Guest Post by Thomas McKelvey Cleaver
As a child of the Fifties, I was acutely aware of the flu, since my mother was certain to march me over to Dr. Scott’s office around Halloween to get that sharp prick in my arm as he gave me a flu shot. Back then, it was entirely possible to end up catching the flu as a result of the shot, but whether that happened or not, every year Mom took us to get the shots, and it became a ritual I have followed in most of the years since.
Mom had good reason for her diligence. She was a survivor of the Great Flu Pandemic of 1918 She was just past her third birthday when the homesteads in the San Luis Valley of Colorado were first hit, yet she remembered how the family in the next farm all died – mother, father, three children – over the course of a weekend, and how her mother decreed no one would leave the farm until it was over. The family subsisted on the food her mother had canned in harvests previous, and they thanked God there was a well on the land.
Some 20-40 million of Mom’s fellow residents of Planet Earth weren’t so lucky. With a planetary population of only about one billion as of 1900, the Flu Pandemic of 1918 ranks with the Black Death of the 13th Century as one of the great disasters of human history. Comparable numbers now would be 80-100 million dead.
My great-uncle Jim McKelvey, First Sergeant of an artillery battery of the Missouri National Guard commanded by a future President, remembered that the unit was pulled out of the Meuse-Argonne Offensive in late September due to the fact that over half the men in the unit had been hit with the “Spanish Influenza” as it was known. Indeed, the 1918 pandemic may have had as much to do with ending The Great War as the Allied Offensive that began that August, when troops on both sides of the trench lines fell victim to the disease in those crowded conditions.
We tend to forget, in our technological age, that microbes have likely had more effect on the development of human history than all the armies in all the wars of recorded history. 700 years ago the Black Death came to a Europe devastated by the Hundred Years War and denuded of cats as a result of the Catholic Church’s war against the old religion of Europe (known to the good Fathers as “witchcraft”). The Norway rat and its fleas – which carried the Plague bacillus from the Middle East to the ports of Europe and then across the continent – were the effective destroyers of the Middle Ages as the surviving lords in the manors suddenly had no serfs to bring in the harvest because the countryside was overrun with the disease-bearing rodents due to the priestly-created lack of an effective predator. The resulting loss of belief in religion that came from the Church’s inability to deal with the disaster led to both the Renaissance and the Reformation.
It’s happening again, folks. In place of a gaggle of religious ignoramuses killing off the “familiars” of the “witches,” we have the governments of the planet unable in the face of a building disaster to marshal the necessary resources. The result may have an effect on our global society as profound as that which Europe experienced in the Black Death. As the New York Times put it in early July:
If a much-feared pandemic of avian influenza starts sweeping through the world’s population anytime soon, neither the United States nor international health authorities will be prepared to cope with it. There is not enough vaccine or antiviral medicine available to protect more than a handful of people, and no industrial capacity to produce a lot more of these medicines quickly.
What is a pandemic? It’s not just an unusually bad version of the flu that appears each winter. Pandemics are caused by highly contagious strains of virus to which people have no immunity, that arise from chance scrambling and recombination of an animal flu virus and a human one, which results in a strain whose molecular identity is wholly new.
In the last century, pandemics occurred in 1918, 1957 and 1968. There appear to have been four flu pandemics during the 19th Century: in 1833, 1836, 1847 and 1889. Purely on a statistical basis, the fact it’s been nearly 40 years since the last one suggests the time for a new one may be near.
Remember the flu emergency last fall? I sure do. She Who Must Be Obeyed and I were in line at our local Sav-On for the shots when they announced there was a shortage and asked younger folks to leave the line. Fortunately, my status as Auld Phart allowed me to stay in line and get my shot, and SWMBO told them she had an older relative she would be caring for on a coming visit. We got our shots. Fortunately for all, the flu season wasn’t as bad as it might have been, but just take the scare that happened in October and November – with people traveling from county to county here in greater L.A. and being willing to stand in line for more than 8 hours for chance to get a shot – and multiply that by a factor of 100,000. That will be what life will be like during the Great Pandemic of 2 – – -.
