At the beginning of the Summer of 2009, the threats described below were eclipsed by an overreaction to Swine Flu
. Yawn. What else is new? This was all predicted years ago and it will unfold exactly as described below. It's inevitable. Unless, that is, we get our priorities straight and come to our senses before the coming pandemics wipe out many millions or even billions of people. Read on. Swine Flu was merely a recent scare that underscores what we have been saying on this page for years.
Here We Go!
The fellow who told this story is a rock climber. A while back, he was tethered to a friend, out on a sunny day, climbing up a sheer wall of rock. It was a popular climbing spot and the wall was covered with a half dozen or more pairs of climbers working their way up the rock face.
They were hundreds of feet from the ground below, when all of a sudden from above, a climber who had come loose fell past them. Also tethered to a partner, the falling climber's safety rope pulled taught, and then . . . a crucial piton came loose from the rock and his buddy was wrenched from the wall. As the second climber passed on his final trip down, our observer heard him exclaim, "Here we go!"
Seeing this tragedy and hearing those chilling last words did not dampen our friend's enthusiasm for his sport. After all, he knew the risk was there. That was part of the thrill. The risk can be calculated, and, in fact, it isn't that dangerous; with care relatively few people die rock climbing.
Other risks can also be estimated. For example, what is the probability that we will face a terrible pandemic from some horrific new disease?
Well we know that any species' exists within a balance of opposing forces. For example, parasites infect hosts and, if they kill them, it is only the hosts that survive that tend to pass on their genes. The future generations descended from those that survived, come to be more resistant to the parasite.
The nursery rhyme "Ring Around the Rosie" has been traced by some to the Bubonic Plague's rose-colored lesions and deadly spread. "Ashes to ashes, All fall down" refers to its consequences that all people faced. The more resistant humans who survived made up songs for their children to sing about the deadly reality they faced. [Note: this interpretation of the nursery rhyme is disputed here.] Bubonic Plague still exists. But increased resistance eventually ended its depopulating impact. Life goes on.
However, viruses and bacteria exist in the billions in every host. The number of individual microbes of any one species of bacteria in all humans combined can be astronomical. If just one of those parasites were to mutate into a new, more lethal, and virulent form, it could start another round of mass death in the human host population. One particularly nasty strain of flu killed 25 million people at the end of World War I (10 to 15% of those infected died). And there have been numerous waves of polio, smallpox, and many other diseases throughout our history.
When a new form of a parasite is introduced—as when Old World smallpox was accidentally (and in some cases intentionally!) unleashed on the native populations of the New World—the effect can be devastating. The New World peoples were decimated, dying by the millions upon millions. Europeans didn't conquer the New World. A virus did.
|A species always harbors within it numerous parasites. Here's an illustration of just how plentiful parasites are:
"In short, if all the matter in the universe except the nematodes [roundworms] were swept away, our world would still be dimly recognizable, and if, as disembodied spirits, we could then investigate it, we should find its mountains, hills, vales, rivers, lakes, and oceans represented by a film of nematodes. The location of towns would be decipherable, since for every massing of human beings there would be a corresponding massing of certain nematodes. Trees would still stand in ghostly rows representing our streets and highways. The location of the various plants and animals would still be decipherable, and, had we sufficient knowledge, in many cases even their species could be determined by an examination of their erstwhile nematode parasites." (Nathan A. Cobb, The "Father of Nematology")
And those are just roundworms. The number of individual viruses and bacteria make the numbers of roundworms seem like a drop in a rather humongous bucket. Indeed, roundworms too are infected by viruses and bacteria.
Here's John Hodgman presenting a more
If video fails to play, left-click here;
humorous view of the situation ;-)
to download, right-click.
So what is the probability that we will again face a horror like the plague or the New World invasion of smallpox?
Well, if one of the unimaginable number of parasites that currently infect humans were to mutate into a more virulent form—or if one of those that infects another species were to mutate into a form that easily infects humans—it could put all of us in the same vulnerable position as the native inhabitants of the New World when they were first exposed to smallpox. We would be biologically unprepared to defend ourselves. Most of our bodies would not have natural defenses, and our technological responses (vaccines, antibiotics, and antiviral medicines) take too long to develop for a timely response. We would suffer at least a few rounds of exposure before any new pandemic died down through the natural process of "weeding out" those most vulnerable and leaving behind only the more resistant folks. If—unlike AIDS in which intimate contact with bodily fluids through sexual or blood to blood contact is required for transmission—the disease is highly contagious, almost everyone would be at risk.
With a fatality rate from such a new disease of just 10 - 15%—and if the lingering threat of Avian Flu materializes and turns out to be merely as lethal as the flu pandemic of 1918, 10 - 15% would be the approximate death rate—if everyone were exposed, more than a billion people could die! If the fatality rate is much higher, as in Bubonic Plague (which, if untreated, is 50-60% fatal today, and much more fatal during the plague years when it killed off one third of Europe), or Avian Flu, or AIDS, or Ebola, or Marburg (the latter, Ebola like virus, kills more than 80% of those infected, and there is no treatment), we will be looking at a death toll in the two to five billion range. So, again let's look at the odds.
Rolling the Die(s)The probability of a particular parasite evolving into a more dangerous form is a combination of the total number of actual "bugs" of that type that exist taken along with the likelihood that any single microbe will mutate into a more virulent form. But before this could result in a new disease affecting humanity, another step is necessary. We also have to consider the likelihood that any such new, virulent parasite will actually spread and take root in the human population, before it kills its first hosts and itself in the process.
The first factor, the likelihood that any given specimen of a parasite will mutate into a powerfully infectious killer is tiny. Very tiny. The only reason that we have been confronted by waves of new diseases is that the number of parasites that could so mutate is huge. Very huge. The number of parasites is as huge as the probability that any one will mutate is tiny. The result is our history of new diseases that are followed by new adaptations (resistance) followed by new diseases in a continuous "arms race." A new form of a parasite evolves. After it kills off the most susceptible, the survivors and their offspring are less vulnerable. As a species, we have developed a resistance to that form. And the process is repeated.
