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Look Both Ways

    One more quick note about Avian Flu: What people really want to know (even after reading my 9-jillion-word story in the magazine) is whether they should be worried. The answer is, yes, you should be worried about all sorts of things, not least of which is that you're probably getting older, which eventually could lead to death. Also you should worry about national leaders who have a hard time thinking about anything beyond the next election. And you should worry about that cheeseburger you're planning to eat at lunch.

   But as for Avian Flu, we just don't know yet if this is going to be the Big One. It could turn into a pandemic on the scale of 1918 or it could remain essentially just a bird flu that sometimes infects an individual human being. Or it could find some middle ground, becoming a relatively modest pandemic, along the lines of the 1968 flu virus. (From the magazine story: "Contagiousness and virulence are often at cross-purposes.")

    In any case, the government surely should appropriate funds for increased disease surveillance in Africa and Asia. And if people really care about disease, they should consider giving money this holiday season to non-profit organizations that care for sick people in the disadvantaged parts of the world. (Again from the story: "Countless people on the planet suffer from rather mundane but totally treatable and curable diseases. The leading killer worldwide of children is diarrhea caused by parasites. Those children don't need a new vaccine; they need clean water.")

    A physician named Steve Holland, of NIH, pointed out that we have medical technology today that didn't exist in 1918. We were walking through a huge clinical facility on the NIH campus, and Holland said, just look around, look at all these gloves and masks, look at all the resources we have to contain the spread of a disease. I didn't use that quote in the story, but it's a point worth making: We're not exactly helpless when it comes to dealing with infectious agents. We should respect Nature's ability to cook up new pathogens, but we should also acknowledge that science and medicine are a lot more advanced than they were in 1918, when no one had even isolated the flu virus. No one in 1918 knew what hit them.

    Perhaps I should be more alarmed about this new bug, but I'm more worried about crossing the street, because I know that's dangerous, having seen someone hit by a car and mortally injured just 13 days ago. So if you're driving, don't drink, and stay alert; if you're walking, cross at the crosswalk, and remember to always look both ways. In other words, take care of the basic stuff before you worry about the exotic threats.

   [Click here to read the transcript of Monday's online chat about the Avian Flu.]

By Joel Achenbach  |  December 14, 2005; 11:34 AM ET
 
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Comments

It's like I always say; there's just no sense in dying healthy. People are so worried about death they forget about life, I think.

Posted by: LP | December 14, 2005 11:43 AM | Report abuse

Allow me to open this boodle with a comment of agreement with you, Joel.

Things have to be put in perspective. That being said, we who live here in the DC metro area were not directly affected by the hurricanes in NO and the gulf coast, although the lack of preparedness and government caring during it and on the other side of it ought to scare us much, much more, especially in the face of a pandemic. But I mean, bird flu pandemic or hurricane or another 9/11 attack or whatever are all of a piece when it comes to dealing with it. Apparently attempting to prepare ourselves in advance is much too troublesome for those who would rather procrastinate or would otherwise not be willing to spend our precious tax dollars on "something which might not happen" so such money can be handed over to Halliburton on no-bid contracts.

There are many, many people (including a lot of children) living in poverty here. Which is, as we know (because this administration has essentially told us), is all their fault. Presumably, those who are so stupid as to get the bird flu shall be categorized as deserving it, as well.

Those of us who think outside the box are, unfortunately, doomed to be governed by people who cannot even find the box.

Hmmm, maybe I'd better go wash my hands again.

Posted by: firsttimeblogger | December 14, 2005 11:44 AM | Report abuse

Third para., third line: "considere [sic] giving money"

[Sorry! I know I'm a pain . . .]

Posted by: Tom fan | December 14, 2005 11:47 AM | Report abuse

Thanks. I need the backup. I used to be able to type and spell.

Posted by: Achenbach | December 14, 2005 11:50 AM | Report abuse

I think epidemiologist are the economists of the medical world. They have predicted nine of the last five pandemics. Remember swine flu anyone? Of course, the sky only has to fall once to exonerate Chicken Little. The difference between Cassandra and The Boy Who Cried Wolf is largely hindsight.