The little dark clouds are spreading and getting bigger. Distant thunder could be heard last month when the Russians revealed their first outbreak of avian flu in eastern Siberia. The wild flocks summering there will be leaving next month for the warmer climates of Western Europe, the Middle East and North Africa, undoubtedly bringing the flu with them as they wing their way west as they have since time immemorial.
A major front page report on July 31 in The Washington Post details how unprepared we are.
Public health officials preparing to battle what they view as an inevitable influenza pandemic say the world lacks the medical weapons to fight the disease effectively, and will not have them anytime soon.
Public health specialists and manufacturers are working frantically to develop vaccines, drugs, strategies for quarantining and treating the ill, and plans for international cooperation, but these efforts will take years. Meanwhile, the most dangerous strain of influenza to appear in decades — the H5N1 “bird flu” in Asia — is showing up in new populations of birds, and occasionally people, almost by the month, global health officials say.
If the virus were to start spreading in the next year, the world would have only a relative handful of doses of an experimental vaccine to defend against a disease that, history shows, could potentially kill millions. If the vaccine proved effective and every flu vaccine factory in the world started making it, the first doses would not be ready for four months. By then, the pathogen would probably be on every continent.
“The only reason nobody’s concerned the emperor has no clothes is that he hasn’t shown up yet,” Harvey V. Fineberg, president of the National Academy of Sciences’ Institute of Medicine, said recently of the world’s efforts to prepare for pandemic flu. “When he appears, people will see he’s naked.”
If you don’t think a pandemic like this won’t affect every part of society, think again.
In hopes of slowing a pandemic’s spread, public health specialists have been debating proposals for unprecedented countermeasures. These could include vaccinating only children, who are statistically most likely to spread the contagion; mandatory closing of schools or office buildings; and imposing “snow day” quarantines on infected families — prohibiting them from leaving their homes.
Other measures would go well beyond the conventional boundaries of public health: restricting international travel, shutting down transit systems or nationalizing supplies of critical medical equipment, such as surgical masks.
Did I mention they’re not sure surgical masks will be effective, even if people have enough of them to wear them and know how to dispose of them properly so they don’t spread the disease further?
Michael T. Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, says that such measures as described above would fall far short. He predicts that a pandemic would cause widespread shutdowns of factories, transportation and other essential industries. To prepare, he says, authorities should identify and stockpile a list of perhaps 100 crucial products and resources that are essential to keep society functioning until the pandemic recedes and the survivors go back to work.
What he’s talking about is an economic meltdown that could bring on a worldwide Great Depression that would make the Thirties seem like good times.
Why not just make more vaccine? Not easy:
About 300 million flu shots are made worldwide each year. The vaccine protects against three flu strains. If the global production capacity were directed to make only H5N1 vaccine, the output could be 900 million shots.
Unfortunately, virologists are almost certain people will need two doses about a month apart to mount a successful immune response against a wholly new strain such as H5N1. That would cut the theoretical number of recipients worldwide to 450 million. If each shot requires a larger-than-usual amount of vaccine to work, the number will be even smaller.
Can the world produce more flu shots? Not easily.
Because nearly all flu vaccine is made by growing the virus in fertilized chicken eggs, special factories and a steady supply of eggs are required. Consequently, a key element of pandemic planning is getting more people to get yearly flu shots, which will give companies a larger market and an incentive to expand their plants.
Around the world, flu vaccine production has risen by just one-third in the past decade. New plants in Brazil, South Korea and the Netherlands will boost global production by an additional 25 percent in the near future.
So, while we focus on a coming civil war in Iraq and its political fallout here at home, the birds keep flying around the world. When this comes – and the only question is “when,” not “if” – there won’t be enough vaccine produced in time and there won’t be sufficient antivirals to at least reduce the intensity of the infection because we didn’t pay enough attention to the problem two years ago.
The Presidunce may be reading about The Great 1918 Pandemic between brush-clearing photo ops down at Prairie Chapel Pig Farm, but BushCo is too interested in important problems like teen abstinence and eliminating Social Security and saving Karl Rove from doing time in the can to focus on this coming catastrophe.
How are lower taxes going to save us when we’re confronted with a world-wide pandemic?