To estimate the frequency with which it is likely that a devastating new version of a parasite will race through the human population, we can look at what we know of human history. How often does a terrible pandemic pathogen get loosed on humanity? Various estimates could be made depending on how one evaluates the historical data. The Bubonic Plague significantly reduced the human population for a number of years. But if we look at how many people died in a single year, the flu of 1918 killed more people than the Plague (and many more than the entire death toll from World War I over its four years). The Plague pandemic, however, lasted a number of years and came in more than one wave over the centuries. There are still small outbreaks of it. The flu of 1918 disappeared as quickly as it came.
What Is the Risk to Humans from the Bird Flu Virus in Asia?"The H5N1 virus does not usually infect humans. In 1997, however, the first case of spread from a bird to a human was seen during an outbreak of bird flu in poultry in Hong Kong. The virus caused severe respiratory illness in 18 people, 6 of whom died. Since that time, there have been other cases of H5N1 infection among humans. Most recently, human cases of H5N1 infection have occurred in Thailand, Vietnam and Cambodia during large H5N1 outbreaks in poultry. The death rate for these reported cases has been about 70 percent. Most of these cases occurred from contact with infected poultry or contaminated surfaces; however, it is thought that a few cases of human-to-human spread of H5N1 have occurred.
"So far, spread of H5N1 virus from person to person has been rare and spread has not continued beyond one person. However, because all influenza viruses have the ability to change, scientists are concerned that the H5N1 virus could one day be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If the H5N1 virus were able to infect people and spread easily from person to person, an “influenza pandemic” (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person."
(US Centers for Disease Control [CDC], May 9, 2005)
Some experts are saying that SARS has disappeared and that the risk is over. But we don't need to worry: Avian Flu is still here now that Swine Flu appears to have come and gone. And more are on their way.
Hemorrhagic Fever, anybody?
If video fails to play, left-click here; to download, right-click.
Swine Flu versus Bird Flu
And the winner is . . . Bird Flu by a Landslide!
Some Pretty Ugly Scourges
So, Just How Commonplace Are These VVMD's (Vile Visitations of Mass Death)?
The beauties pictured above may just be the tip of the iceberg. Experts estimate that malaria, for example, which has been around throughout the millions of years of human evolution, has probably killed between 20 and 30 billion people. It continues to take between one and two million human lives each year and the deadliest form is starting to show serious resistance to medication; malaria is now on the upsurge (it was only killing half a million people/year not very long ago).
Smallpox had been around for centuries. Even after weeding out those most susceptible, in its last waves it still killed 20-40% of those it infected. It was finally eradicated by vaccination in the 1970s. However, by that time it had killed about 400 million people in the Twentieth Century alone! So counting major disease outbreaks is somewhat subjective; pandemics are in the eye of the beholder, so to speak. If we were to consider the Plague to be the last major pandemic, occurring 650 years ago, we might come up with a conservative estimate and predict that truly deadly pandemics will arise naturally once every 500 to 1000 years. But in addition to the fact that this would arbitrarily ignore other major diseases, there are other reasons to consider it a gross underestimate.
First of all, at the dawn of civilization 10,000 years ago, at the start of agricultural societies, the worldwide human population was around 10 million or so. This increased slowly, and at the start of the worst bubonic plague years (1347), the population was only a little over 400 million. It didn't break one billion until the 19th Century. So for the majority of recorded human history, other than those parasites that could jump to humans from another species, the parasites already infecting humans that could mutate into a more virulent form only had a few hundred million human hosts to live in; they were "incubated" in millions of humans. The absolute number of parasites that could mutate was much less than the number existing today when existing parasites are incubated in billions of humans.
Secondly, in less dense human populations in which travel was relatively slow, the vast majority of deadly organisms that came into being simply killed their hosts and died off, never to have much impact on the world. With high density populations and rapid travel of large numbers of people, the likelihood that a new deadly bug will survive and establish roots in the human population is much, much greater. This is the reason that places like China are likely to be the source of new virulent agents. And the increasing population density of our planet—which is making more and more of the world as crowded as China has been—is also why the risk of our seeing new devastating diseases is increasing. Dramatically.
January 2, 2012, 4:28 pm
A Public Policy Expert Looks at the Bird Flu Threat
By LAURIE GARRETT
Responding to experiments in the Netherlands and the United States in which scientists created a highly transmissible form of the potentially deadly H5N1 bird flu virus, the National Science Advisory Board for Biosecurity urged scientific journals not to publish details of the work out of fear that the information could be used by terrorists. Laurie Garrett, senior fellow for global health at the Council on Foreign Relations and a recipient of a 1996 Pulitzer Prize for her coverage of an Ebola epidemic, responds to questions about the public policy implications of bird flu and bioterrorism. Her latest book, “I Heard the Sirens Scream,” offers a detailed account of the 2001 anthrax attacks and the bioterrorism policy actions that resulted.
Q. What are the policy implications of the creation of a lethal form of bird flu?
A. The most fundamental question is whether such research should be carried out at all and, if so, under what conditions.
It would be wrong to view the Dutch and Wisconsin H5N1 experiments as isolated, one-off events. Indeed, in July 2005, The Proceedings of the National Academy of Sciences published a paper by Lawrence Wein, of Stanford, and Yifan Liu, of Harvard, that amounted to a recipe for concocting botulism-laced milk. Bruce Alberts, who was then the editor of the journal, resisted suggestions that he censor the paper, writing in an accompanying editorial that “protecting ourselves optimally against terrorist acts will require that both national and state governments, as well as the public, be cognizant of the real dangers.” Mr. Alberts is back in the hot seat today, now editing Science, a journal in which the H5N1 experimenters hope to publish their work.
A long list of potentially frightening experiments conducted over the last 10 years by biologists all over the world have demonstrated that it is possible to construct a virus out of its most basic chemicals, using a published genetic blueprint as your guide. Scientists have now published such blueprints for the organisms that caused the Black Death, several types of influenza outbreaks, Ebola epidemics, the 2003 SARS pandemic and many more.
Ten years ago, deciphering those blueprints was a costly and time-consuming task, but today the entire genetic sequence of a human being can be figured out in a couple of days, at a cost of about $1,000. Viruses, which are orders of magnitude tinier than humans, have minute genetic maps that can now be machine-sequenced in minutes, at a cost of less than $5. Some devices are in the pipeline that would bring the time and cost of genetically mapping a virus down to seconds, at a cost of about 50 cents.
