“If liberty means anything at all, it means the right
to tell people what they do not want to hear.”

- George Orwell

The article also reported that the U.S. government is aware of the threat:

Bush administration officials have been talking about pandemic flu preparedness for years, and they say they will soon release a pandemic flu plan, in the works for more than a year. Senate Democrats say that the administration is not doing enough, and they are writing their own bills that call for more spending and coordination.

President Bush this week asked the leaders of the world's top vaccine manufacturers - Chiron, Sanofi-Aventis, Wyeth, GlaxoSmithKline and Merck - to come to the White House on Friday to discuss preparations for pandemic flu, said people with knowledge of the meeting who insisted on anonymity because the White House has not yet announced the meeting.

The research on the 1918 virus is directly applicable to current concerns, Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, and Dr. Julie L. Gerberding, director of the Centers for Disease Control and Prevention, said in a joint statement. "The new studies could have an immediate impact by helping scientists focus on detecting changes in the evolving H5N1 virus that might make widespread transmission among humans more likely," they said.

In a related story, the Strib also looked at the potential impact of such a pandemic in Minnesota with projections of as many as 20,000 deaths within a short period of time:

If the dire predictions of an influenza pandemic come true, Minnesota's health officials expect 1.25 million state residents to become infected.

In a matter of days, a surge of patients would overwhelm the hospital system. State government officials and hospitals, using emergency powers, would sort patients through triage, even moving them among regions of the state.

Still, each hospital bed in the state would have as many as five patients waiting to fill it, according to Minnesota emergency preparedness officials.

An estimated 20,000 people would die. And it would all happen in four to eight weeks.

Read the rest of the article to learn more about the plans that are being put into place to deal with this. The paper also had a sidebar about an upcoming international conference on coordinating responses to an outbreak.

News of this potential pandemic has already appeared on CNN, Fox and other outlets due to recent announcements from the WHO and the U.S. Centers for Disease Control (CDC). The numbers sound incredible and therefore might be easy for most people to dismiss, especially in a time where we've come to expect that we have a pill for just about everything. Here, however, are some of the salient points I learned from editing the afore-mentioned article (which is scheduled to appear in the April issue of Risk & Insurance magazine).

- Historically, pandemics sweep the globe roughly every 30 years or so. The deadliest in more recent times was the 1918 Spanish flu that killed a reported 20 to 40 million people, although recent analyses suggests this number could have been as high as 100 million. The 1957 Asian flu and 1968 Hong Kong flu pandemics "only" killed approximately two to eight million each.

- The bird flu, a strain known officially as H5N1, is already present in Southeast Asia, but currently is only communicable to humans via direct contact with infected birds or animals. Even so, however, 28 of the 43 people who have been contracted the flu have died. For a pandemic to start, H5N1 must first mutate into a form that can pass from human to human (a not uncommon transition in the virus world).

- What's known about H5N1 so far shows it is very similar to the strain of virus responsible for the 1918 outbreak in its structure and the way it attacks the human body. This strain attacks the immune system by turning it against itself, resulting in chain reaction shut downs of critical functions leading to death, often within 48 hours.

- The smaller death tolls of the 1957 and 1968 outbreaks were more a result of different, "less" virulent strains – and not necessarily due to more advanced medical treatment.

- If you look at Department of Health and Human Services statistics of the infection rate, mortality and demographics in the U.S. from the 1918 outbreak, and then update it for today's population and density you get the 1.7 million number over an 18 month period. Even more startling is that this strain hit hardest among the healthiest. If the same proportions hold up, 50% of the deaths would come from the 15-44 year old age group - not the very young or very old as commonly happens. This group are also the ones who, when first coming down with symptoms, are most likely to think "I can shake this off" and continue to try to go about their lives, infecting others.

- The single best way to prevent influenza is get a flu shot each year. However, because the normally circulating influenza viruses are constantly under going slight genetic changes (i.e. antigenic drift) we need to make a new influenza vaccine each year. It typically takes approximately 8 months from determining the new strains of virus to include in the vaccine and actual final production of vaccine.

- Currently on a worldwide basis, there is only industry capacity to produce about 330 million doses of vaccine each year (even if you know in advance which strain to prepare for). To increase this capacity will take major investment and a number of years.

You may know that it wasn't a coincidence that the 1918 pandemic occurred during World War I. The high degree of mobility between troops being sent back and forth from one part of the world to another, plus the number of refugees, helped spread the disease throughout port cities and population centers.

Would you say that, today, the world population is more mobile or less mobile than 1918? Are our population centers larger? And, say, didn't we just have a big to-do this flu season about the shortage of vaccine for this year's garden variety influenza?

If the bird flu does make the jump to human-to-human transfer the mortality is likely to be stunning. Beyond that, however, is concern about what will happen economically and socially. The insurance losses alone will dwarf anything that happened because of 9/11, for one. Also, think about what happened to the Toronto economy when SARS broke out there a couple of years ago. Travel was banned. People were afraid to go out, even for work or to shop for groceries.

What will the airlines do if travel is either prohibited by government decree or by personal fear? What would be the effects on business if even healthy workers stay home? What would the political fallout be like for governments thought to be unprepared?

Again, I don't go looking for these types of stories. It just turned out that what I believe to be credible information fell into my hands at a time when I happen to have a blog. I thought long and hard about which is more irresponsible: for me to share this information or to keep quiet. My hope is that this will spread awareness, not panic.

I encourage you to look into this further on your own. The information isn't that nebulous or hard to find. You can visit these WHO and CDC sites, or "google" the topic or Dr. Osterholm. By all means, come to your own conclusions.

At the least I think you'll find this subject is food for thought - and prayer.

Update:

For those who have access to the on-line Wall Street Journal or the print version, check out today's (March 4) Page One for this article . It describes how poor countries such as Cambodia, that may find themselves on the frontline of an avian flu pandemic, may be the least equipped to identify and respond to the threat.