Tuesday, January 25, 2005

Bird flu and bullshit

CDC's concerns about bird flu are just barely poking their head above water, but at least some signs are visible. The Denver Post reported this week (byline Anne Mulkern) that the agency is readying quarantine and school closure plans and examining how to ration vaccine. Since there is no vaccine for bird flu yet, this is rather curious. CDC is also asking states to get pandemic plans ready.
"The situation is different than it's ever been before" with the avian flu, said Dr. Ken Gersham, chief of the communicable-disease program at the Colorado Department of Public Health and Environment. "I think it is scary to people who know a lot about flu and what could happen."
Indeed. I think we (and others) have been saying that for some time (see links to previous posts in sidebar on left).

Now that the rest of the world is awake, we are starting to rewrite public health history in this country (from the Post story):
"When you look at health threats, here is one that we essentially know is going to happen," Dr. Bruce Gellin, director of the U.S. Department of Health and Human Services' vaccine program, said of a flu pandemic. "We don't know when it's going to happen. We don't know how severe it's going to happen."

Planning for such a pandemic began about two years ago.

Former Health and Human Services Secretary Tommy Thompson told Gellin, a specialist in infectious disease, that a national pandemic plan was his "No. 1, 2 and 3 priorities." A draft was issued in August and is posted online. No date has been set for a finalized report.
I have no doubt that there are knowledgeable people within CDC and DHHS who are, and were, scared to death of this thing. There are plenty of competent and dedicated public health professionals in the federal employ. But the implication that this has gotten the high level political support commensurate with the size of the threat is . . . well, what's that technical phrase for this . . . bullshit?

High level political support requires making a serious concern visible and public so that adequate resources can be allocated by cash-strapped state health departments who need urgent reasons to shift around the paltry contents of their shrinking pots of money. This didn't (and wasn't going to) happen during the election campaign when the Bush Administration didn't want to remind people about the flu vaccine fiasco, how dependent we were on the rest of the world or how we face threats not related to the "axis of evil."

Meanwhile, the ninth fatality has occurred in Viet Nam, a 17 year old (via Pro Med). Teenagers and young adults are disproportionate victims, unlike usual influenza were it is the very young and the very old.

There is always concern about "creating panic" by being too frank about the possibilities, given there are also significant uncertainties. Sometimes public anxiety is useful, however, and this is one of those times. As we have noted before, the Bush Administration has never been shy about issuing frightening alerts when it suits their purposes. But in this case, they would also be alerting the public to the fact that adequate preparation for a tangible threat has not happened, a threat of reasonable probability that would make an al Qaeda attack and even the tsunami look like a powder puff .

Is this an Administration that we can trust to "keep us safe"? Some questions answer themselves.