The speed and cheapness of deciphering microbes has spawned what’s known as the synthetic biology movement. So-called life hackers are now swapping genes for diseases in and out of hundreds of species of microbes. Nothing currently written into law, treaties or scientific codes of ethical behavior anticipated the synthetic biology revolution.
Q. What steps have world leaders taken to protect citizens from bioterrorism?
A. In the early 1970s, the Nixon administration and the Brezhnev Soviet regime agreed to mutually destroy their bioweapons programs and signed a treaty called the Biological Weapons Convention. Mr. Brezhnev was convinced that President Nixon was trying to trick him, so he ordered creation of the Biopreparat program in the Soviet Union, which weaponized anthrax and mutant strains of killer viruses, including smallpox. The program ran full pace, with some 60,000 employees, until Boris Yeltsin shut it down in the mid-’90s.
Meanwhile, more than 130 countries have signed onto the treaty, but it has no teeth and is unenforceable. George W. Bush ordered America to withdraw from the treaty a few weeks before the 9/11 attacks, and the United States remains leery of it today. The main concern is verification: If a nation is accused of making bioweapons, as Iraq was in 2002 by the Bush administration, it is almost impossible to disprove the claim. And the reverse is true: If a nation claims to have shut down its bioweapons program – again, as Iraq did in 1993 – it is impossible to verify compliance with the treaty.
Why? A biological weapon can be made in a high school biology lab, a dose sufficient to kill thousands of people may fit inside a thimble-size container, and the only clear signal that it has been released from its test tube would be a surge in hospitalizations and sickness.
In the absence of a tough global treaty, many countries have drawn up codes of conduct for biosecurity, addressing the so-called dual-use conundrum, which states that well-intentioned research conducted in open facilities may also be used for nefarious purposes, including bioterrorism.
The Bush administration pushed hard after 9/11 and the anthrax mailings to create such a code, the key element of which is the National Science Advisory Board for Biosecurity, the body that recommended censorship of the methods used in the Dutch and Wisconsin H5N1 experiments. Because the Dutch work was financed by the National Institutes of Health, the N.S.A.B.B. could chime in on it. But the Dutch researchers had already followed their country’s code of conduct on biosecurity, which is a bit different from that of the N.S.A.B.B. Countries all over the world — including Israel, France, Germany and Japan — have such codes, and their key provisions are not internationally consistent.
Q. Why has it been so difficult to get accurate information about outbreaks of bird flu around the world?
A. We are not sure when the first case of “bird flu” caused by the H5N1 virus occurred, though it is certainly a virus of Chinese origin. The first human case may have been in China in 1996, though even that is disputed amid allegations that the Chinese failed to note, or covered up, cases dating back years earlier. Therein lay the rub: Transparency about flu outbreaks is as much a political issue as a biological one.
Many governments have, since the 1997 bird flu outbreak in Hong Kong, either hidden their cases or failed to provide virus samples and detailed human case information to the World Health Organization or its veterinary counterparts in a timely fashion. Even when political will is operating, biology is a tricky business.
Disease surveillance requires a constellation of factors operating together: physicians spotting suspicious cases; blood and tissue samples collected promptly and properly and sent to well-equipped laboratories for analysis; trained disease detectives who know how to enter poor, remote areas and track flu’s spread. Here in the United States, we have often failed to pull that constellation together in a timely fashion. Aligning the stars in such areas as a remote Indonesian island, in the middle of the Mekong Delta, inside a Cairo slum or among Nigerian villagers is an exceptionally difficult task.
Related Links: Audio: Michael Specter on the dangers of studying bird flu.
ABSTRACT: ANNALS OF MEDICINE about the creation of a highly contagious form of the H5N1 (bird flu) virus by Dutch scientists. To ignite a pandemic, even the most lethal virus would need to meet three conditions: it would have to be one that humans hadn’t confronted before, so that they didn’t have antibodies; it would have to kill them; and it would have to spread easily. H5N1 meets the first two criteria but not the third. Flu viruses mutate rapidly, but over time they tend to weaken. Researchers hoped that this would be the case with H5N1. Nonetheless, for the past decade the threat of an airborne bird flu lingered ominously in the dark imaginings of scientists around the world. Then, last September, the threat became real. At the annual meeting of the European Scientific Working Group on Influenza, Ron Fouchier, a Dutch virologist at the Erasmus Medical Center, in Rotterdam, reported that simply by transferring avian influenza from one ferret to another had made it highly contagious. Fouchier explained that he and his colleagues “mutated the hell out of H5N1”—meaning that they had altered the genetic sequence of the virus in a variety of ways. That had no effect. Then, as Fouchier later put it, “someone finally convinced me to do something really, really stupid.” He spread the virus the old-fashioned way, by squirting the mutated H5N1 into the nose of a ferret and then implanting nasal fluid from that ferret into the nose of another. After ten such manipulations, the virus began to spread rapidly around the ferret cages in his lab. Ferrets that received high doses of H5N1 died within days, but several survived exposure to lower doses. When Fouchier examined the flu cells closely, he became even more alarmed. There were only five genetic changes in two of the viruses’ eight genes. But each mutation had already been found circulating naturally in influenza viruses. Fouchier’s achievement was to place all five mutations together in one virus, which meant that nature could do precisely what he had done in the lab. Fouchier’s report caused a sensation. Scientists harbored new fears of a natural pandemic, and biological-weapons experts maintained that Fouchier’s bird flu posed a threat to hundreds of millions of people. The most important question about the continued use of the virus, and the hardest to answer, is how likely it is to escape the laboratory. Last December, the National Science Advisory Board for Biosecurity, a panel of science, defense, and public-health experts, was asked by the Department of Health and Human Services to evaluate Fouchier’s research. The panel recommended that the two principal scientific journals, Science and Nature, reconsider plans to publish information about the methods used to create the H5N1 virus. It was the first time that the Advisory Board, which was formed after the anthrax attacks of 2001, had issued such a request. Widespread alarm led Science and Nature to agree to postpone publication. For the whole story at The New Yorker, click here.