Posted by: yellojkt | December 14, 2005 11:53 AM | Report abuse

You're more likely to get hit by a car, but nobody would be interested in a online live chat about it. The sad truth is that the likely reasons for injury and death just aren't sexy enough to garner interest.

Posted by: Bayou Self | December 14, 2005 11:56 AM | Report abuse

Main Entry: jil·lion
Pronunciation: 'jil-y&n
Function: noun
Etymology: j + -illion (as in million)
: an indeterminately large number
- jillion adjective

Who knew a 802.777777 was "an indeterminately large number".

Posted by: omnigood | December 14, 2005 11:57 AM | Report abuse

*an* online live chat. I wish this thing had an edit function.

Posted by: Bayou Self | December 14, 2005 11:57 AM | Report abuse

ack, identity crisis returns. It must be time for lunch. Yeah, that's the ticket.

Posted by: omni* | December 14, 2005 11:58 AM | Report abuse

I meant to write 802.77777777777777777777777777778.

Posted by: omnigood | December 14, 2005 12:00 PM | Report abuse

Yeah, now I'm making sense.

Posted by: omnigood | December 14, 2005 12:01 PM | Report abuse

Life is invariably fatal.

I'm willing to put it off as long as reasonable, but I'm going to stop and smell the cheesburgers along the way.

bc

Posted by: bc | December 14, 2005 12:02 PM | Report abuse

Sure, worry about the basic stuff, but what happens when the bad-luck lottery of life just happens to choose you as its fortunate winner?

The chance of getting an adverse reaction for the smallpox inoculation by contact transmission is one in 27 million, stats according to the CDC. How did I get so lucky as to have come down with a case of eczema vaccinatum via contact transmission?

I'm lucky indeed. I pass. I pass as a very fair-skinned African-American may pass for Anglo. I don't look like I was smallpox-vaccine injured. I don't look on the outside like I live with a rare genetic disorder, either.

If you're going to cover viruses as reporters, then for heaven's sake, cover immune system response.

I testified at the Advisory Committee for Immunization Practices in June 2002. The last forum about the advisibility of unleashing smallpox inoculation upon a broad public was, luckily, held in San Antonio. I was the last person to speak at the last of four nationwide forums.

The second most important thing that happened to me that day was meeting Rebecca Rex of Houston, vice president of the Texas-based PROVE, Parents Requesting Open Vaccine Education. In that funny way that many things in life are connected, her grandmother was a resident of Elsa, Texas, and knew the Barbers, Lillian Barber being the last person in the United States to die of naturally occurring smallpox.

Rebecca testified before I did, and I missed a portion of her remarks because I was unaware that one had to offfically register in order to approach the microphone. But I did hear Rebecca tell of her experience of having generalized vaccinia after her inoculation. To this day, Rebecca remembers doctors poring bleach over her inoculation site scars in an attempt to lighten them. My bout with the vaccinia virus was much worse, and to this day, I have no scars whatsoever. Why?

Why did George Washington, my Plantagenet cousin, have only mild scars on his nose, (as Joel, you write in "The Grand Idea") as a result of having full-blown smallpox? Why? Why do some people get avian flu--or Spanish flu and die, while others may have been exposed and lived?

A question for the cosmos, why? A question for science and physicians and immunologists, why? A question for God, why?

Posted by: Loomis | December 14, 2005 12:02 PM | Report abuse

SCC: "cheeseburger".

Damn me all to hell.

bc

Posted by: bc | December 14, 2005 12:03 PM | Report abuse

No, not all of you, just the middle finger of your left hand.

Posted by: omnigoof | December 14, 2005 12:10 PM | Report abuse

Not to divert the Boodle into an unrelated direction, but Terry Neal, WP.com's Talking Points columnist, is leaving to return to the Dead Tree version of WP. His final article had a cute reference to a certain Douglas Adams novel. To underscore his departure, he no longer accepts email. So, in case you're reading this, so long, Terry, and thank you.

Posted by: CowTown | December 14, 2005 12:15 PM | Report abuse

an edit function would be good

note to hal: how about some new functionality that grants at least a limited number of do-overs -- we could un-type some of those infelicitous key-strokes

that would be a good start towards cleaning up our pasts

of course there's the SCC rule barring the un-typing of other people's key-strokes

Posted by: kp | December 14, 2005 12:22 PM | Report abuse

I'm So Worried

I'm so worried about what's happening today,
In the Middle East, you know.
And I'm so worried about the baggage retrieval
System they've got at Heathrow.
I'm so worried about the fashions today,
I don't think they're good for your feet.
And I'm so worried about the shows on TV
That sometimes they want to repeat.

