Topic
The past teaches an avian flu epidemic could claim tens of millions.
The grim prospect of an avian flu epidemic is beginning to register widely on the public's imagination. Still, after all these months of monitoring avian flu, we still seem very hazy about the scope of a possible pandemic. The most likely analogy is the Spanish flu of 1918-19, but even there the analogy is weak.
First, medical science was far less advanced than it is now. If Spanish flu had erupted in 1998, say, it would have caused millions of deaths, especially in the less developed world. But the industrial nations would have done far better than they did in 1918.
On the other hand, transportation is far faster than it was at the end of World War I. Many soldiers in the trenches died of flu in hospitals within sound of the guns. US soldiers falling ill today in Iraq or Uzbekistan are likely to be in Germany within hours, if not back home. A wounded soldier with an early case of flu could spread it across thousands of kilometers before anyone noticed.
But let us consider that H5N1 on balance is just about as deadly as Spanish flu was. How would we fare against it?
Twelve terrible weeks
John M. Barry, in his book The Great Influenza, notes that the pandemic lasted two years, but was at its worst over just 12 weeks in the fall of 1918. At that time the earth's population was 1.8 billion-about one-third of today's.
The most recent estimates are that 20 percent of the 1918 world population was infected; in some regions the infection rate was essentially 100 percent, while in others it was quite low. In the US, about 28 percent of 105 million were infected.
The mortality rate also varied. In the US, about 675,000 died, or about 0.65 percent of the total population. Bryan says Italy lost 1 percent, and Mexico somewhere between 2.3 percent and 4 percent. Perhaps 5 to 9 percent of all the young adults in the world died in the 1918-19 pandemic, and the total deaths may have been as high as 100 million. That would have been around 5 percent of the world population. Apparently the only area to escape the Spanish flu altogether was an island in the mouth of the Amazon River. Many native communities in Alaska and the Pacific islands were exterminated.
Another Great Influenza?
In creating a scenario for a new pandemic, let's ignore the regional variations and stick with a world average of 20 percent infections and loss of 2.5 percent of the total population. That's just half of the estimated death rate in 1918-19. Let's also assume that we get a first wave in the spring of 2006, a severe wave in the fall, and then dwindling cases in 2007 and 2008.
With 6.4 billion people, that means 1.28 billion cases of avian flu worldwide. It also means 160 million deaths, the great majority of them occurring in three months.
My own college has a total of 8,000 students, faculty, and staff. About 1,600 of us would be infected, including 100 faculty. Forty of us would die. British Columbia has just over 4 million inhabitants. With a 20 percent "attack rate," 800,000 of us would get sick. With 2.5 percent of us dying, we would lose 100,000 British Columbians.
In Canada, 6.4 million of our 32 million would be infected. The death toll would be 800,000. In the US, about 60 million infections would lead to 7.5 million deaths. (Total US deaths from all causes in 2002 were about 2.4 million, with influenza and pneumonia killing 65,000.)
China's 1.3 billion would suffer 260 million cases and would lose 37 million to the flu.
Danger for mothers and babies
The US National Center for Health Statistics estimates that 6.4 million pregnancies ended in the year 2000. Discounting the 1 million miscarriages and 1.3 million abortions, that meant just over 4 million live births. Assume 4 million pregnant Americans in a pandemic, with a 20 percent infection rate. That means 800,000 women. In 1918, the death rate from influenza among infected pregnant women ranged from 23 to 71 percent. Let's say 30 percent mortality in 2006: 240,000 US deaths in this group alone.
Moreover, a quarter of the pregnant survivors of Spanish flu lost their babies. That suggests an additional 140,000 US deaths in 2006. And a recent report suggests that many babies in utero during the pandemic suffered lifelong physical and intellectual damage because of their mothers' illness. So the new pandemic's effects could last long into the 21st century.
Assume that avian flu also selectively attacks and kills more young adults, as Spanish flu did. If the young adult population suffers 5 percent mortality, twice the average I'm suggesting, we can expect the 150,000 US forces in Iraq to lose 7,500 young men and women to avian influenza. It may be some consolation to reflect that the insurgents will suffer proportionally, and receive less effective medical care.
Collateral damage
Meanwhile, people would also go on dying of heart disease, cancer, stroke, Alzheimer's and all the other diseases. With little or no health care available at the peak of the pandemic, death rates from those diseases would also rise sharply. I realize that most estimates by government health agencies are far lower than the ones I suggest here. The Public Health Agency of Canada, for example, says that between 11,000 and 58,000 Canadian deaths could occur from a new flu virus infecting between 15 and 35 percent of the population. The BC Centre for Disease Control forecasts 6,800 deaths from a 1968-style pandemic, but makes no estimates for something on the scale of Spanish flu.
