Monday, July 04, 2005

Pandemic possibilities

'Bird flu experts warn of pandemic', says BBC News, reporting on a conference of health officials and researchers in Singapore. A relatively new strain of influenza, H5N1, has infected millions of birds in southeast Asia over the past few years, and there have been 54 deaths where humans have contracted the disease. The fear is that influenza viruses mutate very easily and a strain could emerge that is far more infectious to human beings. Since this potential new strain does not actually exist yet, no vaccine can be prepared. Nor can we know how effective anti-viral drugs will be.

World Health Organisation (WHO) regional spokesman Peter Cordingley told the BBC that rich nations appear complacent about a human pandemic. 'We don't know what the fatality will be. We can expect it to be very high. There will be enormous economic dislocation. Stock markets will close, international travel and trade will be limited.'

While nobody can rule out the possibility of a pandemic in the future, it is better to examine what we actually know about H5N1. Between December 2003 and June 2005 there were 108 cases reported to the WHO, of which 54 were fatal. While H5N1 is a major problem for farmers in terms of livestock losses, it is a mere blip in terms of human disease. The human cases that have occurred have been the result of the peculiarly close relationship between animals and humans in rural communities in the countries affected, most notably Vietnam.

The gloomy predictions of a human pandemic are speculative, and depend on the creation of a new virus. New human strains of influenza do emerge from time to time, but there has been no major pandemic since the 'Hong Kong' flu of 1968-69. It seems wrong, therefore, to assume that another major outbreak is inevitable in the next few years. Certainly, the comparisons with 1918, when 50million people may have died, seem utterly misplaced. At that time, Europe was dislocated and weakened by four years of war, and developments such as intensive care and anti-viral drugs had not been made.

As numerous disease scares in recent years have shown, most notably with SARS, fears of devastation run way ahead of the actual problems caused by illness. In the end, fewer than 1000 people died from SARS. The 'economic dislocation' was caused by the hysterical response to these cases. Our age has an ill-defined sense that disaster could strike at any moment - what the late Susan Sontag termed 'Apocalypse From Now On'. The possibility of new and nasty diseases keys into that fear. Ironically, this is especially true in the West, where serious infectious disease is now relatively rare.

As Dr Michael Fitzpatrick points out elsewhere on spiked, 'in practice, raising the alert over flu will do little to change any of the conditions that encourage the global spread of the virus'. Instead, it will create unnecessary fear, economic hardship and diminished resistance to authoritarian measures. There is plenty of room for sensible preparation for a possible pandemic, but ominous statements from health officials about the risks of avian flu are likely to do more harm than good.

(First published on spiked's Don't Panic page.)