Thursday, September 22, 2005

The World Reassurance Organization (aka WHO)

The latest from WHO (via Reuters) tries one's patience:
The growing number of people with bird flu-like symptoms in Indonesia does not mean the outbreak is becoming worse, and there is no sign the virus can be passed easily among people, top U.N. health experts said on Thursday.

Alarm has spread in populous Indonesia after four people died and with now 10 are under observation in the capital.

But there is no evidence the H5N1 virus has mutated into a form that could trigger a pandemic, said Georg Petersen, the World Health Organisation's Indonesia representative.
Nevertheless, he pointed to the possibility of transmission through very close contact with an infected person.

"I think very close contact with a sick person might infect that caretaker. That is why in hospitals we need to take all precautions ... That would be in a way a human-to-human transmission, but that demands close, close contact," he said.

"Anytime someone coughs and you get it ... that would be much more what we would call transmission from human to human."
One wonders what it would take for these guys to say, "Holy Shit, we're fucked unless we get busy and prepare to manage the consequences."

But the World Reassurance Organization doggedly refuses to say out loud what everyone else can see. This virus has gone human to human and is spreading in Indonesia. The fact that it may (or may not) be as efficiently transmitted as current endemic strains of human influenza doesn't mean things have not changed. They obviously have, and to say there is no evidence the virus has mutated because they haven't sequenced it completely, just a lie. As is this:
Dr Margaret Chan, the WHO's global special representative on avian flu, also said on Thursday there was no sign the virus had mutated into a form that could easily spread among people.

"So far there is no evidence for increased chance of human-to-human transmission," Chan told Reuters by telephone from Sydney after attending a WHO conference in Noumea, capital of New Caledonia in the South Pacific.

The rise in the number of suspected cases did not point to an epidemic, she said.

"With increased surveillance it's not unusual that you would pick up more cases," Chan said. (AFP via Khaleej Times; my emphasis)
This may be true as a general proposition, but in this specific instance it isn't (and WHO knows it). AFP reports (via Khaleej Times) that a five year old boy and a five year old girl died on Wednesday from a bird flu like disease (confirmatory tests pending) and 13 people with symptoms of bird flu were being treated at a Jakarta hospital on Thursday. This is an increase of nine from the day before. There is also good evidence of transmission from only casual contact with infected birds, as with the cases of visitors and non animal care workers at the zoo, and within-in family transmissions.

All this (and more) does point toward an epidemic. "Pointing toward" doesn't mean we are there yet. But anyone with even a few neurons firing and not using one to breathe and another to drink coffee with must see this as an imminent threat. Imminent, as in "just around the corner." This could still turn out to be just more "simmering" of this very malignant virus. But no one should bet on it and WHO should be acting as if the genie were already out of the bottle.

Time to end your coffee break at WHO and get to work. If that means scaring the crap out of everybody (because sometimes being scared is warranted), so be it. If it's OK to scare people with vague terrorist threats, how much more appropriate is it when the threat is real and imminent.