The Story








Questions to Debate:

1.) How concerned are you that this virus will mutate to human-to-human spread?

2.) Is the government doing enough to fight/stave off a pandemic?

3.) According to the figures stated above, is the federal government overestimating the risk or underestimating and not doing enough?

4.) How would you handle this seemingly-imminent pandemic if you were the president?

With the fact that something like a virus has a high mutation rate, which of this one or rates generally in the population I am not aware off, I think its all rather dangerous really. Its like aids, you give people meds for it, they only take it for a bit then stop, then the virus adapts and becomes immune to the treatment. I am not saying lets not do anything, being other diseases have been stomped out pretty much, but I will voice my concern over it all.

I myself have not had a flu shot in years, I do not really know how long its been. I also have not had to flu in years. I do know that the way we work medicine, or impact the ecology overall in various organisms has manifested in those organisms evolution pretty much, and forces us to keep up if you will in an arms race of sorts.

I am glad to hear about new forms of medicine, as medicine is truly a combined arms aspect of science and technology, and to not forget human endeavor. I do think genetics and related could play a large role in the fitness of the human race over a long period of time, but then again no one is really is the 100% know phase on it all.

I think many times people get this idea that somewhere someone is going to make it all better. I do not buy into it and people need to work with the government in relation to fear on this particular disease.

I do not trust statistics fully, they are only a representation of it all, not the entire truth of the situation. Who knows how many people may have the disease actually at this point, or how it will spread. This in turn needs to be taken into account of course in any counter measure, we can deal with the unknown and be successful, I think our space program points that out.

If I were president how would I handle the situation. Probably with infomercials based around the subject, hour long most likely about what we know. This of course would have to come after the establishment of infrastructure that would deal with the disease of panic I am sure. I would does out any potential vaccinations on a basis of whom needs it the most, like elderly and children, of course giving out to more as more are produced. I also in a time like this with a potentially new black plague on the horizon be making it very lucrative for various companies to the come to rescue, with like no taxes being paid for that year, or two years, and making public the names of companies that would support such a move to help the public. I also would probably try to make an outreach to other nations, like china of course to combat it early, and gain information. I might also try to various other means of protection at places of international travel and of course do a lot more random testing of international cargo coming into the U.S. I would use the idea that this is a occurrence that does not occur every year to gain support for such in terms of funding and other politicians backing, and what it means if we are not successful.

1.) How concerned are you that this virus will mutate to human-to-human spread?

Very concerned. The more people that get the avian flu from birds the more potential the virus has to cross with a human communicable flu virus and break loose into the general world population. If its recombinant form retains the lethality of H5N1, the number of deaths could be huge.

2.) Is the government doing enough to fight/stave off a pandemic?

No. The most important thing is to boost the public health system dramatically so that it will be better prepared to deal with this potential pandemic or some pandemic in the future. Some of us argued for such a dramatic increase after 9/11 to cover this possibility along with the consequences of terrorist use of biological agents. Instead we spent everything on tax cuts and an unnecessary war. Secondly, we need to build public facilities capable of quickly growing massive numbers of doses of vaccines as soon as the human virus is identified and a vaccine is developed. As you will recall from last year, we are totally dependent on foreign sources of flu vaccine.

3.) According to the figures stated above, is the federal government overestimating the risk or underestimating and not doing enough?

It's hard to tell. Until the aftermath of the Katrina response embarrassment it seemed the administration was doing nothing. It then announced a fairly dramatic effort. I'm not sure how much of this is damage control and how much is real. I still don't think the administrations response is comprehensive enough given the need for public health to compete with other administration priorities for funds (war and tax cuts).

4.) How would you handle this seemingly-imminent pandemic if you were the president?

I answered this somewhat under #2. The US is well behind several European countries in making preparations. We may be too late. Stockpiling Tamiflu and other anti-viral agents is important but there is limited production capacity even though the manufacturing license for Tamiflu is now being shared. A crash program to boost public health programs at the state and local level is essential.

Questions to Debate:

1.) How concerned are you that this virus will mutate to human-to-human spread?

The potential is certainly there. Virus particles are made of two parts, the outside jacket and material on the inside. We know that the internal part of avian flu can wreck havoc once inside human cells. However, the outside of avian flu does not recognize human cells very well. One potential scenario involves swine. Avian flu does attach to swine cells ok, but does not disrupt them as badly as human cells. It also is the case that human influenza attaches to swine cells fairly well. A worry is that a pig could be a mixer, switching the outside jackets. So far it has not happened.