I'm so worried about what's happening today,
In the Middle East, you know.
And I'm so worried about the baggage retrieval
System they've got at Heathrow.
I'm so worried about my hair falling out,
And the state of the world today.
And I'm so worried about being so full of doubt
About everything anyway.

I'm so worried about modern technology,
I'm so worried about all the things
That they dump in the sea.
I'm so worried about it, worried about it,
Worried, worried, worried.
I'm so worried about everything that can go wrong.
I'm so worried about whether people like this song.

I'm so worried about this very next verse,
It isn't the best that I've got.
And I'm so worried about whether I should go on
Or whether I shouldn't just stop.
I'm so worried about whether I ought to have stopped.
And I'm so worried because it's the sort of thing I ought to know.
And I'm so worried about the baggage retrieval
System they've got at Heathrow.
I'm so worried about whether I should have stopped then,
I'm so worried that I'm driving everyone round the bend.
And I'm so worried about the baggage retrieval
System they've got at Heathrow.

-- "I'm So Worried," by Monty Python

Posted by: Achenfan | December 14, 2005 12:23 PM | Report abuse

You have all probably seen this circulating the internet at some point, but it nicely sums up the whole stop and smell the roses/cheeseburgers theme:

Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well-preserved body, but rather to skid in sideways, chocolate in one hand, wine in the other, body thoroughly used up, totally worn out and screaming "WOO HOO what a ride!"

I also find it a handy excuse for not spending time doing my nails.

Posted by: ABJunkie | December 14, 2005 12:25 PM | Report abuse

ABJunkie: That's exactly why I intend to take up skydiving when I'm in my 80's.

Posted by: CowTown | December 14, 2005 12:30 PM | Report abuse

"Saving up your money for a rainy day,
Giving all your clothes to charity.
Last night the wife said,
'Oh boy, when you're dead
You don't take nothing with you
But your soul - think!'"

-- from "The Ballad of John and Yoko"

Posted by: Dreamer | December 14, 2005 12:32 PM | Report abuse

I really wanted to go skydiving in my early 20's, but then I had kids and that desire completely evaporated. By my 80's I may be ready again.

Posted by: ABJunkie | December 14, 2005 12:38 PM | Report abuse

I'm trying to break out of lurker mode here, although frankly it's more daunting with the boodle getting such good press. But circumstances seem to be coalescing to allow me to join in a bit more, so here goes...

So...bird flu is sexy and deadly, but not (yet) worthy of all the hype. If it were to arrive, the public panic might be worse than the disease itself. At least in the US, we are more informed, knowledgeable, healthier, and have a much more robust public health infrastructure than we did than 80 years ago.

Of course, bird flu could be much worse than I expect. My prognostication and a buck fifty almost buy you a decent cuppa joe.

Bird flu is getting so much press now primarily because of its political genesis; the current Administration was not sufficiently funding the research and tracking functions needed to keep ahead of this, and countless other, possible threats to the homeland. With bird flu, the media attention caused someone to recognize that "homeland security" must include robust public health and medical surveillance functions, along with R&D on treatment and delivery and logistics and contingency planning. Had these efforts been properly supported by the Administration since it took over, the story would drawn far less public attention.

In the really big picture: Linda's questions are not answerable, even in the boodle. Not that it hasn't dealt with metaphysics before.

Posted by: silvertongue | December 14, 2005 12:43 PM | Report abuse

Hey, George Bush, Sr. did it (skydiving). It can be done.

Posted by: CowTown | December 14, 2005 12:43 PM | Report abuse

Somehow it's more appealing to consider sliding somewhat gracefully into the grave as opposed to screaming into it from the sky at terminal velocity. Of course, as much as I ski, I'll very likely take a tree, embedded in my face, with me into my grave.