But we don't have to create them. Here's a new one
that spontaneously arose in the Fall of 2012. Luckily,
it doesn't seem to be very infectious, so far.
September 29, 2012
Potentially Deadly Virus Related to SARS Appears to Be Not Easily Spread
A new strain of a potentially deadly virus related to SARS, which has killed one man in Saudi Arabia and left a Qatari man critically ill in London, does not appear to spread easily from person to person, the World Health Organization says.
Still, officials are urging vigilance, saying that health workers around the world should be on the lookout for anyone with acute respiratory syndrome and requiring hospitalization who had been in the Middle East, where the virus first surfaced, or in contact with a suspected or confirmed case within the last 10 days. On Saturday, the health organization, which was rushing to develop a diagnostic test, said that doctors should test for the virus only if the patient is severely ill, so as not to overburden the health care system.
The virus, as yet unnamed, belongs to the coronavirus family, like SARS. That is the same family of virus as the common cold.
In 2002, a SARS outbreak that began in China went on to infect 8,000, killing one in 10 victims. Vigilant screening and containment helped stem its spread. So far, there is no indication that this virus, never before identified in humans, is as easily transmitted.
“From the information available thus far, it appears that the novel coronavirus cannot be easily transmitted from person to person,” W.H.O. said in a statement on Friday. “Given the severity of the two laboratory confirmed cases, W.H.O. is continuing to monitor the situation in order to provide the appropriate response, expertise and support to its member states.”
The organization issued an initial alert last Sunday saying that researchers had discovered the new virus in a 49-year-old Qatari man visiting London. That man, who is in critical condition in a London hospital, had previously visited Saudi Arabia, where another person was infected with the virus and later died. Both victims suffered kidney failure, according to health officials.
A spokesman for W.H.O., Glenn Thomas, told reporters in Geneva on Friday that they were making progress in developing diagnostic tests but that much work remained.
“From the evidence we have, and given that there are only two cases confirmed so far, and there was a distance and time distance between the two cases, the assumption is that it isn’t easily transferable person to person,” he said.
Public health officials have not recommended any travel restrictions, but with tens of thousands of Muslims preparing to make the annual pilgrimage to Mecca in Saudi Arabia in October, Mr. Thomas said they would be working closely with local authorities to monitor the situation.
Eight months later . . .
The Next Pandemic: Not if, but When
TERRIBLE new forms of infectious disease make headlines, but not at the start. Every pandemic begins small. Early indicators can be subtle and ambiguous. When the Next Big One arrives, spreading across oceans and continents like the sweep of nightfall, causing illness and fear, killing thousands or maybe millions of people, it will be signaled first by quiet, puzzling reports from faraway places — reports to which disease scientists and public health officials, but few of the rest of us, pay close attention. Such reports have been coming in recent months from two countries, China and Saudi Arabia.
You may have seen the news about H7N9, a new strain of avian flu claiming victims in Shanghai and other Chinese locales. Influenzas always draw notice, and always deserve it, because of their great potential to catch hold, spread fast, circle the world and kill lots of people. But even if you’ve been tracking that bird-flu story, you may not have noticed the little items about a “novel coronavirus” on the Arabian Peninsula.
This came into view last September, when the Saudi Ministry of Health announced that such a virus — new to science and medicine — had been detected in three patients, two of whom had already died. By the end of the year, a total of nine cases had been confirmed, with five fatalities. As of Thursday, there have been 18 deaths, 33 cases total, including one patient now hospitalized in France after a trip to the United Arab Emirates. Those numbers are tiny by the standards of global pandemics, but here’s one that’s huge: the case fatality rate is 55 percent. The thing seems to be almost as lethal as Ebola.
Coronaviruses are a genus of bugs that cause respiratory and gastrointestinal infections, sometimes mild and sometimes fierce, in humans, other mammals and birds. They became infamous by association in 2003 because the agent for severe acute respiratory syndrome, or coronavirus. That one emerged suddenly in southern China, passed from person to person and from Guangzhou to Hong Kong, then went swiftly onward by airplane to Toronto, Singapore and elsewhere. Eventually it sickened about 8,000 people, of whom nearly 10 percent died. If not for fast scientific work to identify the virus and rigorous public health measures to contain it, the total case count and death toll could have been much higher.
One authority at the Centers for Disease Control and Prevention, an expert on nasty viruses, told me that the SARS outbreak was the scariest such episode he’d ever seen. That cautionary experience is one reason this novel coronavirus in the Middle East has attracted such concern.
Another reason is that coronaviruses as a group are very changeable, very protean, because of their high rates of mutation and their proclivity for recombination: when the viruses replicate, their genetic material is continually being inaccurately copied — and when two virus strains infect a single host cell, it is often intermixed. Such rich genetic variation gives them what one expert has called an “intrinsic evolvability,” a capacity to adapt quickly to new circumstances within new hosts.
But hold on. I said that the SARS virus “emerged” in southern China, and that raises the question: emerged from where? Every new disease outbreak starts as a mystery, and among the first things to be solved is the question of source.
In most cases, the answer is wildlife. Sixty percent of our infectious diseases fall within this category, caused by viruses or other microbes known as zoonoses. A zoonosis is an animal infection transmissible to humans. Another bit of special lingo: reservoir host. That’s the animal species in which the zoonotic bug resides endemically, inconspicuously, over time. Some unsuspecting person comes in contact with an infected monkey, ape, rodent or wild goose — or maybe just with a domestic duck that has fed around the same pond as the wild goose — and a virus achieves transcendence, passing from one species of host into another. The disease experts call that event a spillover.
Researchers have established that the SARS virus emerged from a bat. The virus may have passed through an intermediate species — another animal, perhaps infected by cage-to-cage contact in one of the crowded live-animal markets of the region — before getting into a person. And while SARS hasn’t recurred, we can assume that the virus still abides in southern China within its reservoir hosts: one or more kinds of bat.
Bats, though wondrous and necessary animals, do seem to be disproportionately implicated as reservoir hosts of new zoonotic viruses: Marburg, Hendra, Nipah, Menangle and others. Bats gather in huge, sociable aggregations and have long life spans, circumstances that may be especially hospitable to viruses. And they fly. Traveling nightly to feed, shifting occasionally from one communal roost to another, they carry their infections widely and spread them to one another.
