H5N1 assumptions, the good, the ugly, and the who knows

Today Crof and Fla_Medic each covered an editorial from The Australian, Australia unprepared for epidemic, their excellent offerings notwithstanding, I would also like to comment.


Given the magnitude of international air travel and the likely length of the asymptomatic incubation period of any new influenza virus, which would certainly exceed the time taken to fly between any two points on the earth’s surface, it is highly likely that the entry of a new virus into Australia is almost unstoppable.

Professor Peter Curson of the Centre for International Security Studies at the University of Sydney has recently highlighted the difficulties facing traditional quarantine measures in an age of mass air travel.

If, however, the first case arriving in Australia is detected and isolated in time, there is still a chance that an epidemic on our continent can be prevented.

The current H5N1 virus has been known so far to have infected at least 385 people around the world, mostly in Asia, and the death rate — despite all modern available treatment, including all the currently available vaccines and antivirals — is approximately 63 per cent.

If and when a pandemic next occurs, if the new virus retains the same pathogenicity of the current avian influenza virus, we can expect about 4 billion people to die in the world over a six-month period. And that is how long it will take for a truly protective new vaccine to be developed and produced.

And the virus will be no respecter of wealth or class or education or intellect. In fact, if it behaves like past influenza viruses, it will not spare any age group. Even physical fitness will provide little or no protection.

I have frequently bemoaned the inability of many to understand and admit, or just to understand, that a pandemic from an genetically avian A/H5N1, but adapted to enable sustained human-to-human transmission, does not have to behave as 1918′s H1N1 pandemic strain.  I have bemoaned it so often that recently I created a brand new category, [Poverty of aspect], to tuck these frequent moans into.

I am going to be somewhat lazy, actually not lazy per se, but bone weary from a blisteringly stressful week at my “day job”, and point those who have not seen my brief comment on Crof’s post to two of my previous posts.  They lay out some of why I believe Dr. John Graham, the Australian editorialist, might be closer to a correct assumption than those who believe 1918′s pandemic is as bad as it could possibly ever be.  Please note: “Closer to correct” doesn’t mean I’m saying he IS correct, only possibly closer to the measure.

Vindication-of sorts, and Vindication-of sorts II.

No one knows what the next pandemic will offer humanity, whether it will be a relatively “non-event” such as 1968′s or whether it will be a beast beyond our current imagination, we just don’t know.  Dr. Graham doesn’t know, our officials don’t know, our most renowned and well-respected virologists don’t know, and I certainly don’t know.

We can only attempt to understand the future by what we DO know, even though that is pitifully lacking.  And, what we DO know at this point in time, and A/H5N1′s epidemiological profile, is that it is a DIFFERENT beast, the likes of which we have never seen before.

Interestingly, at least to me, is our collective willingness to believe, without question, assumptions based on a past event, an event that is for the most part only understood via assumptions and empirical data, over data coming out of our current labs underpinned with our greater scientific and continually evolving understanding.

If we heard about the full range of potentials for an H5N1 pandemic Dr. Graham’s editorial wouldn’t be so shocking to our sense of reality, instead, we could judge his words and opinions on what he bases them on, the science as we know it at this moment in time.  That “science” says it may, just may, be possible that billions would die.


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