Posted by: Scottynuke | December 14, 2005 12:45 PM | Report abuse

On an unrelated topic:

I find this AP piece by Nedra Pickler on WaPo dot com interesting:

http://www.washingtonpost.com/wp-dyn/content/article/2005/12/14/AR2005121400180.html

And this sentence in particular, beginning the second to last paragraph:

"Bush got a more better reaction from a group of House Democrats that he hosted for a briefing on Iraq before the speech, who emerged complimentary of the president's strategy and his recent doses of candor about the situation there."

Am I the only one who sees the Hand of W in this?

bc

Posted by: bc | December 14, 2005 12:50 PM | Report abuse

My 12-year-old daughter left for school this morning crying because she had not completed her "reading log" so she will be penalized one letter grade on her Reading grade. Her Reading grade. When was the last time a college asked for your Reading grades?

I kissed her on the head for each question I asked her, "Will I love you less if your Reading grade is lower?" No (kiss). "Will you have a terrible life if your Reading grade is lower?" No (kiss). "Will you NOT get into college because your Reading grade is lower?" No (kiss).

This is a kid who reads EVERY night for about an hour before she goes to sleep. Her silly 6th grade teachers have decided to make reading into a chore. Keep a log, write a comment on everything you read for pleasure. Yuk.

When will the 6th Grade teachers get that memo about enjoying life?

Posted by: TBG | December 14, 2005 12:51 PM | Report abuse

I like to say, "Live fast, die young, leave a good-looking corpse."

Too late for me though, dammit.

bc

Posted by: bc | December 14, 2005 12:53 PM | Report abuse

Scottynuke: That's funny, I think of downhill skiing as being much more dangerous than skydiving. But it's something akin to driving being far more dangerous than flying, and people (myself included) tend to have a greater fear of flying than driving.

Silvertongue: That may explain some of the hype, but we all got pretty riled up about West Nile virus too.

Posted by: ABJunkie | December 14, 2005 12:55 PM | Report abuse

I am sure that is my mantra, particularly the part about the chocolate and the wine. mmm chocolate. mmmmmmmmwine.

We worry too much. That is a luxury very very few of our forefathers back to the mists of time have had.

Posted by: dr | December 14, 2005 12:55 PM | Report abuse

How many people die of flu or related illnesses in the US per year, even without an extra pandemic? That extra handful from the last SARS scare was but a small, small percentage of that, I recall.

Wasn't it George Sr.'s 80th he skydived? Probably not quite as exciting as the one into the Pacific all those years back, but I'd choose boring anytime when skydiving is concerned.

Re: Skiing, I've heard 'Bono' as a verb before....

Posted by: Les | December 14, 2005 12:55 PM | Report abuse

Humph.

Since I posted that link, the WaPo appears to have changed that particular piece of html content over to something from one of their writers...

Good thing I clipped'n'saved that one.

bc

Posted by: bc | December 14, 2005 1:03 PM | Report abuse

Indeed, dr. In yesterday's Health section, there was an article called "To Survive Stress, Keep It Brief," about the neuroscientist Robert Sapolsky. An excerpt:

"The body's reaction to stress can become chronic and pernicious. This doesn't happen because a physical threat to safety continues for a long time, but because humans -- endowed with imagination, memory and language -- have the ability to create psychological stress, even when no physical or emotional threat is present. Sapolsky, author of the book 'Why Zebras Don't Get Ulcers,' calls this 'adventitious suffering -- the pain of what was, what will be, what could be or what someone else is experiencing.'

"The body makes no distinction between immediate, in-your-face stressors and chronic, in-your-imagination ones, Sapolsky said. Faced with either kind of threat, the body reacts, and when the threat is sustained psychologically, the physically destructive stress response continues.

"An individual's personality or the frame of mind in which one encounters stress also can determine its health effects."

Posted by: Tom fan | December 14, 2005 1:03 PM | Report abuse

I'm popping in and out of the Boodle because I've got a crazy day. Welcome, silvertongue. Good post. More.

Back later.

Posted by: CowTown | December 14, 2005 1:06 PM | Report abuse

bc - They were probably stricken at Bush getting a "more better" reception.

Posted by: Bayou Self | December 14, 2005 1:06 PM | Report abuse

TBG, you sound like a great mom. My 7 year old already thinks of reading as a chore. It's very depressing. One more thing for me to worry about.

