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Thursday, September 22, 2005

Muted Applause? Huh?

Let me tell you that a global influenza pandemic freaks me out more than any run-of-the-mill oil depletion scenario. But I can only try to avoid my gaze from the stuff weaving through the web for only so long.

I have tended to follow what local epidemiologist Dr. Michael Osterholm has said over the past dozen years ever since I read about his fondness for marathon swimming events. (Something about people like skeptic Dr. Michael Shermer and his marathon biking exploits, environmentalist/author Bill McKibben and his marathon X-C fascination, and others leads me to believe that pushing the edge physically transfers subliminally to intellectual achievement) So when I read the transcript of a recent Osterholm lecture, I hope he has just slipped into rhabdomyolysis of the mind from overexerting his imagination. I swear the kind of nightmares that Osterholm plays out can race through your mind when your body starts to bonk after a dozen hours into a marathon sporting event.

An epidemiologist understands probability and statistics better than your average Joe. So when Osterholm said this:
I want to leave you today that the risk of a pandemic influenza event is 1. It is going to happen. It is not *if* it is going to happen, it is when and where and how bad. And that I think has to be the understanding we have today as we talk about this issue.
my heart sinks like a stone. Not knowing epidemiology very well but understanding the mathematical significance of this statement, I can either hope that his reputation doesn't suffer that much when it doesn't pan out, or pray that this pandemic comes to pass with a whimper rather than a bang.

Finally, let me just conclude by saying "“what do we do?"

I think frankly from my perspective, we Pray, Plan and Practice.

If Katrina taught us nothing else, it's not enough to have something on paper. It's also something of much greater magnitude than just that chessboard step. It's the whole game we've got to figure out in advance such as the private supply chain.

It's not a matter of if, it's when and where. Am I telling you it will be H5N1? I'm not. I think it will be but no matter there will be more pandemics. If we can't stop Tsunamis, Hurricanes and Earthquakes we surely can't stop pandemic influenza either.

Lack of international political will and support right now: Most of the world doesn't get this.

I have to tell you that as much as our own government has done, we don't understand, that this will make the catastrophic events of the past weeks, pale in comparison. At a minimum assuming we will have virtually no vaccine for 6-8months and supplies remain limited. And our best analysis maybe 1 and half per cent of the world will have access to vaccine within the six months. But even if our country had that luxury, the global economy will still collapse.

And finally I think that given the viral characteristics, the epidemiology we are seeing, we have to understand that there is more than just a passing resemblance between the 1918-20 experience and the current H5N1. There really is a model here we have to look carefully at.

We can't be surprised if the Levees break here. And I'm afraid that as a World we will be.

We have to understand these are the implications, this is what we are facing. And if we do nothing else we have to plan as if "what if this is tonight, what if it is one year, what if it is five years from now". And we need to move all three of those together.

Thank you very much.

[muted applause]

Osterholm says that money will not provide an immediate solution, but I have to ask: Where do I donate?


Professor Anonymous Anonymous said...

".. the risk of a pandemic influenza event is 1". That's right. We have every year at least one pandemic influenza. A few people even die in consequence. In fact the epidemic is always present somewhere in the world. So we cannnot even speak about risk but about a fact.

The last really bad worldwide influenza was 1918 -1919. It did kill a lot of people but at that time the deaths were seen to be connected to the war time malnutrition etc. New reasearch has shown a connection between tuberculosis (lung tuberculosis was very widespread in Europe that time) and influenza deaths. Most patients died from pneumonia and other after effects of the influenza, as today.

11:36 PM  
Professor Blogger JMS said...

My grandfather told stories of being forced to stay indoors for months, and watching the coffins roll by outside. He was about 7 years old.

I think I've been avoiding giving h5n1 too much mindshare because I just don't know what to do about it.

Not a healthy response, in any case.

1:11 AM  
Professor Anonymous Anonymous said...

I just don't know what to do about it.

Start developing the habits of handwashing, not sharing eating utensils/toothbrushes with loved ones, stock up on the N95 masks, tamiflu, perhaps a forced air resperator (this one I actually have for other reasons), Spray disinfectants.

If you want to 'grow' your own 'protection' - do your own research on what polypore mushrooms cause what effects.

7:39 AM  

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