November 22, 2005
Tuesday

"The indication is that we will see a return of the 1918 flu virus," warns the nation's top health official. "The projections are that this virus will kill one million Americans . . ."

A quote ripped from today's headlines about an impending "bird flu" pandemic? No, the year was 1976 and the prediction regarding the "swine flu" fell 999,999 deaths short.

That's something to remember as we endure the current hysteria. Another is that we've been here before with the same virus everybody is currently squawking about - avian influenza type H5N1 - which hit Hong Kong in 1997. Typical headline: "Race to Prevent World Epidemic of Lethal 'Bird Flu.' " I was there too, with a piece that was anti-hysteria (and therefore grossly irresponsible).

The world death toll from that "wave?" Six.

But this time it's for real, right? Predictions of worldwide deaths range from a United Nations official's "5 million to 150 million" (translation: "we're clueless") to one U.S. health official's estimate of 180-360 million. ABC News sent feathers flying saying there'd be a billion dead.

But the best prediction is no avian flu pandemic at all, especially in the short period before we have stockpiles of effective vaccines and drugs. The feds have already purchased over $150 million of vaccine, but don't expect any before late next year.

We're constantly told, "we're overdue" for a biggie. Google "avian flu," "pandemic," and "overdue," and you'll get over 40,000 hits. Of the last century's three flu pandemics, the last was in 1968, so it's been 37 years since, explains the director of the National Institute of Allergies and Infectious Diseases Dr. Anthony Fauci.

Yet the time between the second and third pandemics was only 11 years. There's no cycle. As risk communication expert Peter Sandman says, the "overdue pandemic" is mere superstition.

But isn't it also "just a matter of time" before the avian flu mutates to become transmissible from human to human? No.

It's almost a state secret that H5N1 wasn't discovered in Hong Kong in1997, but rather in Scottish chickens in 1959. Millions of Chinese were apparently also infected in the early 1990s. Never say never, but avian flu has been flying around the globe for at least 46 years and hasn't done its mutation trick yet.

Still, what if H5N1 does go pandemic in the next few years? Will it really be a repeat of the catastrophic 1918-1919 Spanish Flu that killed half a million Americans, and about 25-50 million worldwide? That's the working assumption of U.S. and world health organizations and numerous self-appointed "experts," who find scariness and media attention are directly correlated.

But the comparison is ludicrous; medicine has advanced a bit in 87 years.

Aside from the forthcoming H5N1 vaccines, there were no antiviral drugs in 1918, no antibiotics, and no pneumonia vaccine that provides lifetime protection against 23 types of pneumococcal bacteria and is available right now.

Ersatz expert and former Newsday reporter Laurie Garrett, now with the Council on Foreign Relations, claims that unlike our annual flus that usually kill indirectly by exposing the body to secondary (and treatable) bacterial infections, Spanish flu "was a direct killer" and therefore, "Had antibiotics existed, they may not have been much help."

Wrong.

"Even in 1918 there was a window of opportunity so that if they had drugs they could have made a major difference," one of the nation's top virologists, Dr. Frederick G. Hayden of the University of Virginia in Charlottesville, told me. "It would have been susceptible to both antibiotics and antivirals."

Stanford University researchers have also assembled a Web site that quotes from the medical journals of the time. Summarizing their reports, the website declares: "It was this tendency for secondary complications that made this influenza infection so deadly."

We do have time, we do have the weaponry of modern science, and we do have the experience of three prior pandemics to draw upon. Until we have an avian flu vaccine, we must simply prepare ourselves for a considerably worse-than-usual flu season - and stop running around claiming the sky is falling.

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