Posted by: ABJunkie | December 14, 2005 1:08 PM | Report abuse

When a friend emailed me that chocolate and wine witticism, I was, quite frankly, appalled. I know it sounds good, and I certainly agree that life should be enjoyed. But I think people use that attitude as an excuse for hedonism, which is NOT the way to happiness.

I know someone whose motto is "Life is a party!" and he is one of the least happy people I know.

I heard it from the Dalai Lama: often you are presented a choice between pleasure and happiness. These days, advocating moderation and right living can seem downright unpatriotic, but I have a pre-9/11 mentality. I have a copy of George Washington's little book about manners on my bookshelf where I see it every day. I believe that if Washington received that email, he wouldn't forward it to anyone.

Posted by: Reader | December 14, 2005 1:20 PM | Report abuse

Back in my motorcycle riding days we used to say "Live fast, die young, leave a good lookin' corpse." Well, those days are long past. After working in hospitals for 9 years, I'll never bike again, but I have stuck with at least one risky behavior (not counting daily driving on the Beltway). For over thirty years I have loved whitewater canoeing. A famous paddler, Walt Blackadar, once said that this sport affords one "the opportunity to die in a beautiful place", and I think that as long as none of my friends were endangered, I'd prefer to just go into a big rapid and never be seen again. I've seen the "go peacefully in his sleep" thing, and it's mostly tubes and needles and I pass on that. Nope. Make it quick and make it final, and give any debris to the nearest med school.

Posted by: kurosawaguy | December 14, 2005 1:25 PM | Report abuse

Hear hear, Reader!

Manners (once described by Heinlein as the grease that keeps the gears of society moving) are so incredibly rare these days. You probably WILL be able to relate to this, which is rather depressing:

I take a commuter train in to work every day. This very morning, I was sitting in a seat opposite a handicapped-accessible seat, so that there was a large open space between the seats. A woman gets on the train, looks at the open space, puts her rollaway laptop case smack dab in the middle of the open space and proceeds to sit in the next row down. Much too much trouble to put it at her feet in her row, or (horror of horrors) actually hold it in her lap! Awfully convenient arrangement if someone needed room to maneuver into the handicap seat, I must say.

*SIGHHHHHHHHHHHHHHHHHHHH*

Posted by: Scottynuke | December 14, 2005 1:30 PM | Report abuse

Thanks ABJunkie. We'll see when she doesn't get into college because of her Reading grades.

Posted by: TBG | December 14, 2005 1:30 PM | Report abuse

I have plagarized and misappropriated bc's blog post from the last boodle about the fetal/human mice cells.
His: http://www.10thcircle.com/10/?p=19
Mine: http://livebythefoma.blogspot.com/2005/12/are-you-pondering-what-im-pondering.html

Forgive me, for I have sinned.

Posted by: yellojkt | December 14, 2005 1:36 PM | Report abuse

I find it tiresome having to get excited over every new trendy worry. Instead I picked the brain of my favorite ENT MD.

He said that "Taking into account that the better number of current Avian Flu fatalities were in areas where the culture is HIGHLY ag-centric (read: they are constantly in contact with the animals) and not all that advanced in the public health arena, that a raging pandemic is unlikely (but not impossible).

So it might be arrogant, but I refuse to worry until it has an actual presence in the US. Especially since I have yet to finish Christmas shopping.

Posted by: Clairebell | December 14, 2005 2:01 PM | Report abuse

No problem yellojkt.

Please exSCCuse the poor comma placement in my comment on your blog.

bc

Posted by: bc | December 14, 2005 2:20 PM | Report abuse

coming to my senses, i feel a need to explain myself. In the previous boodle I wrote:

"Kane, I think the idea of doing lurker week when there are to be no new Kits and the Kaboodle closed down was a joke. But then again I have tennis elbow."

tennis elbow is an inflamed elbow which is a swolen elbow and we all know the elbow is the funny bone, ergo: a swolen sense of humor. Haha.

Posted by: omnigood | December 14, 2005 2:25 PM | Report abuse

and:

Who knew that 802.77777777777777777777777777778 was "an indeterminately large number".

9*802.77777777777777777777777777778=7225:the number of words in the bird flu article.

