These, however, are from this week's issue of the well-respected Science magazine. Their editorial points out:
THE STARTLING SPREAD OF H5N1 ACROSS MUCH OF THE GLOBE HIGHLIGHTS OUR vulnerability to the emergence of novel subtypes of influenza virus. Yet despite our fears of pandemic human disease, H5N1 is primarily a disease of birds. Olsen and colleagues (p. 384) outline the unseen network of influenza among migratory birds that spans Earth. H5N1 has engendered alarm not only because it is unusually virulent, laying waste to poultry and causing severe economic losses for farmers, but also because it can, with some difficulty, infect humans and other mammals. So far, the virus has killed more than half of the nearly 200 people known to have been infected.
It's interesting that ANY discussion of bird flu engenders a reflex "fear/hype" response amongst some posters, (and the usual media culprits) as if the very existence of the discussion (and the provision of neutral information) is an affront to propriety. For example, here's a simulation from the Los Alamos National Laboratory on Avian Flu infection dynamics should 10 people be found positive in a major America City like Los Angeles. The low probability, high impact nature of the Quicktime movie simulation speaks for itself. But as the Science editorial goes on to say:
An energetic response to H5N1 does not have to be alarmist. [emphasis mine] We can marshal existing concern about this particular strain of avian influenza to build a long-lasting international infrastructure to monitor and thwart threats from such emerging infections.
And Americans are concerned. They're a little concerned about bird flu (or the pandemic flu version) and very concerned about the government's abitilty to deal. This AP-Ipsos poll points out that
Only half of Americans are confident their government will deal effectively with the bird flu if it reaches the U.S., and they want strong steps including human quarantine and closed schools if there's an outbreak in the population, according to a poll.
The AP-Ipsos survey, out Friday, found widespread expectation that birds will become infected in this country in the next year, as the government predicts. One third worry someone in their family will get it.
Tara King, posting at Aetiology, highlights one of the many issues:
Here's one of the problems:
Last fall, President Bush proposed approximately $7 billion in emergency funding to help states prepare for a possible outbreak of bird flu. But only about $600 million was earmarked for local public health departments. Congress has approved roughly $3 billion of Bush's proposed funds, setting aside around $350 million for local preparedness.
As I've mentioned before, local public health departments are, more often than not, understaffed and underfunded. Even those who work there may not have the qualifications to head up a pandemic response team. Even running a fairly simple mass vaccination campaign (if there is such a thing as a "simple" one) could easily swamp the resources of many local health departments--and that's assuming that the workers would 1) remain well themselves, and 2) diligently report for work in the event of a pandemic. Neither is certain.
"Supporting local public health is the best bang for the buck," said Etkind. "We can have all the vaccines we need, but who is going to administer them? Who is going to work in the labs? Remember the anthrax scare?"
"Finally there's federal recognition that they can't do this alone, because it's not like the CDC is a huge force of saviors that will swoop in.... It's not going to happen. They're finally getting that.
"On the other hand," Smith said, "the federal plan calls for the development of a local 'infrastructure' for medical convening and planning. I'm it around here in terms of infrastructure."
And that's how many counties are as well--they have a few doctors or nurses who are "it" as far as local public health goes. This is where the rubber meets the road...and if a pandemic were to happen tomorrow, there'd be a lot of engine trouble, to say the least.
Any discussion of solutions has to start with a cogent discussion of the problem. Understanding that coping with any kind of infections disease emergency will be difficult-to-impossible with our current just-in-time goods-and-delivery system (which includes health care), and understanding the scope of influenza pandemics, and understanding that pandemics are inevitable (whether from H5, H9 or something else unanticipated) are a necessary part of the conversation.
Also of note, emptypockets discusses current NIH funding here.
The media (NBC today, ABC in May with a made-for-TV movie) will have their own handling of the topic, and I can't assume they'll do a bang-up job.
But then again, that's why there's blogs.
Modified for posting at Daily Kos from The Next Hurrah