As for the novel coronavirus in Saudi Arabia, its reservoir host is still undiscovered. But you can be confident that scientific sleuths are on the case and that they will look closely at Arabian bats, including those that visit the productive date-palm groves at the oases of Al Ahsa, near the Persian Gulf.
What can we do? The first obligation is informed awareness. Early reports arrive from afar, seeming exotic and peripheral, but don’t be fooled. One emergent virus, sooner or later, will be the Next Big One. It may show up first in China, in Congo or Bangladesh, or maybe on the Arabian Peninsula; but it will globalize. Most people on earth nowadays live within 24 hours’ travel time of Saudi Arabia. And in October, when millions of people journey to Mecca for the hajj, the Muslim pilgrimage, the lines of connections among humans everywhere will be that much shorter.
We can’t detach ourselves from emerging pathogens either by distance or lack of interest. The planet is too small. We’re like the light heavyweight boxer Billy Conn, stepping into the ring with Joe Louis in 1946: we can run, but we can’t hide.
David Quammen, a contributing writer for National Geographic, is the author, most recently, of “Spillover: Animal Infections and the Next Human Pandemic.”
Man With Drug-Resistant TB Locked Up
Apr 2, 2007 9:35 PM (ET)
By CHRIS KAHN
PHOENIX (AP) - Behind the county hospital's tall cinderblock walls, a
27-year-old tuberculosis patient sits in a jail cell equipped with a
ventilation system that keeps germs from escaping. Robert Daniels has
been locked up indefinitely, perhaps for the rest of his life, since last
July. But he has not been charged with a crime. Instead, he suffers from
an extensively drug-resistant strain of tuberculosis, or XDR-TB. It is
considered virtually untreatable.
County health authorities obtained a court order to lock him up as a
danger to the public because he failed to take precautions to avoid
infecting others. Specifically, he said he did not heed doctors'
instructions to wear a mask in public. . .
Though Daniels' confinement is extremely rare, health experts say it is a
situation that U.S. public health officials may have to confront more and
more because of the spread of drug-resistant TB and the emergence of
diseases such as SARS and avian flu in this increasingly interconnected
"Even though the rate of TB in the U.S. is at the lowest ever this
last year, we live in a globalized world where, if anything emerges
anywhere, it could come to our country right away," said Mark
Harrington, executive director of the Treatment Action Group, an American
The World Health Organization warned last year of the emergence of
extensively drug-resistant TB. The new strain, which has been found
throughout the world, including pockets of the former Soviet Union and
Asia, is resistant not only to the first line of TB drugs but to some
second-line antibiotics as well.
HIV patients with weakened immune systems are especially susceptible. In
South Africa, WHO reported that 52 of 53 HIV patients died within an
average of 25 days after it was discovered they also had XDR-TB.
How to deal with people infected with the new strain is a matter of
Dr. Ross Upshur, director of the Joint Centre for Bioethics at the
University of Toronto, said authorities should detain people with
drug-resistant tuberculosis if they are uncooperative.
"We're on the verge of taking what was a curable disease . . . and making it incurable,"
August 4, 2009
Chinese Town Sealed Off After Plague Deaths
By MICHAEL WINES
BEIJING Officials have sealed off an isolated town of 10,000 people in rural west-central China after an outbreak of pneumonic plague killed two residents, the state-run Xinhua news agency reported Monday.
An official who answered the emergency line at Renmin Hospital in Ziketan, where the outbreak is centered, said that all roads into and out of the area had been closed off, but that residents remained free to move about within the town.
The official, who refused to give his name, said it was unclear when the blockade would be lifted. Repeated calls to a plague emergency phone line produced only busy signals.
The World Health Organization in Geneva is “concerned and monitoring the situation closely,” a spokeswoman said.
Ziketan is an ethnically Tibetan town in the east of Qinghai Province, one of China’s largest and least populated regions. Officials said the first victim, a 32-year-old herdsman, died Thursday, and the second, a neighbor who also was a herdsman, died Sunday, more than a day after being admitted to a hospital.
Local health officials told Xinhua that they had quarantined 10 other people, mostly relatives of the dead men, but that none had developed coughs or fever, signs of the deadly disease.
Pneumonic plague, which attacks the lungs, is closely related to bubonic plague, which killed scores of millions worldwide in the 1300s. But while bubonic plague is commonly spread by flea bites, the deadlier pneumonic plague bacteria is spread through the air by coughing, and it kills about 6 in 10 sufferers if it is not treated.
The W.H.O. spokeswoman, Aphaluck Bhatiasevi, said that China regularly reported small, sporadic outbreaks of bubonic plague but that having it evolve into pneumonic plague was “unexpected.”
The organization said that the mortality rate could be reduced to about 15 percent through treatment with common antibiotics.
Most cases of plague occur in Africa, but the United States records about 10 to 15 cases a year, mostly in rural areas.
China has an unfortunate history of producing new viral strains. Two devastating influenza pandemics, in 1957 and 1968, both originated in China, each killing more than a million people. . . . "China is the perfect breeding ground for new viruses," said Christoph Scholtissek, a German virologist whose research has linked China's traditional farming system with the emergence of lethal human viruses. . . . There is little doubt that crowded conditions, like those in China, play a major part in the spread of SARS. Shoppers in Guangdong province, which has a population of 76 million, throng the busy markets for fresh meat. . . . "Viruses transfer when you have a density of population of people and animals," said Ian Jones, a professor at the School of Animal and Microbial Sciences at the University of Reading in England. "Given that about a quarter of the world's population is living in China, things are just bound to pop up there." (Stefan Lovgren, National Geographic News, May 6, 2003)
For a moment, try to take the point of view of a virus or a bacteria. Consider, from their perspective, how much better life is today, when compared to the plague years. Despite antibiotics (that are losing their effectiveness and were always ineffective against viruses) and vaccines (that often can only be developed after a new bug has been around for years), new germs of today simply have it easy. Take a look:
If video fails to play, left-click here; to download, right-click.
Just imagine how excited a jungle village 'bola would be, if it ever got a glimpse of what life could be like in a typical crowded city.