Posted by: omnigood | December 14, 2005 2:27 PM | Report abuse

and:

bc, it's the middle finger of your left hand, because if you touch type on qwerty key board that'ss the finger going to hell.

Posted by: omnigood | December 14, 2005 2:30 PM | Report abuse

time to get sensless in the new kit.

Posted by: omnigood | December 14, 2005 2:31 PM | Report abuse

Boy, do a couple hours of honest work and you miss a lot. This job is definitely interfering with my boodling.

Loomis, a couple of things. First, no offense to you personally, but we've got to stop electing your relatives president. You done pretty good with the very first George, and maybe a few other early ones, but this last batch (most especially the last two Georges) have been pretty execrable (just had to work that word in), as I think you yourself would admit. I voted for Kerry, of course, but wasn't happy about it. Who else you got lined up in your geneological wings?

OK, motivation for the war. I've wrestled with this more than Jacob wrestled with Yahweh, and hate to be a wuss about it, but still can't firmly decide. I think there is much merit in Cohen's argument that the NeoCons were blinded by their own ideology and hubris (and rank stupidity and incompetence, etc.), and thought they could remake the Middle East (highly ironic for a bunch who only a year or two earlier derided the concept of "nation-building" as some sort of wacky liberal hallucination). But then I have trouble squaring some of that with Chaney and the oil connection--that it was all about oil, oil oil, as Baer and Syriana and many other sources think...and which I'm perfectly willing to believe. Then there is (you should pardon the phrase, or perhaps it's only a bad metaphor) the mind of George Bush himself, a bad mixture of religious/messianic complex and Oedipal crap about fixing Dad's mistake of 10 years earlier, out-doing dear old Dad, Texas (you should pardon the phrase) machismo, etc. Maybe what I really think is that all three of those factors came together in (Major Cliché Warning! Egermancy! Egermancy! Everyone to get from street!) a "perfect storm" of blundering.

What I REALLY have a hard time believing is that, having lived through Johnson, Nixon and the Vietnam era--and having watched the Soviets fail so miserably in Afghanistan, we have learned nothing, nothing, nothing. Most especially the Pentagon, the current leadership of which were wet-behind-the-ears LTs back in the day--or learned their trade directly from them (Powell being the most obvious example). I realize they fired Shinsecki (SCC: hell if I know how to spell it), but even so, I'm amazed that so many military rolled over and went belly-up to a handful of bullies like Wolfowitz, Perl, Feith, etc., people who had themselves never served a day in the military. If they had been Dems in powerful offices who'd never served but were issuing those kind of orders, the Pentagon would have been in open revolt. (And here's the other part of it--although I'm perfectly willing to believe the Chaney/Halliburton/oil connection, I can't believe the Pentagon, for all its mistakes, cares that much about Big Oil.)

Cohen says, "Neo-Conservatism crashed and burned in Iraq." Well, would that it were so. It certainly SHOULD have crashed and burned, it deserved to crash and burn...but has it? I just don't see it, much as I wish it were true.

The reason I wanted your opinion of Syriana, Loomis, is that I saw the screenwriter, Gaghan, being interviewed for an hour (I think it was Charlie Rose), and was fairly impressed, and then saw another show interviewing both Gaghan and Baer himself, and was again impressed. And it was getting excellent reviews--and then along came Cohen to rain on it.

Regarding the fear of avian flu turning into something as virulent as the Spanish Influenza: a couple of things no one has yet discussed (as far as what I've read, anyway, and I've tried to read everything out there):

While it is true that, as Joel says, "we have medical technology today that didn't exist in 1918. ...We're not exactly helpless when it comes to dealing with infectious agents. We should respect Nature's ability to cook up new pathogens, but we should also acknowledge that science and medicine are a lot more advanced than they were in 1918, when no one had even isolated the flu virus," there are two problems.

First, while we have much better medicine now, that is true in the Western World, but not in the Third World, and only partly true in the Second World (guess that's a place). So that even if you postulate that H5N1 might have about the same virulence, yes, probably not nearly as many Americans will die. And yes, we know a lot more about quarantining procedures, isolating epidemics, viz. SARS, etc. The Third World will be obliterated just about the same as it was in 1918 (given the same virulence and contagion). Good for you and me; not so good for them. They knew about quarantines in 1918, too--but did absolutely not one damn thing about using it. Virtually zero. (Barry's book is a 400-page testament to the people who did nothing. It's mind-boggling.)