My 5 percent total mortality figure may be wildly pessimistic. Assume that I'm quintupling the real death toll; if just 1 percent of humanity dies from a flu pandemic in the next couple of years, that will be 64 million deaths in excess of the 50 million or so worldwide "natural" deaths every year.
But this is just a simple arithmetical extrapolation from the generally accepted numbers of 1918-19 to the possible numbers of a modern pandemic. (If I have made errors in calculation, I look forward to prompt corrections.)
As huge as the numbers may be, we would individually experience the pandemic on smaller terms: In a college with 8,000 persons, no one would know all 40 of the dead.
But the pandemic would not be smooth. Some communities would escape with just a few cases, or none at all. Others would suffer terribly. All would endure months of severe anxiety and dislocation, and would emerge poorer and less functional than before the pandemic.
Perhaps the survivors would simply try to forget the trauma and get on with life. But we can hope that a more thoughtful and humane world will recall the price paid for ignorance and wishful thinking-and choose never to pay such a price again.
Crawford Kilian, a frequent contributor to The Tyee, follows avian influenza here. ![[Tyee]](http://thetyee.cachefly.net/ui/img/ico_fishie.png){kind=small}
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freebear
7 years ago
Comments on "A Disaster to Make Hurricane Katrina Look Mini
I do not wish anyone ill will (no pun intended), but the pandemic will likely happen; it may be the earth'sway of shaking off a specieis of parasite that is doing harm to its host.
Who knows,perhaps some governmnet is trying to harness the avian flu and mutate it so that it can spread from human to human and to be used as a biological weapon?
The future looks so bleak I have to wear blinders!
clubofrome
7 years ago
When asked what he thought was a realistic number of humans that could continue on a sustainable journey here on earth, Paul Erlich said_________?
Enter now for a chance at valuable prizes....
Grumpy
7 years ago
One has to remeber that in 1918, after 4 years of a horrible war, much of the population in Europe were under nourished, if not starving. Hygene was poor and the returning soldiers were greatly in poor health. This is a recipe for a pandemic.
Today, avian flu is a risk but we are better able to cope. We must address persone hygene much more carefully; ample paid sick days for people ill with flu.
What will kill us is people continuing to work when sick, because they must!
christwhy
7 years ago
natures way just like aids and mad cow.
just eat lots of fast food, pork rinds, and sugarless food, you'll be fine
Name
7 years ago
Grumpy, the mortality rate for humans infected with H5N1 (Avian flu) in Asia is about 50%. Better hygiene and health won't help much.
Name
7 years ago
...there is one known medication thought to be effective against H5N1 -- Tamiflu. It's manufactured by a single Roche factory in Switzerland and governments are frantically lining up to stockpile supplies, but demand far outstrips supply. The US has been quite late to start vs. European governments -- not sure what Canada has done.
edensw
7 years ago
If you're looking for this book, (The Great Influenza) the author is John Barry, not John Bryant.
I'm not a fan of George W. Bush, so I'm not saying this to point out how astute he is. He's been reading Barry's book, which is not exactly something you'd take to the beach. Add this to his pointed reference to avian flu at the UN, and the fact that Chertoff was apparently distracted from Katrina by a conference on H5N1, and it begins to look like the government is taking notice of the danger--perhaps too late. See http://books.guardian.co.uk/news/articles/0,6109,1550672,00.html and http://seattletimes.nwsource.com/html/nationworld/2002500873_katrespond17.html
scylla
7 years ago
Good thinking, freebear and christwhy - unless, of course, it hits you and yours and then you'll be singing a MUCH different tune.
In this case, you make Dubya look good, as edensw points out.
jsinger
7 years ago
I think it would be reasonable, given the fact that Bush is bragging about his holiday reading list, to have him take an exam so that he might prove that he actually read any part of any of the books he mentioned. I can't believe he reads anything beyond children's books.
Maybe Laura reads to him. That would be better than the little he must be able to read and decipher for himself. No one who actually reads comprehensively would be capable of the mangling George imposes upon the English language daily.
I hope someone is reading to the man. He needs all the exposure to history and concepts he can get (as do we all).
Regarding Avian Influenza: Let's hope that we and our neighbours have more dedicated, intelligent, and reasonable minds planning disaster response for that scenario than have been evident pre and post Katrina. We need our best minds and hearts addressing the issue.
