Mike Davis on the Monster at Our Door

Senate majority leader Bill Frist (R-Tenn.), had already criticized the
administration in an extraordinary (and under-reported) speech at
Harvard at the beginning of June. Referring to Washington's failure to
stockpile an adequate supply of the crucial anti-viral oseltamivir (or
Tamiflu), Frist sarcastically noted that "to acquire more anti-viral
agent, we would need to get in line behind Britain and France and Canada
and others who have tens of millions of doses on order."

>From below post.

Bill who hopes it is way off base!

............................................


http://www.tomdispatch.com/index.mhtml?emx=x&pid=13470

 
Tomgram: Mike Davis on the Monster at Our Door
"Follow that chicken" is not one of the more inspiring lines in the
history of detective fiction, nor one of the more frightening in the
genre of horror. It's perhaps on the level of that classic grade-Z
sci-fi film, Night of the Lepus, in which the giant, rampaging, mutant
rabbits were just... well, big bunnies. And yet, don't be fooled, the
chicken, probably first domesticated in Southeast Asia some 8,000 years
ago, might prove the death of many of us, and for its possible
depredations, we are painfully unprepared.
In 1918, a flu epidemic emerged from the trenches of World War I's
Western Front -- essentially the war?s equivalent of the slums -- and
swept across the world (twice) ridding it of somewhere between 25
million and 100 million human beings (the equivalent in today's
population terms of possibly upwards of a billion people). There have
been flu pandemics since, but none faintly on such a scale. For nearly a
decade, epidemiologists, public health officials, and veterinary
researchers -- by now, in fact just about the whole global
medical/scientific community -- have been warning that such a new
pandemic is a frightening possibility, if not a near certainty. At the
same time, some of them have been performing prodigious genetic
detective work as a mutant flu virus, H5N1, has lodged in the systems of
wild fowl in southern China, moved into massed domestic fowl populations
nearby, and begun to spread to human beings; all the while still
genetically evolving in birds (domestic and wild), swine, and even
perhaps people, "looking for" the means to leap not just from bird to
bird, or bird to swine, or even from bird to human, but from human to
human at a staggering rate.
Nothing could more quickly remind us that we humans are part of nature
than a flu pandemic; yet three quite unnatural changes in our world have
drastically increased the danger of such a pandemic. A livestock
revolution has gathered domestic birds together -- think Tyson chickens
-- onto giant corporate farms in prodigious numbers, clustering them
into what are essentially giant bird slums, where any new disease is
guaranteed to spread more easily. Meanwhile, throughout the third world,
impoverished human beings have been gathering in far greater urban
concentrations than anything imaginable a century ago, and any of these
are potential hatcheries for a pandemic. Finally, globalization and
global air travel have made the spread of a pandemic, once started,
almost instantaneous. In the meantime, H5N1, spreads by an older set of
air paths -- avian migration routes -- having just made it to Russia.
And we wait.
What makes this an especially dangerous situation in the U.S. is that
the Bush administration has largely chosen to redirect its public-health
budget to preparations for "biowar" possibilities -- smallpox, Ebola
Fever, and the like -- which may never endanger us, while scanting the
kind of biowar (think Hitch***'s The Birds, not Osama bin Laden) that
is actually likely to do so. Between the administration's priorities and
Big Pharma's urge to go for the profits -- flu shots are unprofitable
products -- America's public health structure is in increasingly woeful
shape and certainly, despite endless warnings about what might come, in
no shape at all to deal with a nationwide flu pandemic.
All of this, by the way, I know only because Mike Davis has just
published a must-read, brief new book, Monster at our Door, The Global
Threat of Avian Flu, a scientific detective story, a tale of potential
horror, and a sociological thriller about our 21st century world. This
is a situation with which we should all be acquainted. Even the
President evidently belated agrees. Along with Alexander II: The Last
Great Tsar (about which I won't even speculate) and a history of salt,
he's taken John M. Barry's account of the 1918 flu pandemic, The Great
Influenza off to Crawford to read. Maybe I should send a copy of the
Davis book down to Crawford as well and Cindy Sheehan could present it
to him at their meeting.
Recently, avian flu, which for some years had flown below the headlines
and nested on the inside pages of our newspapers, has hit the
front-page. (On this issue, as Davis points out, the New York Times has
been especially good.) The latest headlines -- about a potential vaccine
for this possible pandemic -- undoubtedly caused a collective sigh of
relief. Unfortunately, relief is not actually in sight as Mike Davis
explains below, offering his latest update on the monster at our door.
Tom

