Here's an interesting
op-ed story from the SF Chronicle:
THE WAR ON HYPE
The deadly terror lurking around the corner may not be such a big, ominous threat after all
Since James A. Lewis is director of the technology and public policy program for the Center for Strategic and International Studies in Washington, this sounded interesting. After all the smallpox vaccination program for civilian heath care workers was a complete failure (23 page .pdf):
Three key failures are responsible for the continuation of this serious gap in biodefense:
- Sufficient resources were not allocated nor requested in time for public health agencies to properly implement the program, leaving state and local agencies without the funding to manage vaccinations without cutting other health services.
- An adequate compensation plan to compensate volunteers who may suffer side effects from the vaccine was not in place when vaccinations began
- Healthcare workers, first responders, and the public at large are not persuaded that smallpox is a serious threat that warrants participation in a limited vaccination program.
But I was rather surprised to find avian flu at the top of Lewis' hype list, even though homeland security issues fill the rest of the article (as they should), and avian flu is not amongst this fellow's expertise.
From Lewis' editorial:
Americans receive a steady stream of warnings and alarms about new and horrific perils that await them. Pandemics, dirty bombs, cyber attacks, bioterror and other exotic threats are always on the verge of being unleashed onto a shamefully unprepared republic. Yet, judging from statistics on life expectancy, violent deaths and war, we live in much less perilous times than any generation before us.
Avian flu, for example. We are cautioned that a pandemic on the scale of the 1918 Spanish influenza outbreak, which cost hundreds of thousands of lives, is only months away. One World Health Organization estimate says 2 million to 7 million people will die in the next pandemic. But it is not 1918. The WHO reports that since 2003, there have been 152 cases of avian flu, resulting in 83 deaths. A flu pandemic has been regularly predicted since 1997 and (knock on wood) it has never arrived. (my bold)
It's true that it's not 1918. In fact, our just-in-time technology is far more vulnerable now than in 1918, and global travel is far swifter. These two factors alone increase pandemic consequences enormously, even for a mild pandemic. And our medical system can not cope with a pandemic because it would be overwhelmed with patients. Medical improvements compared to 1918 are irrelevant if there's no room at the hospital, and 30% less staff to care for you, or no gowns, gloves, and medicines.
"There's no way to get people to take precautions without frightening them," Sandman said.
What is likely to lead to panic is giving false reassurance, he said. "When you mislead people, when you overreassure people, they feel abandoned--because they are," he said. That's what happened in the United States during the flu pandemic of 1918 and during the SARS (severe acute respiratory syndrome) outbreak in China in 2003, he added.
"People panicked because the government was telling them there was no SARS," he said.
"People are much better able to handle a crisis when they are told the truth" and "treated as adults."
Sandman goes on to say:
However, there is danger in overplaying a threat as well as in false reassurance, Sandman said. He zeroed in on the oft-repeated statement, "A pandemic is not a matter of if, it's a matter of when."
"That's true of a pandemic; it's not true of a severe 1918-like pandemic," he said. "In that case, it's if."
He added, "Just as overreassuring people backfires, alarming people in ways that won't last, that won't stand up to investigation, backfires. There's an unknown probability of a pandemic of very high magnitude."
Arnold Monto, a preeminent epidemiologist and flu expert at the University of Michigan School of Public Health puts it this way (from a webcast on 1/24):
"Most of us believe that the probability of an H5N1 pandemic is low but real and because it's real and would have enormous consequences, active and vigorous response is necessary".
H5N1 is one nasty virus that many people are tracking. But despite careful language, no matter what we say, any posting on H5N1 will attract posters levying the charge of 'fear mongering'. Or that Rumsfeld stands to make millions because of tamiflu investments (it's true, but irrelevant).
I think Sandman is right. Treat people like grown-ups and tell them the truth. Every expert who studies this virus is extremely concerned, and even those like Monto, or Peter Palese from Mount Sinai, or Ian Lipkin from Columbia, or Anne Moscona from Cornell, or Robert Webster from St. Jude (all eminent in their field) who think the chances of this virus going pandemic are low, also think (like Monto) the chances are also real and the consequences are enormous.
Now what would a grown-up do with that information? Not write articles like Lewis did, IMHO. The better way, the grown-up way, is to keep informed, and consider whether your own personal disaster preparedness plans are up to speed. And that's what we intend to do.