On that note I'd like to take this opportunity to mention Human Factors Engineering. Has anyone else read Kim Vicente's 'The Human Factor - Revolutionizing the Way We Live With Technology'? It won the 2003 National Business Book Award, and Dr. Vicente was chosen by TIME Magazine as one of 25 Canadians under the age of 40 who is a "Leader for the 21st Century who will shape Canada’s future".
I was deeply impressed by the book and feel that the field of Human Factors Engineering discussed therein is essential at this time in many many areas of our lives. Vicente includes real human beings in his definition of technology, thereby allowing a realistic view of complete systems created and dealt with by humans. The field of Human Factors Engineering apparently attempts to make use of our scientific knowledge in all areas, including those related to psychology and sociology, when planning, executing, and trouble shooting systems. Apparently there are Human Factors textbooks, and even formulas that incorporate human behaviour!! I'm sure the subject is very complex, but at least these people are trying to take a systematic and reasonable approach - apparently with good effect in a few safety related systems (medical and aviation examples are given).
I cannot recommend 'The Human Factor' highly enough, for people on either the 'left' or the 'right,' because we all need Vicente's kind of thinking (and more Human Factors Engineers) big time.
Fiat lux
7 years ago
Note to christwhy:
Your comment on eating pork rinds may have been a joke, but, for the record, agribiz pork farms are feeding the manure of their pigs back to them. A few years ago a scientist friend told me that an agribiz pork producer came to their lab, wanting to know whether he could feed his pigs twice with their own manure........not mentioning the tons of chemicals fed to all livestock, especially chicken, pigs and cattle.
As an organic cattle producer without a market for organic beef in this area, I'm forced to take my animals to the auction sales. I took 7 beautiful, healthy cattle to the sales a couple of weeks ago. Neither of them has ever seen a shot, any chemicals, medications, grains, the meat of dead animals processed as cattle feed, growth hormones, or steroids.
When those animals were loaded on the trucks of the buyers, they were shot full of antibiotics, hormones and steroids, until it was coming out of their ears. They're now somewhwere on a huge feedlot, being stuffed with artificial feeds and grains to fatten them and every time they change hands the procedure is repeated, until they may get 5-6 times the recommended dosages.
Then that garbage meat is sold in the supermarkets and to fast food joints and governments are wringing their hands why kids become obese monsters.
So, why do people have to pay extreme prices for organic meats in the cities? Because it is a bloody racket to skin them. We can produce healthy organic meat cheaper that the agribiz operations, but have no market for it. People want to eat stinking yellow tallow in their steaks, calling it marble.
As far the BSE hysteria is concerned, it is a manmade illness caused by the feeding of the carcasses of dead animals to cattle. The illness was then used to break Canadian farmers, so multinational agribiz corporations can pick up their animals and lands for a song.
This, my friends, is the "competitive equilibrium of wealth creating, neoclassical market economy" our governments are so hooked on, being taught in our universities as a "science".
As far the flu epidemic is concerned, we're stocking up, so that, if necessary we won't have to go to town for shopping for a couple of months. We may still get it, but at least we'll try. Ed Deak, Big Lake.
skeptikool
7 years ago
Fiat lux,
You mentioned feeding pigs their own excrement.
I recall several years ago reading in one of those counterculture back-to-the-earth magazines, of a piggery having a human outhouse providing a direct feed. The pigs couldn't get enough and were healthy prized animals. Of course, I doubt the commune's inhabitants' diet included the chemicals and anti-biotics ingested by many today. And, no doubt, the pigs had much other organic food grown on the farm.
On the topic, I believe that our fetish toward personal cleanliness and hygiene, particularly where well-fed children are concerned, may have tended to weaken the body's immune system.
clubofrome
7 years ago
The answer to this weeks quiz....500 million. That's half a billion. There are over 6 billion inhabitants now.
Stump
7 years ago
To mount a partial defence of Erhlich, our pop. of 6 billion doesn't appear sustainable and a great number live in desperate straits while others are forced to hit the gym to burn off unwanted pounds.
His numbers may have been inaccurate, but I think there may be a germ (couldn't resist, sorry) of truth to the idea we've overloaded Planet Earth.
Eddy Haskel
7 years ago
It all boils down to how well you would like the half billion to live. The energy required to make two beer tins is equal to one tin full of gasoline. How many beer drinkers respect that energy waste considering how many of the items litter every corner of the planet?
skeptikool
7 years ago
Let's not get sucked into the Establishment's diversion game, by heaping blame for many of the woes of the woprld on over-population.
Everything would work very nicely with diminished greed, sane distribution, reduced waste and obsolescence, preservation and development of agricultural land, protectuion and development of fish stocks etc.
