Todd: Is it true that a halk million Americans could die if bird flu were to achieve medium pandemic proportions in the US?
Dr. Hearne: Yes, we think it is possible. First, while I think your point here is to explore the "disease du jour" implications of an avian flu pandemic, and that's OK, I'd like to explain the mission of our organization, Trust for America's Health (TFAH). TFAH is a non-profit, independent advocacy group whose mission is to improve the health of our families, communities and country. We believe that preventing disease and protecting communities requires a strong, effective and responsive public health system. TFAH conducts science-based research, reports on issues, shares best practices and we demand that our public health system works to fight current and emergent threats of all kinds, of which, avian flu is but one. Education is an important part of our outreach efforts and so we released a report in June called "A Killer Flu?" about the avian flu problem and the problems we face prparing for it or some other inevitable pandemic. To get back to your original question about "projected dead," in the report we used CDC computer models that are extrapolated from the relatively mild 1968 Hong Kong flu model, increasing the Hong Kong death rate by a factor of three and increasing the contraction rate to the World Health Organization's estimate of 25%. In this way, and to summarize the table for a "Mid-Level Pandemic Flu" in the report, the United States Would have approximately 66 million flu cases. Of those, over 2 million people would require hospitalization and over half a million people would die. In comparison, the general public is largely unaware that in a typical year it has been normal for 36,000 to 40,000 people, ussually either the very young or very old, to die from the flu. If the avian flu were to make the leap to humans and spreading rapidly trans-globally, under the best of circumstances societies would be unprepared for the impact. We think there is significant danger of this happening and a significant need to prepare.
Todd: Did you say the "inevitable pandemic"?
Dr. Hearne: Yes. Many health experts worldwide feel that it is inevitable that a new, severe strain of flu will emerge. Virologist and epidemiologist predict that flu pandemics emerge three to four times per century. We can't be sure that a pandemic will emerge from this H5N1 avian influenza strain, but the warning signs are troubling.
Todd: How would our society be impacted by a pandemic flu event?
Dr. Hearne: Well, first of all, we could be faced with a "High-Level Pandemic" which would be Hong Kong flu times a factor of six or more. And, we have a highly interdependent global economy now. Most hospitals in California and across the nation do not stockpile the excess protective equipment that would be required during pandemic conditions. But what happens if the supply chain we rely upon becomes disrupted? If we don't make efforts to supply ourselves in advance, preparation of a pandemic, once a pandemic happens, obtaining supplies could become difficult or impossible. Then there's the troubling state of our vaccine industry. We rely on 50-year old technology that uses eggs to manufacture flu vaccine, so the entire vaccine manufacturing process is in need of modernization. It will take approximately six to nine months to develolp and bring to the marketplace a vaccine specifically engineered for a new flu strain. In the interim, antivirals such as Tamiflu are recommended as a stopgap solution, but we have limited supplies of antivirals stockpiled. Our society is largely uneducated about and unprepared for the possible disruptions that a flu pandemic could cause in our everyday lives. Besides the obvious impacts like getting sick or knowing someone that is sick or caring for someone that is sick, many things we take for granted could change. During a major pandemic, schools or certain businesses chould be shut down. You might be restricted on where you can travel or how you travel. The potential implications are staggering.
Todd: I agree. What about the economic impacts?
Dr. Hearne: Asia's poultry and related industries have already suffered over $12 billion in lost business and can expect more of the same. Thinking about US business, if we extrapolate conservtively from the 1968 Hong Kong flu numbers, we would be out 71$ to 166$ billion due to death and lost productivity. Remember, the World Health Organization (WHO) is warning countries that they should be preparing for 25% of their populatons to get sick from the pandemic virus. There are other scientist who think the number could be closer to 50%. Either way, the hit to local and global economies will be huge.
Todd: OK. My head is starting to spin. What else can we regular folks do to prepare?
Dr. Hearne: Your government could be doing a better job stockpiling Tamiflu, the antiviral. In May the US had 2.3 million doses stockpiled. We recently ordered another 3 million doses. That's 5.3 million doses total. At that rate, there would be 61.5 million Americans who could be infected but would not receive antiviral medication. What can you do? Get involved! Get the health food industry involved. Support your local health department! Contact your congresspersons. TFAH just relased (on October 12th) a "Checklist of Concerns" at a briefing on Capitol Hill in DC, about pandemic flu preparedness. We issued a top-ten list of concerns. The Bush administration announced that they ecpect to release a revised national plan sometime later this month (October). We want to make sure that the plan incorporates views of leading health and science experts. And more importantly, we want to make sure the plan gets adequate funding. It's important that while we regonize the potential dangers of a pandemic, we also regonize that there's alot we can do to improve our preparedness in the interim. We need to remain prepared for this pandemic, but not panicked.
Todd: Could you summarize the checklist of concerns for us?
Dr. Hearne: Yes. We need a single high-level official who is responsible for coorinating the governtments response. So, question one is, who is in charge? Next, how will we track the disease globally and anticipate its spread to the US? What mechanism will we have to place to idenify the existence of a pandemic outbreak in the US? What can we do to build vaccine capacity and ensure enough for the entie American polulation. Is the US planing to purchase enough antiviral for 25% of the population likely to get sick from a pandemic? Is there funding for anti-viral research? That's important. As I mentoned before, do we sufficient stockpiles of emergency medical supplies? We could expect a run on the hospitals. We call this "surge capacity." How do the various levels of planning from local to state to federal all work together to support surge capacity? How do we educate and what authority do we have to discipline the public on necessary health measures like quarantines, restrictions on public gatherings, travel, and on the use of mask? An emergency of this magnitude will require a huge public communications effort to educate the public and it needs to take place before the pandemic hits. Are we funding this? How do we get the word out to all sectors of the economy and society, including government, that they need to have contingency plans for how to continue to function in the case of severe absenteeism? Lastly, and most importantly, does the federal plan include a request to Congress for enough resources to implement it?
Todd: And will Congress have the foresight to pass it?
Dr. Hearne: Good question.
Todd: Dr. Hearne, I'd like to thank you for taking the time to do this interview. And thank you for all the important work you're doing.
Dr. Hearne: My pleasure. If anyone would care to see the Killer Flu report I mentioned, you can find that and more at our website address http://healthyamericans.org/reports/flu
Todd: Thank You!
