Fear over H1N1 swine flu has subsided after climaxing late last week, when we didn’t know what to expect. On Wednesday, the pandemic threat level rose to 5 just before my flight from Oakland to New York. Several passengers sported face masks during the tense ride.
But as my co-blogger already described, the atmosphere in New York City the next day felt unexpectedly calm. Residents clamored about their days normally and Chris and I quickly forgot any anxiety we arrived with. A few days later I find myself in Boston, and he has already hit DC and Pittsburgh. Life goes on, and the planet continues to turn with barely so much as a wobble from the flu.
At this point, the early analyses suggest the new strain is relatively mild. For terrific coverage of the disease without spin, visit Aetiology and Effect Measure. In short, it appears that maybe we got lucky this time. Still, H1N1 also reminds us of the possibility of a dangerous global pandemic. Sure, it’s the stuff of media porn, but the threat is very real–even with 21st century medicine and technology. The swine flu scare demonstrates that it’s nearly impossible to predict new strains of the flu virus. But we’re also not helpless when it hits, and the worldwide focus should now switch to strengthening our preparations.
In today’s era of globalization, we need to have the resources in place to deal with a pandemic situation as it arises. We must make sure to have the capacity to generate a domestic supply of the associated vaccine as quickly as possible. (Note: This also involves mitigating the present climate of media-propagated fear surrounding vaccines). Furthermore, it’s vital that honest information regarding any new virus be made available to the public as quickly as possible, in a clear manner as possible to avoid widespread panic. Easier said than done.
Fortunately, it now appears that perhaps the H1N1 swine flu was mainly a drill. So folks, do you think we’re ready for the real test?
May 4th, 2009 at 11:37 am
Let’s get recursive. Let’s think of our arrangements for responding to a pandemic as an immune system at the level of society. Our biological immune systems are immensely complex, but they do have two basic components: alert and response. I think we’ve done a good job of creating an alert system that’s relatively more sensitive than the body’s. However, our response system seems slower than the body’s: it takes so long to build up the response (vaccines) that we have to manufacture them in advance and stockpile them.
This suggests to me that we should dedicate some effort to building faster response systems. I’m sure that the CDC is all over this problem. We are fundamentally limited by the reproductive rate of the virus, but I wonder if we couldn’t engineer a generic viral body that we could then spike with the appropriate surface proteins to combat a particular virus. Does anybody know the state of research on this approach?
May 4th, 2009 at 11:48 am
Ready? No. But let this be a wake up call.
May 4th, 2009 at 12:04 pm
One concern, as I understand it, is that a more virulent form of this swine flu could return in the fall. I believe this is what occured in 1918.
May 4th, 2009 at 1:46 pm
I think we’re as prepared as our current technology can allow. Erasmussimo’s breakdown is apt: our alert phase is pretty well developed now. I work for a provincal health department in Canada, and our system is the one that recently identified the crossover of the flu into some pigs, as well as kept track of all the (so far mild) cases that have sprung up in our region. Working in the administration charged with alerting the populace, I’d say our system is as decent as you can hope for. But until there’s a way to create a vaccine faster than the virus can finish killing (should a powerful enough strain emerge), our reaction abilities are going to come up woefully short. So ready? Probably not, no, but definitely better prepared than 1918.
May 4th, 2009 at 4:41 pm
For anyone ineterested in the biggest disease epidemic of all time- the flue pandemic of 1918- I would stroingly recommend John Barry’s great Pulitzer Prize winning volume on the topic.
May 4th, 2009 at 5:09 pm
Eric: I’d heard the same about 1918′s relatively moderate spring version. I think the biggest difference between now and 1918 is that I assume we’ll have people working over the summer to come up with a specific vaccine.
Given the effort put into predicting the likely strain(s) each year when developing the standard flu shot, It’d be rather silly not to target this one as part of that effort.
May 4th, 2009 at 7:16 pm
Sheril,
I am absolutely hoping we are. New strain via mutation this winter – second phase, it’s about how much time we do have to prepare for clever viruses. I’d say this is worse than being struck by a meteorite. If i had a choice, the meteorite.
Claire
May 4th, 2009 at 10:36 pm
List of things more deadly than swine flu: http://bsirolly.blogspot.com/2009/05/ways-to-die-swine-flu-edition.html
May 5th, 2009 at 6:17 am
This reminds me of scenarios like:
“How do we evacuate New York if we know a large meteor will hit it?”
“How do we evacuate the cities around Vesuvius when it erupts again?”
“What do we do if the Yellowstone supervolcano erupts again?”
“What do we do when the ‘Big One’ hits California?”
The answer to all is: there’s not much to do but clean up after the mess. Let’s look at the case of a super-flu which had a high kill rate and a relatively long period before symptoms showed. Let’s pick on New York again – roughly 8 million people. Let’s assume that the entire city was instantly quarantined so that there was no sicko spreading the disease beyond the city. You have roughly 2 weeks to develop an effective vaccine and vaccinate over 8 million people. It’s beginning to sound a bit like the plot of “I Am Legend”. Now let’s bring reality into the picture: how do you keep 8 million people in a city when every person is terrified of catching the super-flu and dying from it? It’s just not going to happen; people will panic, people will migrate, people will spread disease. Many will die, but most will survive.