MISSION STATEMENT
INLUENZA THREAT NEEDS A GLOBAL RESPONSE
© Influenza-Pandemic.com
A virulent form of influenza (identified as H5N1) is spreading across SE Asia with 195 potentially new cases in Vietnam. It has killed 113 (4/27/2006) people and may be mutating into a human to human virus similar to the 1918 influenza pandemic that killed over 20 million people world-wide. Researchers from the US Center for Disease Control (CDC) and World Health Organization (WHO) have been monitoring the progress of the virus in Asia with increasing apprehension.
There is still a great deal of uncertainty about the threat and impact but concerns among health officials have been rising and a Pandemic Summit of nations to finance a World War II type mobilization of resources may be the only solution if current fears are realized.
The March 21st news that there may be 195 new cases of avian influenza in Vietnam caused the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP) to conclude: "If many of the people test positive for the H5N1, it could mean that the virus is improving its ability to spread from person to person, thereby increasing the risk of a flu pandemic."
The H5N1 virus was first identified in Hong Kong in 1997 where several people died, but the mass slaughter of poultry seemed to have stopped the virus at that point. Since then, more cases have been recorded in SE Asia especially around chicken farms. A projection from researchers at WHO says that if the H5N1 virus were as virulent as the 1918 influenza virus millions could die world-wide, and possibly 1.8 million in the United States.
NO VACCINE
There is no effective treatment and an effective vaccine development could take 6-8 months to develop, although clinical trials of an H5N1 vaccine made by Sanofi Pasteur, Swiftwater, PA will begin shortly.
Right now the H5N1 virus is so virulent in birds that it is killing the eggs usually used for vaccine culture, leading to safety concerns and the need for ultra safe processing conditions in which to develop an effective vaccine. Vaccine producers are going to need more time and financial incentives to develop effective responses to the virus.
When vaccines do become available, production is limited to industrialized countries. Only a handful of industrialized countries in Europe, North America and Australia produce influenza vaccines and so a vaccine will probably not reach many countries in Latin America, Africa, and most countries in Asia without a major change in production, distribution and finance. One US producer, Chiron, makes its vaccine in Europe not in the United States, so that these supplies would have to be imported - assuming the European Union agrees.
WHO WARNING
In a chilling January 20, 2005 assessment, the World Health Organization said the threat of the new virus has many similarities to the 1918 influenza pandemic suggesting that deaths could be in the millions.
In 1918, at least twenty million died world-wide including 600,000 in the United States. At 2005 population levels, the proportion of deaths caused by a 1918-type influenza could rise 300% resulting in 60 million world-wide deaths including 1.8 million in the United States.
The WHO assessment says vulnerability is universal:"More relevant to preparedness planning is the fact that no virus of the H5 subtype has probably ever circulated among human beings, and certainly not within the lifetime of today's world population; population vulnerability to an H5N1-like pandemic virus is universal."
INADEQUACY OF CURRENT PREPAREDNESS
If the threat becomes a reality, nations around the globe may need to mobilize their economies into World War II type conditions focusing on the treating of millions of influenza cases and deaths and the need to maintain essential services for feeding, clothing and maintaining order. Richer nations may be asked to spend billions of dollars to fight a global war against the disease.
There is a limited supply of anti-viral drugs that should offer temporary relief to some people, but a Dutch study financed by the WHO suggests that the effect would be temporary and not stave off the virus indefinitely. The public may be misled into believing that these anti-viral drugs can provide an antidote.
In the United States, the Department of Health and Human Services has circulated a preparedness report, DRAFT PANDEMIC INFLUENZA PREPAREDNESS AND RESPONSE PLAN (August 2004), that places significant responsibility on state agencies to coordinate treatment and care.
The problem is that limited drug supplies from a handful of drug companies create the specter of panic demands for drugs, potential black markets as millions clamor for relief from paltry supplies and alternative supplies from potentially unsafe sources.
An estimated 40 million Americans lack health insurance and may run the risk of being barred from commercially run hospitals placing impossible demands on public health services.
Nursing shortages. Healthcare workers will suffer high mortality rates in a pandemic so that the ability of hospitals and clinics to provide care to patients will quickly deteriorate.
Healthcare shortages. Hospitals beds in the United States and other countries will quickly fill up resulting in a shortage of beds and nurses so that millions may be forced to care for families and friends without hospitalization and nursing care.
Order, distribution economic dislocations have been delegated to the Department of Homeland security, which has focused on terrorist attacks, not pandemics.
ECONOMIC CONSEQUENCES
Economic consequences would be equally severe:
Supply breakdowns. The US Department of Health and Human Services report warns that if truck drivers refused to deliver products to communities, deliveries of food, medicines, soap, milk and drugs may be disrupted.
Economic losses. A pandemic could cost the United States hundreds of billions of dollars, according to one government report.
Import restrictions. Already concerns are being expressed about textiles imported from Asia that contain chicken feathers that might contain the virus in pillows or down clothing, suggesting that imports from Asia might be subject to embargo with far-reaching results as health authorities seek embargoes to contain the disease.
Fuel and critical material shortages. Imports of fuel and critical materials such as steel products, electronics, autos and engines and parts could be disrupted or curtailed by influenza and resulting quarantines. The United States dependence on imports and foreign vessel carriers and mariners for these deliveries could result in a substantial curtailment in the event of a pandemic. Under such a scenario, the import dependant United States could be faced with an economic shutdown unless domestic alternatives are developed quickly.
Airline shutdowns. Temporary shutdown of air links with Asia would have serious repercussions to global air carriers possibly driving weakened carries such as United Airlines permanently out of business.
Global recession. Disruptions on supplies, economic and social uncertainties, health care shortages would contribute to an economic downturn.
A NEW GLOBALIZATION
A serious problem during the 1918 influenza was the reluctance of political leaders to recognize the threat early and take precautionary steps. In 2005 WHO and many governments including the US Department of Health and Human Services are preparing pandemic plans to aid countries in the event of a pandemic.
If the potential of social, economic and healthcare damage is high, it may require a World War II type mobilization to meet the needs for healthcare, law enforcement, essential services, etc.
A Pandemic Summit may be the only way to mobilize resources and public awareness so as to speed preparedness, allocate funds and provide direction to governmental agencies, drug companies, public health authorities and health care workers.
If an influenza pandemic is imminent the need for the globalization of financial aid, treatment and care creates an unprecedented challenge to industrialized and non-industrialized nations to work together for the common good. It's an unlikely scenario, but not impossible.
A.P.MARGARONIS
________________________________________________
© Influenza-Pandemic.com