They fail to limit their population, so nature does it for them
Gypsy Moths: Hairy Today, Gone Tomorrow
Periodically, gypsy moths multiply out of control and population density reaches such a high proportion that entire leafy forests are defoliated. One such outbreak in New England (in 1981) left the trees denuded in the middle of the summer. Standing in the forest, one could hear the crackling sound of millions of gypsy moth larvae as they munched away and dropped a steady stream of their feces from up in the trees. Efforts to control them were to no avail. A few seasons of such defoliation and the trees would die.
But in the second summer, a predicted turnaround occurred. When a gypsy moth population gets sufficiently dense, there is an outbreak of a virus (and/or a fungus). As fast as they appeared and completely dominated the forests, they disappeared, returning to their typical background numbers. Gone. Just like that. Why? The virus and the fungus that infected them are around all the time. What changed was population density. Because of the vast increase in number of gypsy larva hosts for the virus, the actual number of existing viruses within the gypsy moths grew so huge—and the population density was so great (facilitating the spread of a virus)—that it was just a matter of time before a devastating mutant variant could establish itself and decimate the gypsy moth population.
Human Gypsy Moths
Like the gypsy moths—who failed to control their overpopulation—human population density is rapidly approaching such a critical mass. And thanks to the Catholic Church, politicians like George W. Bush, and other like minded religionists, things are going to get much worse. Not only do these religionists believe that birth control goes against the wishes of their supposed, almighty creator—you know, the one with the obsessive-compulsive preoccupation about what His creations do with their sex organs—they also oppose and prevent others from making birth control technology available to the people of our world. As China stabilizes its population, these religionists demand and insist that we force the rest of the world to watch the human population explode without having the resources needed to be able to bring it under control. The result is that much of the world is becoming as densely populated as China has been.
||[Planned Parenthood] is teaching kids to fornicate, teaching people to have adultery, every kind of bestiality, homosexuality, lesbianism—everything that the Bible condemns. (Pat Robertson, The 700 Club television program, April 9, 1991)|
I would like to outlaw contraception . . . Contraception is disgusting: people using each other for pleasure. (Joseph Scheidler, Founder and National Director, Pro-Life Action League)
Despite the slowing rate of increase of the human population, it continues to grow at an unsustainable pace. By 2025, with the help of such religious ideologies, the world population will reach 9 billion. At some point between 2050 and 2100, it will reach 13-15 billion. This means that there will be thirty to fifty times more incubating hosts for new parasites to evolve within than at almost any point in human history. (The same logic applies to livestock, which are often intermediary hosts in the development of new human parasites. With a huge human population, the sheer number of animals being raised to feed the human horde has also increased exponentially.) That increases the likelihood that a new deadly virus will come into existence by a factor of thirty to fifty.
And since now, unlike almost any other point in human history, any such new virus will almost surely come into existence in a densely packed swarm of fast traveling human hosts, the likelihood that a new deadly strain that arises WILL THEN establish roots in our species is many times greater than it has ever been before. Using a most conservative calculation, this has to at least double the risk once again.
The result? The odds of creating a new pandemic virus are far more than 100 times greater than at any point in history. Even if you were to estimate that pandemic bugs have only been created and unleashed at a rate of once every millennium or so, at a frequency a hundred times greater, we should see one . . . fairly soon. At the very least, since our population quintupled over the last century and extremely high population densities became the norm along with ubiquitous rapid transportation, an estimate today of once every hundred years would be conservative.
Swine Flu. AIDS.
Ebola. SARS. Avian Flu. Marburg. They're just the tip of the iceberg. Like the iceberg's tip, they are indications that something is happening below the surface, so to speak. But as much as they are signs of what is coming, despite the widespread devastation of AIDS, so far, they are all "also rans." None of them is about to completely transform the world and human history. However, each of them continues to evolve into new forms. There is "hope" for them yet :-(
In addition, there is a tremendous increase in the risk that brand new communicable and virulent diseases will evolve, as their breeding ground has now gone from millions of human organisms (and their livestock) to billions upon billions. And it is doubtful that the next time, the bigoted, deluded fundamentalists among us will be able to claim the new disease is being visited upon homosexuals as punishment for their sins.
Three Equally Valid Explanations for Parasitical Diseases
Explanation 1, circa 1347: At the height of the Bubonic Plague, the Catholic Church commissioned a group of learned medical men of Paris. They had been educated in church controlled universities, in which only church approved notions about how to understand the world were taught. The conclusion of this learned group? That "the plague was a result of a conjunction of Saturn, Jupiter, and Mars in the 40th degree of Aquarius at 1:00 P.M. on March 20, 1345, causing hot, moist conditions, which forced the earth to exhale a virulent sulfurous miasma."
Explanation 2, circa 1520: "Our bodies are always exposed to Satan. The maladies I suffer are not natural, but Devil's spells . . . And one must in no wise doubt that plagues, fevers and every sort of evil come from him . . . [A]ll the physicians who heal these infirmities, as though they proceeded from natural causes, are ignorant blockheads." (Martin Luther)
Explanation 3, circa 1991: "AIDS is the wrath of a just God against homosexuals. To oppose it would be like an Israelite jumping in the Red Sea to save one of Pharaoh's charioteers . . . AIDS is not just God's punishment for homosexuals; it is God's punishment for the society that tolerates homosexuals." (Reverend Jerry Falwell)
Wanna Go Ebola-ing?
| What Me Worry?
What Me Worry?
[To download, right-click
the animated image]
|But don't worry. In addition to torpedoing any international cooperation that could effectively reduce dangerous population growth, America's recent fearless leader's very first act as President (way back in January of 2001) was to cut off aid to those countries that provide women with information and resources for birth control. And to make sure we are unprepared to face the pandemics of the future without relying solely on divine providence, he also cut funding for the Center for Disease Control and related medical research. Yet his compassionate conservatism—based in his deep, heartfelt concern for the truly needy—caused him to try to establish permanent, huge tax breaks for his billionaire buddies. (You know, those guys who were suffering under the terribly heavy tax burden they were carrying, while the rest of America was goofing off.) So there really was no need to worry. After all, he was praying devoutly.
