June 16, 2005 -- U.S. health officials and infectious disease experts have been sounding the alarm for more than a year on the deadly potential of a widespread pandemic of the bird flu troubling Southeast Asia.
But their warnings have become unmistakably ominous as they struggle to convince the public and policy makers of the need to prepare for the mass casualties, chaos, and devastation that will likely result if the disease spreads across the world.
As of June 14, 103 people have been infected with bird flu in Vietnam, Thailand, and Cambodia, according to the World Health Organization. Officials yesterday also disclosed the first reported case in Indonesia.
Normally, 104 cases of any disease would hardly grab the attention of public health experts. But bird flu is different. More than half of the cases have been fatal, suggesting an unprecedented level of harm for a modern flu. Humans have no natural immunity to the virus causing the disease, known as H5N1, and no vaccine is available.
In congressional hearings and on television, officials have repeatedly advised the public of the potential for millions of casualties if bird flu gains the ability to easily spread from birds to people or between humans themselves.
Bird Flu Warnings Get Stronger
But the warnings have now become decidedly darker as officials warn of a catastrophic economic shutdown and a global political crisis if bird flu strikes an unprepared world.
"This is much larger than a public health threat. The vast majority of the world just doesn't get how vulnerable we are," says Michael Osterholm, MD, associate director of the National Center for Food Protection and Defense in the Department of Homeland Security and a former bioterrorism advisor to the Bush administration.
Federally run tests of an experimental bird flu vaccine are under way and due to yield preliminary results later this summer. Even if it's effective, no one expects manufacturers to be able to quickly make enough to protect the U.S. population.
Osterholm complains that U.S. officials and companies have not planned for the widespread logistical disruptions that would result if bird flu were to spread within the next couple of years. His warnings range from inadequate planning for hospital overcrowding to the fact that the U.S. market has only 2.5-week supply of caskets.
Local and federal agencies have not planned for widespread disruptions to schools and workplaces as the public is told to stay home and gymnasiums are converted to emergency medical facilities, he says. Travel restrictions and a run on vital supplies, such as masks able to filter flu viruses, would "no doubt" lead to an economic shutdown, he adds.
What to Do?
Asked at a Thursday forum hosted by the Council of Foreign Relations what can be done to immediately prepare for a bird flu outbreak, Osterholm says there's probably little we can do at this point.
What can the U.S. do to prevent the continued spread of flu from billions of Asian chickens and ducks? "The bottom line message is: almost nothing," says Osterholm, who is also a professor at the University of Minnesota.
World Community Unprepared
Others offer equally stark warnings that the U.S. has not engaged foreign governments over how nations will react in the event of a global pandemic and economic standstill. Poor and middle-income governments have already begun to complain that they are being left out as industrialized countries make deals to buy stockpiles of antiflu medications, says Laurie Garrett, the council's senior fellow for global health and a former journalist.
"We have no agreed-upon mechanisms of any kind," Garrett says. "This could turn into a big, bloody mess."
Bush administration officials told lawmakers two weeks ago that they are hard at work completing a national flu response plan governing issues such as quarantines, hospital capacity, and distribution of emergency pharmaceuticals.
Anthony Fauci, MD, director of the National Institute for Allergy and Infectious Diseases, acknowledged in an interview that officials' public statements about bird flu have become unusually stark. He attributes the warnings to concerns over bird flu's apparent harm and to the lack of human immunity.
Officials are also trying to galvanize support for new laws that would give pharmaceutical companies incentive to produce large amounts of vaccine against bird flu and other more common types of flu. "That's the thing that we keep trying to drill at," he says.
Fauci says that "the administration is very much up there" in its level of activity in flu planning.
Meanwhile, other experts remain largely unconvinced.
Steven Hoffman, an audience member at the Council forum, rose to say that the experts' stark warnings had convinced him "to get in my car and move to Montana or something."
"It won't help," Garrett told him.