Has Time Run Out?
The Coming Avian Flu Pandemic
By Mike Davis

Deadly avian flu is on the wing.
The first bar-headed geese have already arrived at their wintering
grounds near the Cauvery River in the southern Indian state of
Karnataka. Over the next ten weeks, 100,000 more geese, gulls, and
cormorants will leave their summer home at Lake Qinghai in western
China, headed for India, Bangladesh, Myanmar, and, eventually, Australia.
An unknown number of these beautiful migrating birds will carry H5N1,
the avian flu subtype that has killed 61 people in Southeast Asia and
which the World Health Organization (WHO) fears is on the verge of
mutating into a pandemic form like that which killed 50 to 100 million
people in the fall of 1918. As the birds arrive in the wetlands of South
Asia, they will excrete the virus into the water where it risks
spreading to migrating waterfowl from Europe as well as to domestic
poultry. In the worst-case scenario, this will bring avian flu to the
doorstep of the dense slums of Dhaka, Kolkata, Karachi, and Mumbai.
The avian flu outbreak at Lake Qinghai was first identified by Chinese
wildlife officials at the end of April. Initially it was confined to a
small islet in the huge salt lake, where geese suddenly began to act
spasmodically, then to collapse and die. By mid-May it had spread
through the lake's entire avian population, killing thousands of birds.
An ornithologist called it "the biggest and most extensively mortal
avian influenza event ever seen in wild birds."
Chinese scientists, meanwhile, were horrified by the virulence of the
new strain: when mice were infected they died even quicker than when
injected with "genotype Z," the fearsome H5N1 variant currently killing
farmers and their children in Vietnam.
Yi Guan, leader of a famed team of avian flu researchers who have been
fighting the pandemic menace since 1997, complained to the British
Guardian in July about the lackadaisical response of Chinese authorities
to the unprecedented biological conflagration at Lake Qinghai.
"They have taken almost no action to control this outbreak. They should
have asked for international support. These birds will go to India and
Bangladesh and there they will meet birds that come from Europe." Yi
Guan called for the creation of an international task force to monitor
the wild bird pandemic, as well as the relaxation of rules that prevent
the free movement of foreign scientists to outbreak zones in China.
In a paper published in the British science magazine Nature, Yi Guan and
his associates also revealed that the Lake Qinghai strain was related to
officially unreported recent outbreaks of H5N1 among birds in southern
China. This would not be the first time that Chinese authorities have
been charged with covering up an outbreak. They also lied about the
nature and extent of the 2003 SARS epidemic, which originated in
Guangdong but quickly spread to 25 other countries. As in the case of
SARS' whistleblowers, the Chinese bureaucracy is now trying to gag
avian-flu scientists, shutting down one of Yi Guan's laboratories at
Shantou University and arming the conservative Agriculture Ministry with
new powers over research.
Meanwhile, as anxious Indian scientists monitor bird sanctuaries
throughout the subcontinent, H5N1 has spread to the outskirts of Lhasa,
the capital of Tibet; to western Mongolia; and, most disturbingly, to
chickens and wildfowl near the Siberian capital of Novosibirsk.
Despite frantic efforts to cull local poultry, Russian Health Ministry
experts have expressed pessimism that the outbreak can be contained on
the Asian side of the Urals. Siberian wildfowl migrate every fall to the
Black Sea and southern Europe; another flyway leads from Siberia to
Alaska and Canada.
In anticipation of this next, and perhaps inevitable, stage in the world
journey of avian flu, poultry populations are being tracked in Moscow;
Alaskan scientists are studying birds migrating across the Bering
Straits, and even the Swiss are looking over their shoulders at the
tufted ducks and pochards arriving from Eurasia.
H5N1's human epicenter is also expanding: in mid-July Indonesian
authorities confirmed that a father and his two young daughters had died
of avian flu in a wealthy suburb of Jakarta. Disturbingly, the family
had no known contact with poultry and near panic ensued in the
neighborhood as the press speculated about possible human-to-human
transmission.
At the same time, five new outbreaks among poultry were reported in
Thailand, dealing a terrible blow to the nation's extensive and
highly-publicized campaign to eradicate the disease. Meanwhile, as
Vietnamese officials renewed their appeal for more international aid,
H5N1 was claiming new victims in the country that remains of chief
concern to the WHO.
The bottom line is that avian influenza is endemic and probably
ineradicable among poultry in Southeast Asia, and now seems to be
spreading at pandemic velocity amongst migratory birds, with the
potential to reach most of the earth in the next year.
Each new outpost of H5N1 -- whether among ducks in Siberia, pigs in
Indonesia, or humans in Vietnam -- is a further opportunity for the
rapidly evolving virus to acquire the gene or even simply the protein
mutation that it needs to become a mass-killer of humans.
This exponential multiplication of hot spots and silent reservoirs (as
among infected but asymptomatic ducks) is why the chorus of warnings
from scientists, public-health officials, and finally, governments has
become so plangently insistent in recent months.
The new U.S. Health and Human Services Secretary Mike Leavitt told the
Associated Press in early August that an influenza pandemic was now an
"absolute certainty," echoing repeated warnings from the World Health
Organization that it was "inevitable." Likewise Science magazine
observed that expert opinion held the odds of a global outbreak as "100
percent."