A tall order, and one that would work, probably, only in a cooperative world of Democratic Socialist governments.
A recent report mentions an annual fiesta in which 36,000 people pelted each other with up to 100 tonnes of ripe tomatoes. This wasteful obscenity goes back to 1944.
Name
7 years ago
FIAT LUX, some direct marketing channels are definitely in order if what you say is true about raising organic meats. I'd be happy to fill my freezer if I could find a source and I'm sure lots of city folks would say the same. I've checked out local farmers' markets, but meat vendors are rare and the few I've seen are even more pricey than Choices, etc.
Fiat lux
7 years ago
Skeptikool....... our overdone hygiene is definitely a good reason for many of our problems, as people's immune systems are ruined. Even 60 years ago, after WW2, US soldiers couldn't eat vegetables grown in Japan and much of Europe and had to have their own chemically fertilized gardens for their kitchens.
I was a 17 year old private in the Hungarian army, wounded on my leg, but not hospitalized until the end of the war, when my ankle was the size of a football, in a German MASH/ POW hospital Austria. After 3 months in bed I volunteered to work as an orderly, with amputees. We started with about 600 and part of my job was to hold the victim's leg in the operations theatre as it was being amputated, or by German custom, reamputated after the original wound cleared itself and healed.
We did this for almost a year after the war, under the most primitive conditions, virtually without medications, no antibiotics, which were unknown in Europe at the time. Anasthaesia was done by a nurse driping ether on a mask on the patient's face. We had no face maskes and only the doctors had rubber gloves. I was in my old uniform, covered with a sheet with a hole in it to stick the patient's leg through. After it was done, the only attention the wounds were getting was some sulpha spray under the bandages, which was my job, going around with a bottle aand a srynge. The bandages were washed and boiled time after time, as we had no new ones, plus some crepe paper bandages.
In all that time, starting with 600, we haven't lost a single patient and never had any infections after operations. The patients took a long time to heal because we were starving, but otherwise there were no problems.
A friend of mine was doing the same job in Minnesota, in a proper hospital, during the Korean war. With all the cleanliness, medications, antibiotics and proper facilities, their infection rate was 30%. Figure it out !
I've never seen a comune, but from what I've read about them at the time, some had some pretty weird ideas. No wonder many of the former inhabitants now are corporate executives and CEOs. Ed Deak, Big Lake.
clubofrome
7 years ago
Skeptikool wrote:
We had all that before 1 billion people. Perhaps you could add in a helping of self control too. Erlich may have picked out this number from understanding rates of consumption and also having the published limits to growth for reference. But it is still number that probably relates to population in the late 17th century. You are basing your comments on the technological advances that have allowed us to produce all this food. Grown from chemicals, unsustainable. Factory processing of fish at sea, unsustainable. Relying on a tech. fix now is just playing russian roulette. So lets not get sucked into thinking it's a distribution problem. Doing the wrong thing right is still doing the wrong thing.
Besides if we shared the wealth in the first place we may not have had the explosion in population growth. The family unit in a poor country is it's insurance. They have no pensions, no social safety net. Without large families there is no one there for them as they age. Before the colonizers came along they were probably self sufficient, not without hardships, but no one said life here would be easy... unless of course you can exploit the poor for your own gain.
Everything would work very nicely if.....
Fiat lux
7 years ago
name..........I don't want to use this forum to sell anything, but many people around here could sell you low cost organic meat, inspected, cut to order and frozen. The cost of the delivery of frozen meat is not too bad to the Vancouver area. If you can find my address on google, drop me a line. Ed Deak, Big Lake.
skeptikool
7 years ago
Fiat lux/ Clubofrome
Thanks for your responses. Was going to write about pigs, backyard rabbits in wartime Britain, food gluts, fallow farmland and reclaiming deserts, but this backblerry wine is starting to get to me making it dufficult to srtike the right kleys.
getya later
scylla
7 years ago
I read last year that some scientist has developed a process by which chicken feathers can be recycled as chicken feed, One farm in the US produces 3 TONS of feathers a day!!
Now, I don't know of any predator that eats feathers, nor any animal that eats its own shit, but since most everything's been tried in evolution, there must be some disadvantages to doing so and thus their being unknown or rare.
I thought I'd do some research into Corporate farming, but after a couple of sites, it began to be too much to bear.
Fiat lux
7 years ago
Scylla.........the secret of corporate farming is to soak everything with chemicals and feed that garbage to people, then get into the cancer cure racket.
There were no cancers to speak of before the Green Revolution etc. Ed Deak, Big Lake.