Second, I have a problem with the statement that "we have [better] medical technology today." Yes, we do, but what I fear is that, like in 1918, the sheer numbers of sick will overwhelm what resources we do have. Yes, we have oxygen tents and intensive care units, and antibiotics to fight off secondary infections. But do we have a couple of million oxygen tents? No. A couple million intensive-care beds? No. A couple of million doctors and nurses who will not themselves get sick, and who will be available to fight the pandemic? No. Just for argument's sake, let's say we have enough resources to blunt a 1918 re-play by, let's say, 40 percent (I don't believe we have that much, but this is hypothetical). Fine--we blunt it by 40 percent. That means that "only" a million and a half or two million Americans (and let's not talk about the rest of the world) will die. Is that acceptable? Or is that not also a disaster of epic proportions?

What people don't realize about 1918 was that the worst phase, the killing phase lasted only about six weeks. That's a very small time period in which to cram a very large number of sick people. It's not at all like we'd be able to tend to 20 or 30 million people over a longer period of time. Ain't gonna happen that way.

Does it do any good whatsoever to point out that "regular" flu that we have now routinely kills 30,000 people a year, which it does. No. Not one bit. If we can't prevent those 30,000 from dying (and those are almost always the immune-compromised, namely the very young and the very old), just imagine what would happen if a 1918-comparable flu that specifically attacked the young and healthy the hardest came to pass? [Not everyone is aware that one of the oddities of the Spanish flu is that it killed the 20- to 35-year-old age group the most. Joel's article mentioned it, but I'm not sure everyone has internalized it: the 1918 flu killed the strongest first and worst. So if you're a Generation X or Y grad and thinking, "I'll be OK but it's my retired parents and my newborn child I'm worried about--you are dead wrong, bucko.]

Nowadays we have the CDC and robust local and state health departments, and an extensive medical industry and infrastructure. Well, guess what? Those things mostly existed back in 1918, too. Granted, they didn't have a flu vaccine worth a damn--but we don't have one today, either, not for H5N1. So it's a race against time (maybe).

A year ago, I, too, would have said that "today our health care infrastructure is so much more advanced than in 1918." But then, a year ago, I would said that we have FEMA, and we have a massive infrastructure that is ready to kick in a moment's notice for a big hurtricane. Just think about that. That's the one single thing that wakes me up in the middle of the night in a cold sweat: the notion that our government will swing into action and render quick, effective relief and aid.

Yeah, right.

Curmudgeon go lay down now. He tired.

Posted by: Curmudgeon | December 14, 2005 2:48 PM | Report abuse

Now that everyone is on the next kaboodle, I want to mention for the record that the meteorite question in the chat was from me. "Last but not least," as they say.

Posted by: Reader | December 14, 2005 2:58 PM | Report abuse

I wonder if people will one day look back at the carnage on our highways with the same horror that we look back upon smallpox. I hope so.

Posted by: RD Padouk | December 14, 2005 8:44 PM | Report abuse

Some wise person of a statistical bent once pointed out that, if our average lifespan was a thousand years rather than a lttle shy of a hundred, that we would NEVER do anything as risky as driving a car.

Posted by: Bob S. | December 14, 2005 10:31 PM | Report abuse

A retired hospital administrator I know said that he thought with our advances in quarantine and public health that no flu would hit as hard as 1918. He used 1968 as an example, having lived through it.

Of course, we are all descended from people who survived the 1918 flu, so odds are that we might be somewhat more resistant by nature.

All I know is that I didnt get a flu shot and I came down with excruciating bronchitis for 2 weeks. I'm sure it was caused by last year's flu. We should worry more about our ability to respond quickly to changes in the common flu.
There has to be a better way to make vaccines other than chicken eggs for 6 months. We are pretty outdated.

And we also should provide more safe water and food worldwide. The more healthy people are, the fewer diseases they get. So amen there. And stop driving recklessly, you might hit me.

Posted by: Wilbrod | December 15, 2005 1:28 PM | Report abuse

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