An Assessment of the Flu Pandemic Threat

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An Assessment of the Flu Pandemic Threat
Yanzhong Huang Center for Global Health
Studies Whitehead School of Diplomacy Seton Hall
University November 17, 2006
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Question Does the pandemic present a clear
present danger?
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1. The Pros

• The Very Nature of the Virus
• -- an RNA virus, prone to mutation
• -- the possibility for an avian to human transfer
  without gene reassortment

-- H5N1 has a lot in common with the 1918
virus -- the emergence of a troubling new strain
of H5N1 in China over the past year
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• 2) Globalization
• -- The fast spread of infectious disease
• -- economic interdependence just-in-time
  economy

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• 3) The world is ill-prepared
• -- few countries have the system capacities
  needed to cope with large numbers of people who
  suddenly fall ill
• -- the difficulty in scaling up vaccine and
  anti-viral drug production
• -- the U.S. is not well-prepared, either.

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1. The Cons

• Many predictions about the likelihood and
  mortalities of the pandemic are not
  scientifically informed
• Prediction 1
• We are due for a pandemic.
• Comments
• No hard science behind it

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• Prediction 2
• We are sure the pandemic is coming, we just
  dont know when
• Comments
• An admission of ignorance not policy relevant

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• Prediction 3
• The range of deaths could be anything between 5
  million and 150 million.
• or
• A statistical possibility of 180 to 360 million
  deaths
• Comments
• purely speculative based on the worst scenario
  

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• Prediction 4
• The H5N1 is going to mutate into a highly
  contagious and highly virulent virus.
• Comments Not a plausible scenario
• -- the apparent CFR for current human cases is
  deceptive
• -- it is conventional wisdom that mutations allow
  a virus to spread more effectively also reduces
  its deadliness at the same time for good
  Darwinian reasons (e.g., Fort Dix)

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• 2) The Cassandras cry overlooks the difference
  between today and 1918

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• -- 1918 did not see the widespread animal
  outbreaks before the Spanish Flu
• -- The first wave of the 1918 virus in the spring
  was comparatively mild

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-- We are not in a world war

• -- Political commitment Wilson vs. Bush
• -- Advancement in medical science and bio-tech
• The postwar era a quantum jump in our
  ability to detect, prevent and treat infectious
  diseases
• 1918 no intensive care no antibiotics no
  antivirals and no vaccines

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• 3)Even in 1918, the social-economic-political
  impacts were not as bad as claimed
• -- Social impact
• Barry near social breakdown
• Crosby increased social cohesion

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• -- Political impact
• No significant impact on fundamental governmental
  and social institutions in the United States
• -- Effect on national economy
• The coexistence of negative short-term impact
  with not-so-negative aftermath impact

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• -- Effect on military operations and war
  outcomes
• It slowed down military operations during WWI,
  but it did not stop military operations or affect
  final war outcome, because the pandemic affected
  each side equally

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• Question
• Why is there big fuss over the feathers?
• -- People tend to fear unusual and unknown
  diseases more than well-known, more common
  killers (e.g., seasonal flu)

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• Conclusion
• -- Our biggest fear is
• fear itself.
• -- It is scientifically ungrounded and
  irresponsible to exaggerate the threats of a
  pandemic
• -- The need to strike a balance between panic
  and preparedness