As one late spiritual leader, a man looked up to by millions, exclaimed, "A person who is guided by God will never be misguided." Yup, that was said by none other than Osama Bin Laden. Remember the anecdote with which we started this page? Well soon, we too may be able to listen to the news of the approaching pandemic, look at one another, and say, "Here we go!"
True Leadership versus the Manipulation of Fear
All of this has been known for many years. For example, consider this 1996 interview of Donald Henderson, former Dean of the School of Public Health at Johns Hopkins University and the person who directed the successful effort by the World Health Organization (from 1966-1977) to eradicate smallpox. Indeed, these concerns led to the first writing of this page in April of 2005, after America had returned to office a president who was hell bent on turning back the clock on any efforts to bring the population explosion under control. Yet it wasn't until the beginning of November 2005, after world leaders and health experts had become quite strident and frightening as they sounded the alarm, that The Shrub called for the expenditure of money to prepare for an Avian Flu pandemic.
Still stinging from criticism due to his administration's utter mismanagement of hurricane Katrina (another crisis rendered tragic by poor planning, utterly inadequate preparation, and general incompetence), right after one of his Supreme Court nominations was shot down as if she were a joke, with high level advisers under investigation and indictment, and with approval ratings in the gutter, all of a sudden "The Decider" decided "to act" like he was the caring, wise, foresighted, fatherly president he was not.
Indeed, just as the country rallied around his pseudo-leadership after 9-11, if only he could generate enough fear and anxiety, maybe people wouldn't notice how disastrous his religiously guided misdirection had been.
Taking any, even if belated, action is certainly better than ignoring an inevitable crisis that has been predicted for years, predicted by all those in the field of disease control long before the arrival of Bird Flu on the scene. Yet, this sudden attention to this frightening problem could not be seen as a sea change; there was no indication that George Bush or the dogmatically deluded religious right had altered course in the slightest. If you had any doubts about the Bush Administration's concerns about protecting Americans from diseases (versus protecting his rich supporters from taxes and corporations from regulations), consider their actions just four months later:
But You Don't Need to Think about Any
of This: Just Eat Your Meat, Have Your
Dessert, & Follow Hulk Hogan's Advice
on "How to Be a Real American!"
The religiously righteous Bush Administration was guilty of INTENTIONAL mass murder!
Just a few days after Colbert's commentary on the U.S. government's approach to Mad Cow Disease, the Bush Administration revealed its true colors when it released its actual plan for Avian Flu. In the video below, pay careful attention to the Bush Administration's plan, which relied on "the voluntarism and sense of civic and humanitarian duty of ordinary Americans." Those are code words for the religious right's plan for government. Note that this isn't our "interpretation." The religious right has repeatedly made this explicit; they called for and spent the eight Bush years implementing their plan, which combines tax cuts and overspending. They accurately anticipated that this would generate a fiscal crisis that would eventually force the elimination of social programs. The only function of government, in their view, is the maintenance of a military. The government has no business being in the business of social support and safety nets. That's the business of God and churches.
It is anathema to the religious right to have a government that people can turn to in times of need. Why? Because it enables them to turn away from God. To the religiously deluded, the government becomes a secular (read evil), false idol that people can look to instead of prayer and instead of huddling together in their church communities and instead of total dependence on charity organized by "faith-based intitiatives." A government that can be expected to be there for you in times of great need diminishes the need for God and your church community. It must be eliminated.
And the Bush Administration, with its numerous religious appointees at all levels, had been doing just that, i.e., attempting to dismantle all the social safety nets and protections put in place by both "liberals" as well as by old school Republicans, prior to the domination of their party by fundamentalist Christians. The Shrub's religious administration even tried to dismantle Medicare and Social Security. Remember the push to privatize Social Security? That would have gone a long way to eviscerating it. Only during the Bush Administration, which began with the largest government surpluses in history, did the Social Security statements Americans receive change. Prior to the Bush years, those statements reported the benefits a worker can expect to receive at retirement. During the Bush years, the statements were changed to say what MAY be available if funds don't run out; and in those new statements about the benefits that workers had paid enormous social security taxes for, they were told that the funds are expected to run out! So much for social security!
This intentional dismantling of safety nets and intentional evisceration of the government's ability to respond—which would indeed have the desired effect of making people feel more vulnerable, helpless, and religious (!)—is planned murder. OK, maybe we are exaggerating a little: The technical term for negligence that leads to people's death is manslaughter, not murder. And some of the 1300 people who, for example, lost their lives as a result of hurricane Katrina would have died despite the government's best efforts, even had there been careful planning. So the number of criminal counts for manslaughter might be unclear. But in the following video, as you hear those code words for dismantling America's safety nets, it should become clear that they were getting ready for a massive turning to terror and . . . God. Their intention was that their religious goals be realized, no matter how many must die.
Scare Tactics versus Facing Reality
"One of the biggest changes in politics in my lifetime is that the delusional is no longer marginal. It has come in from the fringe, to sit in the seat of power in the Oval Office and in Congress. For the first time in our history, ideology and theology hold a monopoly of power in Washington. Theology asserts propositions that cannot be proven true; ideologues hold stoutly to a world view despite being contradicted by what is generally accepted as reality. When ideology and theology couple, their offspring are not always bad but they are always blind. And there is the danger: voters and politicians alike, oblivious to the facts." Bill Moyers: Democracy in the Balance
So, are we trying to scare you? Well, yes and no. We do believe that—when looking at this issue as well as quite a few others facing our species today—those who aren't worried, aren't paying attention. So we do want to try to awaken folks who are lulled into complacence by a combination of the demands of daily life, the truly pleasant distractions available to many of us with resources at hand, and a sense of despair when we momentarily turn to face horrible realities that seem encased in absolute inevitability. In such circumstances, it seems almost insane not to turn away from reality!
Yes, paradoxically, the hallmark of insanity—a turning away from reality—can seem sane! And this seemingly sane insanity is what most people build their lives upon: simply trying to take care of business and grab whatever modicums of happiness one can from life. This "business as usual" approach to life exists side by side with the awareness of inevitable catastrophes to which we say, "What can I do? I'm only one person. Stop bothering me."
