Facing October

#183


While the summer of ’06 has been anything but slow, avian flu wise, the high season will soon be upon us. In previous years, H5N1 has all but disappeared from the radarscope during the summer. Not so this year, which may portend a busy winter.


While a pandemic may not be upon us right now, the folks who get paid the big bucks for worrying about such things are earning their keep. Pandemic seminars are being held almost every day somewhere in the U.S., and the general level of anxiety is high. It seems, after several years of deep denial, some folks are starting to take all of this very seriously.


Sadly, it was more fun when I was on the lunatic fringe.


As I write this entry, we are watching Indonesia closely. Again. Since last spring, this archipelago nation of 240 million people, spread across more than 6000 islands, has been front and center in the avian flu crisis. Their ability to control, or contain, any avian flu outbreak is severely limited, and they admit the virus is endemic in their poultry population. They now lead the world in human infections. And every day it seems, we hear of more people suspected of having the virus.


Right now, there appear to be 4 clusters of human infection. I say `appears’, because Indonesian officials have stated that it is impossible to say if these are H2H (Human to Human) clusters, and doubt such a determination could be made until there are thousands of human cases. Of course by then, it would be academic.


They, like the rest of the world, are hampered by inexact testing methods, a rapidly evolving virus, and the logistics of dealing with any outbreak. As we just learned from Thailand, one patient who died on August 10th had tested negative for avian flu 8 times, and it was only the 9th test, done on tissue removed from the lungs during autopsy, which produced a positive result.


This is the enemy we face. A deadly pathogen that hides very effectively. One that could, at any point, take off and spread like wildfire.


It is still possible that this virus will never make it to prime time. That it will never find the right combination of genes to turn it into an efficient killing machine. We can only pray that is true.


With October on our doorstep, the traditional flu season will soon be upon us. This is the time of year when seasonal flu (generally H3N2) and H5N1 become far more active. This is the most dangerous time of the year, when thinking about a pandemic. From now, until April or May or 2007, we must remain ever vigilant, as the virus could mutate and spread rapidly.


If that happens, we hope there will be some warning time, some small window in which people who haven’t prepared, can. I expect it will be a madhouse. People suddenly realizing that it is no longer a drill, but that we are facing the real deal, and scrambling to gather in supplies they will need. Those that haven’t prepared by then may find escalating prices and severe shortages.


Of course, preparing is a gamble. You could easily buy up supplies you will never need. The virus might not evolve this year, or even next. Preparing is like buying homeowners insurance. It’s expensive, it’s inconvenient, and it only comes in handy if your house burns down. But most of us would decline to have that big of asset go uninsured.


While the clusters in Indonesia may die down, just like they did in May, my sense of urgency is slowly quickening. Partly this is due to the cases that are being reported, and partly due to the change in tone of governments around the world. The mantra of `not if, but when’ is growing, as are admissions as to how little they can do to mitigate a pandemic, should one should occur.


With the mid-term U.S. elections a little more than a month away, the stock market teasing us with new highs, and gas prices finally dropping, no one has much appetite for throwing a wet blanket on our perceptions. The fact that some pretty heavy hitters are, should give us pause.


It is a pretty good indication how seriously they take this.


And a good reason for us to take it seriously, too.

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