2.) Is the government doing enough to fight/stave off a pandemic?

The government is spending too much money on stockpiling vaccines. They are also spending large sums of money on viral agents which we know do not work.

3.) According to the figures stated above, is the federal government overestimating the risk or underestimating and not doing enough?

Some disease will have a good time going through the human population. The density of humans and the high mobility makes our species likely to have a pandemic. All we can continue to do is to learn as much as we can about these diseases. The knowledge required to stop a rapidly transferred disease is beyond our grasp.

The influenza virus varies. We have no exacting means to know which influeza will emerge to potentially cause a pandemic. Therefore, we do not now what vaccine to make to stop an outbreak. We will need to make the vaccines after the emergence of the disease. The disease will spread faster than the ability to make the vaccines, administer them, and for the immune systems to create protection (10 to 14 days).

The President and government can not do much. With such an outbreak, it would be best to limit human contact until vaccines are available. Individuals with knowledge will be best able to limit their exposure, government can not do that for them.

4.) How would you handle this seemingly-imminent pandemic if you were the president?

I would not spend a bunch of money so I appear to be doing something when I know I am not. Such spending is a pathetic waste of our country's skill and resources.

This virus “could” mutate into one capable of person to person infection. Since this virus is far more deadly than the 1918 flu strain if it did that millions of people would die. Scientific American did a nice discussion of the virus in the November issue. They estimate that an outbreak in the US could develop quickly and sicken 1/3 of our total population. If the virus has a 15% death rate the death toll would be very significant!

We are due for a pandemic such as this and with current vaccine production methods using fertilized eggs we would not have a vaccine for months.

The government seems to be moving in the right direction but much more needs to be done to prepare for the inevitable. We need to fund research into fast vaccine production methods. Some companies are working on it now but we will have no production until 2007 or beyond. The government has ordered a vaccine for the current (non air transmittable) strain so that we would have some protection (it would be effective in partially protecting people from a variation of the strain) but it is not currently possible to make anywhere near the number of doses required if a pandemic breaks out.

We are NOW doing all that we can but we should have started in this direction 10-15 years ago with heavy government funding. Now we are rushing to catch up and let us hope there is no H5N1 virus mutation that can be person to person transmitted in the next 2 years. If there is millions will die.

10 Year old with bird flu


Giving the idea that the virus is out there having contact in numbers not known with humans, or are biology, and mutation rates also in consideration, I do not think time will afford us the comfort that some companies or people think we have.

I do not see why the U.S is not in action in the form of being in the epicenter of what could be a large scale outbreak. I feel its paramount to gain all possible information as early as possible for use in creating any form of protection against such a organism.

Being a society loaded with resource, I think we are in a great position in regards to making calls in regards to human survival or not, we seem to conduct such often actually, I do not see why this would not see the same conduct.

The US is not the center of a large scale outbreak because there has not been such an outbreak yet with transmission human – human. Asia, where people live very closely with their animals is the danger area. In fact Asia is the source of nearly all flu viruses. Here is why.

Many of the viruses, and certainly the worst start in birds. In Asia farmers (and there are lots of small farms) put their ducks on their rice paddies in summer the eat insects that could harm the crop. Then in fall they move the ducks, some of which harbor an avian flu virus, in with their pigs to fatten them up for slaughter. The pigs then pick up the flu virus from the ducks and mutate it into a form more compatible with human to human airborne transmission. The farmers then get this flu from the pigs and it spreads throughout the world. This is why most flu viruses are called “swine flu”.

The very worst and most dangerous viruses go directly from birds (like ducks) to people. This happens in places where these birds are handled primarily by hand such as in Asia (and not the US). The 1918 flu pandemic virus is now known to have come directly from birds. The way it is felt that the virus can mutate to an air borne variety is to get inside of a person who has (at the same time) an already airborne version of a milder flu. We know viruses mutate by “exchanging genes” with other like viruses. Thus the deadly avian virus could pick up the ability to be transmitted person to person while keeping all or most of its deadliness. This, for the reason above, is most likely to happen in Asia but, as with all flu viruses it would spread quickly if not isolated very quickly and Isolation is not easy in the countryside of China or Vietnam etc.