In the same grim spirit, the British press revealed that officials were
scouring the country for suitable sites for mass mortuaries, based on
official fears that avian flu could kill as many as 700,000 Britons. The
Blair government is already conducting emergency simulations of a
pandemic outbreak ("Operation Arctic Sea") and is reported to have
readied "Cobra" -- a cabinet-level working group that coordinates
government responses to national emergencies like the recent London
bombings from a secret war room in Whitehall -- to deal with an avian
flu crisis.
Little of this Churchillian resolve is apparent in Washington. Although
a sense of extreme urgency is evident in the National Institutes of
Health where the czar for pandemic planning, Dr. Anthony Fauci, warns of
"the mother of all emerging infections," the White House has seemed even
less perturbed by migrating plagues than by wanton carnage in Iraq.
As the President was packing for his long holiday in Texas, the Trust
for America's Health was warning that domestic preparations for a
pandemic lagged far behind the energetic measures being undertaken in
Britain and Canada, and that the administration had failed "to establish
a cohesive, rapid and transparent U.S. pandemic strategy."
That increasingly independent operator, Senate majority leader Bill
Frist (R-Tenn.), had already criticized the administration in an
extraordinary (and under-reported) speech at Harvard at the beginning of
June. Referring to Washington's failure to stockpile an adequate supply
of the crucial anti-viral oseltamivir (or Tamiflu), Frist sarcastically
noted that "to acquire more anti-viral agent, we would need to get in
line behind Britain and France and Canada and others who have tens of
millions of doses on order."
The New York Times on its July 17 editorial page, a May 26 special issue
of Nature and the July/August issue of Foreign Affairs have also
hammered away at Washington's failure to stockpile enough scarce
antivirals -- current inventories cover less than 1% of the U.S.
population -- and to modernize vaccine production. Even a few prominent
Senate Democrats have stirred into action, although none as boldly as
Frist at Harvard.
The Department of Health and Human Services, in response, has sought to
calm critics with recent hikes in spending on vaccine research and
antiviral stockpiles. There has also been much official and media
ballyhoo about the announcement of a series of successful tests in early
August of an experimental avian flu vaccine.
But there is no guarantee that the vaccine prototype, based on a
"reverse-genetically-engineered" strain of H5N1, will actually be
effective against a pandemic strain with different genes and proteins.
Moreover, trial success was based upon the administration of two doses
plus a booster. Since the government has only ordered 2 million doses of
the vaccine from pharmaceutical giant Sanofi Pasteur, this may provide
protection for only 450,000 people. As one researcher told Science
magazine, "it's a vaccine for the happy few."
At the least, gearing up for larger-scale production will take many
months and production itself is limited by the antiquated technology of
vaccine manufacture which depends upon a vulnerable and limited supply
of fertile chicken eggs. It would also likely mean the curtailment of
the production of the annual winter flu vaccine that is so often a
lifesaver for many senior citizens.
Likewise, Washington's new orders for antivirals, as Senator Frist
predicted, will have to wait in line behind the other customers of
Roche's single Tamiflu plant in Switzerland.
In short, it is good news that the vaccine tests were successful, but
that does little to change the judgment of the New York Times that
"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."
Moreover, the majority of the world, including all the poor countries of
South Asia and Africa where, history tells us, pandemics are likely to
hit especially hard, will have no access to expensive antivirals or
scarce vaccines. It is even doubtful whether the WHO will have the
minimal pharmaceuticals to respond to an initial outbreak.
Recent theoretical studies by mathematical epidemiologists in Atlanta
and London have raised hopes that a pandemic might be stopped in its
tracks if 1 to 3 million doses of oseltamivir (Tamiflu) were available
to douse an outbreak in a failsafe radius around the early cases.
After years of effort, however, the WHO has only managed to inventory
about 123,000 courses of Tamiflu. Although Roche has promised to donate
more, the desperate rush of rich countries to accumulate Tamiflu will be
certain to undercut the World Health Organization's stockpile.
As for a universally available "world vaccine," it remains a pipe-dream
without new, billion-dollar commitments from the rich countries, above
all the United States, and even then, we are probably too late.
"People just don't get it," Dr. Michael Osterholm, the outspoken
director of the Center for Infectious Disease Research and Policy at the
University of Minnesota recently complained. "If we were to begin a
Manhattan Project-type response tonight to expand vaccine and drug
production, we wouldn't have a measurable impact on the availability of
these critical products to sufficiently address a worldwide pandemic for
at least several years."
"Several years" is a luxury that Washington has already squandered. The
best guess, as the geese head west and south, is that we have almost run
out of time. As Shigeru Omi, the Western Pacific director of WHO, told a
UN meeting in Kuala Lumpur in early July: "We're at the tipping point."
Mike Davis is the author of the just published Monster at our Door, The
Global Threat of Avian Flu (The New Press) and the forthcoming Planet of
Slums (Verso).

Copyright 2005 Mike Davis
posted August 16, 2005 at 10:26 pm
 
 
 
 

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