Homeland Security Watch

News and analysis of critical issues in homeland security

April 21, 2009

A Way To Prevent A Pandemic Decades Before It Starts?

Filed under: Biosecurity,International HLS,Preparedness and Response — by Christopher Bellavita on April 21, 2009

A few days ago, Phil Palin noted the continuing spread of the H5N1 virus in Egypt: “According to the World Health Organization of the 64 cases confirmed to date in Egypt, 23 have been fatal.”

If H5N1 doesn’t ring a bell, it was all the rage in homeland security a few years ago. (I am aiming for  issue-attention-cycle irony, here.  I was unable to find an emoticon to express that.)

A related story yesterday (here) suggested additional H5N1 concerns:

“An unusual pattern of avian flu cases in Egypt — almost all are in toddlers, all of whom have survived — has led some flu-tracking Web sites to speculate that dozens of silent cases are circulating there.”

Other people disagree (with hope): “Right now, it’s all hot air,” said Dr. Robert G. Webster, a flu expert at St. Jude Children’s Research Hospital in Memphis. “I hope to hell it’s not happening, because it would mean the virus is adapting to humans. But there’s not a shred of data.”

“Adapting to humans” is code for “1918 can happen again, but really bad this time.

If we keep dodging the H5N1 bullet (or its various mutations), odds are its a matter of time before something else biological threatens the security of the homeland, including the planetary part of the homeland.

In the video below (click on the image), Nathan Wolfe describes his idea for getting a decades head start on future biological threats — “preventing epidemics before they happen, sidelining them via early-warning systems and alleviating the poverty from which easy transmission emerges.”

The video is 12 minutes, but I thought the first 3 minutes and the last 3 minutes capture the core of what he and his colleagues are trying to do.

(The video comes from ted.com.  If the internet did not exist, TED would be a reason to invent it.)


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Comment by William R. Cumming

April 22, 2009 @ 12:41 pm

WOW! Great item.

Comment by Craig W. Baldwin

April 23, 2009 @ 12:58 pm

Chris Bellavita reminds us that strategic prevention is a possibility given proper strategic consideration and sustained even passionate interest. Nathan Wolfe has committed himself to decade’s long work in a very specific field. His work seeks to manage risk by defining biologic threat capabilities and associated vulnerabilities represented by human activities.

What is most compelling to me is how quickly he identifies the cultural, socioeconomic, governmental and political dimensions of prevention which ultimately limit Dr. Wolfe’s capacity to prevent biologic catastrophe. This is a common theme when prevention planning is the topic of consideration. The problem of strategic prevention can seemingly spiral out of our control.

As a nation what is our level of prevention and preparedness to the influenza pandemic risk? As Phil Palin noted, this is a continuing concern with new cases of human infection being confirmed by the WHO each month. Like Chris Bellavita I have witnessed the steep rise in government and public interest of the Pandemic Flu in 2006 only to watch the precipitous fall in 2007 which continues today. That isn’t to say there aren’t dedicated people and organizations working on the problem. It just illustrates the issue-attention-cycle of our government leaders, the media and public. If the risk has not changed why isn’t there sustained government and public interest in preventing and preparing for the next pandemic influenza outbreak?

First, no outbreak occurred—so the threat wasn’t real. Second, the presidential election process consumed all of 2008 providing great theater but distracting us from strategic planning. Third, the global economic crisis consumes and influences our dialogue and thinking in ways we don’t yet fully appreciate. Each of these reasons can be associated with

Human behavior and thinking naturally tends to be tactical. Early man survived by observing and recognizing danger signals and patterns to which he responded to on a moment to moment basis in order to survive. To act with strategic intent requires setting aside time to think and reflect in the abstract and to prioritize what are the most important issues that require our sustained attention. The more we worry about day-to-day survival the more we are drawn towards ancient tactical behavior—response and recovery based only on our own life experiences and perceptions. It isn’t too much of a leap to say that we would have a very different outlook on the threat posed by a pandemic influenza if a 1918 like outbreak had occurred in the early 1990’s. The 1918 event is nearly 5 generations removed from our current living memory. That is, it has little tactical influence on our day-to-day decision making.

In the strategic realm we consider the historical, current and future contexts in an effort to understand and prioritize pandemic influenza risk to ourselves as individuals, to our families, communities and the nation. What is the threat capability associated with pandemic influenza? Do we assess threat to be low because human-to-human sustained transmission has not occurred? Should we raise the threat level because the mortality rate of those infected with the Avian Flu is 61%? How will we determine when it is time to raise the strategic threat level? What actions are required if the threat level is raised? In considering vulnerabilities and consequences what are the primary and secondary effects of a pandemic on the population, economy, government, business, public safety, public order etc?

These are not questions which can be easily formulated and answered during one or two or even a dozen meetings and the writing of an Influenza Pandemic Plan and one exercise. If strategic pandemic risk is a high priority then it should require and receive sustained attention which considers the cultural, scientific, socioeconomic, governmental and political dimensions to the problem. I am not convinced this is happening and it may never happen until we, as a nation, define what we mean when talk about homeland security and institutionalize strategic frameworks for thinking and doing.

Comment by William R. Cumming

April 24, 2009 @ 9:47 am

Thanks to Craig Baldwin for a great post! The British Coat of Arms contains a single word “Endurance”!

It seems on Pandemic issues what is lacking in governmental and health circles and Congress and Executive Branch is “Endurance.” Sustained thought and action on a key priority. The British government is far far ahead of US on both pandemic protective systems and biologic terrorism. Unfortunately they came to this posture after only being burned by “Mad Cow Disease” where they e.g. buried cows and then had to dig them up and incinerate them. Now of course the secret worry is that the evidence of prior ravages can take years to appear and a large percentage of British population exposed. Also some links to Alzhemiers. In the US of course the battle against 100% testing for “mad cow” goes on and some economic projections are that a MC breakout in US could totally collapse what is left of US economy. “Food” for thought anyhow.

Comment by William R. Cumming

April 24, 2009 @ 9:50 am

“prior ravages” in my comment should have read “prion ravages.”

Pingback by Swine flu: sprinting to tackle a viral end run | Homeland Security Watch

April 24, 2009 @ 10:09 am

[…] take on this urgently unfolding issue, please read and listen — again — to the  Tuesday post and comment by Chris Bellavita, Craig Baldwin, William Cumming, and (indirectly) Nathan Wolfe: […]

Pingback by Trying to tie up the week’s loose ends | Homeland Security Watch

April 25, 2009 @ 4:07 am

[…] Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern.  (See Chris Bellavita’s explanation of pandemic code words) […]

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