Wednesday, August 24, 2005

The Threatened Pandemic Approaches?

In March 2003 I wrote the following words:

In the wake of the First World War a huge influenza pandemic swept the
world, and it is estimated to have killed around 20 million people.
600,000 died in the USA and another 20,000 in Canada -- the so-called
Spanish flu often being brought home by soldiers returning from Europe. That epidemic was one in a regular series of mutations of the structures of influenza which have resulted in major infections around the world.

The question is, has this happened? Last week a new pneumonia came piling out of China, and through Hong Kong is beginning to spread its tentacles around the world. Already two Canadians have died from this disease that has been dubbed Severe Acute Respitory Syndrome, while two more have died in Hong Kong and Vietnam, and there are five possible victims in southern China. The good news is that researchers in Hong Kong have identified the nature of the disease today, which means they are now able to proceed to finding ways of treating it or ameliorating the symptoms.

However, the jury is out on whether this is the "big one" that folks have been expecting; but, as researchers say, even if it isn't, it is only a matter of time before influenza or something akin to it mutates, jumps from other species, and begins to wreak havoc. They remind us that it isn't a case of if something like this happens, merely when. We can hope that when it does researchers will be able to concoct vaccines that might help minimize its impact, especially in the lives of those of us who are fundamentally pretty healthy; but it is among the old, the young, the weak, and the sickly that such epidemics really "do their thing."

Well, SARS did not turn out to be the "big one," at least, not yet, but if you have kept your eyes and ears open you will have noticed way down on the news docket, behind the soap opera of Brad Pitt and Jennifer Anniston, that there is a rising level of concern about the avian flu that is creeping its way westward from China and Indochina, carried along by the wild birds that have been infected. These birds have in turn infected domesticated poultry, and now there are isolated cases of this virus jumping from birds to humans. In Holland it is now illegal to keep domesticated birds out in the open.

All we are waiting for now is the leap from human to human and then the "fun" really begins. Leslie Garrett, one of America's leading authorities on pandemics writes in the latest issue of Foreign Affairs: "In short, doom may loom. But not e the 'may.' If the relentlessly evolving virus becomes capable of human-to-human transmission, develops a power of contagion typical of human influenzas, and maintains its extraordinary virulence, humanity could face a pandemic unlike any ever witnessed."

With words like these, you are tempted to drop to your knees in long bouts of fervent intercessory prayer, while at the same time reaching for the anesthetic power of the brandy bottle! But Leslie Garrett continues, "Or nothing at all could happen." She writes, "Scientists cannot predict with certainty what this H5N1 influenza willd do. Evolution does not function on a knowable timetable, and influenza is one of the sloppiest, most mutation-prone pathogens in nature's storehouse."

OK, we say, putting the brandy bottle down for a moment, but still maintaining a posture of prayer, what might all this mean? If all I have read in following through on this is anything to go by, then the likelihood of this virus completing the transition from birds to human-to-human transmission is substantial if not 100% certain. What we don't know is how virulent it will be when it makes that jump, but let's suppose it is as lethal as the Spanish flu of yesteryear.

The Spanish flu epidemic of 1918-1920 probably killed a lot more than the conservative estimates of 40-50 million deaths. However, if we take that figure and project it onto the world's population today it would be a deathtoll of about 300 million -- or the rough equivalent of the population of the United States spread worldwide. The most vulnerable elements of the population are the very young, the elderly, those whose health is already compromised, and caregivers. There was no escaping the Spanish flu, either: isolated villages in Alaska were found where everyone had died, for example.

The effects of a flu epidemic, if it is only of Spanish flu proportions are hard to predict. The economy would take a beating, that's for sure, and some countries around the world would probably see a precipitative decline in population. Here's another thing to keep your worried in your bed at night, even if they could get the flu vaccine cocktail right to include avian flu, the pharmaceutical industry has never ever been able to produce more than 300 million doses in a single year. "The slow pace of production means that in the event of an H5N1 flu pandemic millions of people would likely be infected well before vaccines could be distributed."

So I ask again the question that I asked when SARS looked like the killer, "Are Christians ready to confort the afflicted, and offer Christ's love and attention to those who are dying or seriously ill? Are we aware of ways that we can protect ourselves from whatever comes down the pike if we are called to minister in an infected situation?"

What baffles me is that I have heard nothing from anyone in any of the churches about how we might pastorally and medically handle this eventuality if it presents itself. Indeed, I would say that the churches are like western culture in general, and have buried their collective heads in the sand.

So, as summer begins to turn to fall, and as the flu season approaches, it is possible (note the word possible) that within the next months or year or two flu could become the synonym for a killer, not something unpleasant that has to be endured. Are we ready?

1 comment:

Guy Fouts+ said...

As the feast of Constance and Her Companions approaches I read your post and wondered whether modern knowledge of germs, disease transmission and the like would trump mercy and comfort. Isolation and quarantine of infected areas seem to be the choice in the Asian countries where avian flu outbreaks have become public knowledge.