The reason for the high level of concern with this particular virus is that in its current, non human to human capable form, it has a death rate of 50%!! If it mutates and becomes airborne and that rate drops in the mutation to only 10% or even 5% it would still be 2 to 5 times as deadly as the 1918 pandemic that killed 40-100 MILLION people. (with a death rate of just over 2% of those infected)

With six months to a vaccine with current production methods and the near certainty that as a minimum 30% of the people in the US (and most industrial countries) and as many as 50% would be sickened you can see the potential for a massive death toll.

The government has ordered millions of doses of anti viral drugs like Tamiflu http://www.tamiflu.com/ which could help keep some people somewhat protected and save lives but it to is hard to manufacture and we will not have anywhere near enough if this flu mutates in the next 12 months.

Lets all hope the virus does not mutate soon. . Faster vaccine production methods as well as better anti viral drugs are coming but they are 1 -3 years away.

Death rates of 50 percent based on how many test cases? I think the number is something like 65, of which half have died. What are the odds that milder cases went unreported? I'd say high.

And, wow! The 1918 flu pandemic killed only 2 percent of the infected and that death total is between 40 to 100 million? Was every single individual living on earth infected? The numbers seem a wee bit off there...

1.) How concerned are you that this virus will mutate to human-to-human spread?

Not very. We had a similar thread two years ago on the avian flu issue. Consider that our knowledge of disease and the mechanisms of transmission today are light years beyond 1918. Penicillin wasn't even discovered for another 10 years, and many (if not most) certainly died of secondary bacterial infections. There were no anti-viral drugs, or respirators.

2.) Is the government doing enough to fight/stave off a pandemic?

Yes. In fact, I think it's a bit overkill. Unless these vaccines are specific to the strain that will infect the population (unknown, doesn't exist at this time), they are useless. I suppose anti-viral medication should be stockpiled just in case (though Gray Seal mentioned they don't work so he might know more than I do about that).

3.) According to the figures stated above, is the federal government overestimating the risk or underestimating and not doing enough?

There is no way to know the risk, so there is no way to assess whether the estimates are accurate. It's art, not science. I think it's a bit overdone, myself. Likely a political PR move as contrition for being low on flu vaccines last year. See! We'll really protect you this time! Well...sorry people, likely the government won't be able to do much more than quarantine until a vaccine to the strain can be developed (which won't happen until the outbreak). Quarantine did seem to work well for SARS, though (an airborne coronavirus that mutates very frequently).

4.) How would you handle this seemingly-imminent pandemic if you were the president?

I'd caution everyone not to panic. Many scientists believe that most new strains of human flu have come from birds. Viruses that kill quickly don't give their human hosts much time to pass it to many others, so a super-deadly strain (like ebola) wouldn't last long, and the other type with carriers who stay sick and mobile long enough to infect a large population are highly survivable for the non-immunocompromised with today's medical advances.

I believe they have enough data on the ill and the % who died to make an estimate of the death rate – but that is immaterial. A death rate of even 5% would be a disaster for the world. Remember the estimate is that HALF the US population could be sickened. That is about 149,000,000 – and 5% of that is 7.4 MILLION dead!

As for 1918 see below. The official number is 40 million dead at 2.5% but I read the book and the reality is that many more died and were not listed as Flu deaths. Thus the upper level to as high as 100 million.


The effect of the influenza epidemic was so severe that the average life span in the US was depressed by 10 years. The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years (Taubenberger). People were struck with illness on the street and died rapid deaths. One anectode shared of 1918 was of four women playing bridge together late into the night. Overnight, three of the women died from influenza (Hoagg). Others told stories of people on their way to work suddenly developing the flu and dying within hours (Henig). One physician writes that patients with seemingly ordinary influenza would rapidly "develop the most viscous type of pneumonia that has ever been seen" and later when cyanosis appeared in the patients, "it is simply a struggle for air until they suffocate," (Grist, 1979). Another physician recalls that the influenza patients "died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth," (Starr, 1976). The physicians of the time were helpless against this powerful agent of influenza. In 1918 children would skip

http://www.stanford.edu/group/virus/uda/

Experts say the question is not IF but WHEN and we are NOT ready for this. When it happens if we still require 6 months to make a vaccine we are in for a disaster of unpesedented proportions.