for similar strains to the one that might emerge, which might be of no use at all, or anti-viral drugs which have been shown to be effective but are expensive and would be needed in very large quantities. With overstated alarm on one hand, and no obvious solution on the other, 'wait and see' is almost certainly the best policy.

What we can say is that in other ways, we are much better prepared for a pandemic than in the past. The SARS outbreak showed the value of tracing and isolating those who have come into contact with infected people. And acute health facilities are much better. For example, life-support didn't exist in 1918.

The biggest danger, as also illustrated by SARS, is that the fear of disease can cause more damage than the disease itself - with serious consequences for economies in Asia and beyond. A measured approach, with well-placed experts keeping an eye on the situation while continuing to research the treatment of those already infected with the existing virus, makes far more sense than serial scaremongering.

Sleepwalking to disaster, Daily Mail, 18 February 2005

He who pays the piper... just about the worst argument against scientific conclusions ever drawn. True, ever scientific researcher comes to their subject with a whole bunch of values. That's why we have scientific debate, to try to sift opinion in such a way as to overcome individual subjectivity or sectional interest. The modern argument, as illustrated very well in relation to the climate discussion, is that if you get any money from any group or company with an interest in a particular outcome, you've effectively been bribed to say something untrue. Healthy scepticism and cynicism are quite separate things.

This article by Dick Taverne illustrates the dangers in this trend: | Research | Careless science costs lives