So, are we trying to scare you? Of course! We believe that only by paying attention to Reality and forcing ourselves to consider horrible truths can we take action and prevent such tragedies. So, yes we want you to join us in coordinated, effective action to stop the insanity. Yes, we want you to be scared into action. However, if we just wanted to scare you, we could play the ex-president's game and present the truly scary reality in such a way that it encourages a sense of helplessness and a need to follow a pseudo-leader who has been trained to imitate a protective authority figure. For example, if our goal was just to scare you with the intimidating voice of authority, we could have presented the bird flu data like this.
The truth is that, as we updated this page in the Summer of 2009, we didn't know whether Swine Flu would be much worse than other flus (that also kill significant numbers of people) or whether Bird Flu will mutate into a form that can cause a human pandemic then, this year, the next, or ever. There are clear signs that the danger from Bird Flu has not passed. Yet, while we can be certain that, without intelligent planning and preventative action, great tragedies will result from horrific pandemics, we can't say exactly when, or even be sure that any one virus such as Bird Flu will be one that causes such a pandemic. Therefore, we should be planning, not panicking.
Along with such leading lights as Osama Bin Laden, George Bush had no need to be concerned about human made catastrophes (like the effects of massive overpopulation). After all as Osama said, one cannot be misguided if one is guided by God! The Shrub made not the slightest effort to proactively plan for or to try to prevent any coming pandemic until he was soundly embarrassed by Katrina, and then other crises made him urgently need to exploit fear and anxiety.
And then he eagerly exaggerated the immediate danger in an effort to restore his plummeting ratings. He tried to appear "presidential" in his concern for our well-being and in his new, foresighted planning, even though he had been ignoring this festering crisis for five years (a deep and profound problem that involves far more than Bird Flu). All of a sudden, in a grand gesture of distraction, his administration started emphasizing the danger, claiming that a pandemic in the immediate future is almost "certain." Just the ticket to get people to ignore your religiously deluded incompetence and righteous indifference to preventable human tragedies.
Yes, this is an extremely cynical view of Bush's presidency. But even more than that it is an indictment of a co-opted democratic system that puts authoritarian, sound-bite, religious ideologues in power, not true leaders. Once again we are confronted by the distinction between authority and leadership.
BTW, if you have any doubts about the accuracy of this view, just consider what happened to Bush's pandemic initiatives. When the particular pandemic didn't materialize and the public's attention waned, an authoritarian powerholder will posture and pose around some other crisis. There was no true leadership there. No true understanding of the problem. And no real action.
Sounds Pretty Hopeless, No?
Yes, long before the free world's former "fearless leader" found it politically expedient to trumpet approaching doom, anybody who was paying attention knew there was a real problem. And unfortunately it may hit us sooner than later.
We heard from the CDC (see the box above), now consider the
WHO Bird Flu Warning
September 16, 2005
The boss of the World Health Organisation, Lee Jong-wook, has issued a
new warning about avian flu.
He has again warned that the virus, which has triggered a major health
scare in Southeast Asia, could mutate into a major killer . . .
"The existing H5N1 hasn't yet acquired its ability to transmit among the
humans," Lee said.
"But when it acquires this ability, and there is some evidence that this
will be the case, I hope this will be simply less toxic than the
existing H5N1, which has killed half the people infected," he told
reporters . . .
The WHO last month said current production of anti-viral vaccines was
insufficient to deal with a catastrophic flu epidemic like the one that
struck in 1918 and killed some 40 million people around the world.
SOURCE: World News
Amid Warnings, Richer Nations Seek Protection From Bird Flu
By ELISABETH ROSENTHAL
September 19, 2005
ROME - As World Health Organization officials repeat warnings about the potential for a deadly bird flu pandemic, wealthier countries are redoubling efforts to buy an experimental vaccine and antiviral drugs in the hopes of protecting their citizens from infection . . .
"We know we're overdue for an influenza pandemic strain, and we know it will occur, but we don't know when or even exactly what virus will cause it," said Dick Thompson, a WHO spokesman . . .
The bird flu virus has two characteristics that make it capable of igniting a pandemic. It is a new virus, so humans have no defenses against it. It produces severe disease, killing about half of those infected, almost all through contact with sick birds.
"H5N1 has pandemic potential but it is not a pandemic virus," Mr. Thompson said, because it does not spread easily among humans.
But flu viruses are prone to mutation and exchanging genetic material when they infect an animal together. So one big fear is that an ordinary human flu virus and the bird flu virus could mix genes, creating a new type of lethal human bird flu virus . . .
Copyright 2005 The New York Times Company
So, yes it is hopeless, if we lose hope and don't do anything about it! If we say, "What can I do?" and turn our backs to the problem and look for something else to think about, we can pretty much count on seeing a rather horrifying scenario unfold by the time of our children's children's generation, i.e., sometime in our lives or the lives of our grandchildren. And given the almost ideal breeding conditions we have arranged for the development of diseases, we can expect more than one "pandemic."
But it is not a foregone conclusion that we will continue to ignore such problems. Nobody is forcing us to bury our heads in the sand. Indeed, we are getting some warning signals (SARS, Swine Flu, AIDS, Avian Flu, Ebola, etc.). And, with just a little luck, we will simply see more of the same, if we can stabilize our population and then have the time (and the wisdom and will) to invest in developing better medical solutions. A series of unimaginable tragedies does not have to be inevitable.
Hopefully, you see where this is headed. Alone and separate we will face inevitable horror as we watch the human masses follow religiously deluded "leaders," like lemmings to the sea. And we won't just watch; as we are swept along, we will be able to turn to each other and say, "Here we go!" However, if we organize around the truths revealed to us by Yo/Reality—and if following The Way of Yo, we become an effective force guiding humanity down a sane path, away from delusion—this and many other tragedies need not occur.
As Saint Howard (Zinn) challenged:
I am totally confident not that the world will get better, but that we should not give up the game before all the cards have been played. The metaphor is deliberate; life is a gamble. Not to play is to foreclose any chance of winning. To play, to act, is to create at least a possibility of changing the world.
Join us before it is too late.
For our children.
And for our children's children.
And if and when it all feels like too much, and
you feel like the photographer who took this picture:
consider the wise words of Gandalf the Grey.
this will be replaced by the SWF.
If video fails to play, left-click here; to download, right-click.