I can't be the only person in the world who's asked the question: "Is the avian flu scare just another big hype campaign from the Bush administration, like Iraq's weapons of mass destruction?"
That's not as crazy as it sounds. When George Bush announced his $7.1 billion plan to fight avian flu, I thought about what public health officials at the UN and other agencies have been saying about the virus itself and its emergence.
For one thing, it's a bird virus, not a human one. Sure, humans can catch it from birds, but we can't pass it from person to person. So the "experimental vaccine" that drug companies in the US will receive $1.2 billion in taxpayer funds to brew will be great for birds, but not very helpful for humans, unless you spend a lot of time raising chickens, and not even then (see below). And we're not even sure the next big pandemic will come from the H5N1 bird flu virus. It may come from a sick pig, for all we know (remember swine flu?).
The Bush plan includes $1 billion to stockpile Tamiflu and Relenza, two antiviral drugs that have had some effect in reducing the severity of the avian flu. But here's the fine print: not every person who's received doses of these drugs to treat the avian flu has shown a reduction in symptoms. In other words, the antivirals don't work for everybody. Whether that's because some people's bodies deactivate the drugs or because there's more than one strain of avian flu out there, no one knows. In addition, antivirals are like antibiotics; if you use them for every sniffle and stomachache, they lose their effectiveness, because the virus mutates and develops resistance to them (if it hasn't already).
Doctors who've studied the cases of people in Asia who've caught avian flu are puzzled by one fact: poultry handlers and chicken farmers don't seem to be getting sick. Yes, that's right. What you're reading in most press accounts is simply not true. Most of the people who've caught the flu in Asia have bought chickens for dinner in public markets where livestock is sold, taken the birds home and slaughtered them in unsanitary conditions. But the people who handle the birds every day, who raise them, sell them in the markets, and slaughter them haven't fallen ill. Why is that?
(There's a subset of people who've caught the virus by giving mouth-to-mouth resucitation to birds injured in cock fights, but how many Americans are going to kiss a chicken? Seriously.)
Consider this: the people who raise and handle birds have been exposed to various strains of avian flu viruses for years. It's highly possible that they have some natural immunity to the current H5N1 virus. Maybe they've had a similar H5N1 virus before--one that wasn't so deadly in its effect. Even more interesting is the notion that they may have already caught the current virus, but didn't get as sick as the folks who've been hospitalized.
And here's where public health officials disagree with one another. The official statistics, based on hospitalized cases of avian flu show that the current strain has a 50% mortality rate. In other words, half the people who contract it will die. But the statistics are based on people who've been so ill that they've had to go to the hospital. What if there's a larger number of people who've already caught the virus from birds and been sick with a normal case of flu that lays them low for a couple of days, and then they recovered from it? Some public health officials are looking at the data and beginning to think that this is the case.
For example, the majority of people in Asia who've died of the avian flu are young children, which would argue that adults have some natural immunity to the bug. Yet we're all operating on the assumption that this avian virus is worse than any other flu bug that comes along. But this flu season, some 36,000 people will die in the United States of flu--we're talking about the ordinary flu bugs that are already extant in the human population--and many of those deaths will be of elderly folks, people with lowered immune systems, and, yes, children (as we've seen with the avian flu).
The press marches in lock step, spewing warnings about a pandemic akin to the 1918 Spanish flu that killed 500,000 people in the US and millions worldwide. But this isn't 1918. People don't live in tiny houses with parents and children sleeping in the same rooms and sometimes whole families in the same bed. We wash our clothes, blankets, bodies, hands, and just about everything else a lot more often than people did in those days. We have modern disinfectants, indoor plumbing, reliable sources of clean (and hot) water, and modern medicine on our side. What's the difference between 1918 and 2005? A difference of 500,000 vs. 36,000, that's what.
The press, however, continues to print the warnings of "experts"--virus researchers at major drug companies and universities who have a direct financial stake in creating a public scare. They'll be the first ones in line for the billions of dollars in funding for new vaccines and research in the Bush administration's bill.
Meanwhile, the Bush administration is requiring state and local governments to spend their own scarce money to buy up stocks of Tamiflu and Relenza. In an earlier budget bill, the Bush administration cut funding for state healthcare infrastructure by $130 million. Only $100 million of that money will be restored in Bush's avian flu plan. Do more with less money, the feds have told us, with a sickening grin on their faces.
Bush's plan isn't just a giveaway of taxpayer money to pharmaceutical companies. The version of the bill that's flying through the Senate (faster than anyone can read it) contains a provision to set up a government agency that will oversee vaccine development and research. Oddly, the Biomedical Advanced Research and Development Agency will be the only federal agency exempt from the Freedom of Information Act. Not even the CIA or the Department of Homeland Security is exempt from FOIA, but for some reason this new agency has to be. Why? The answer is in the title of the Senate bill: The Biodefense and Pandemic Vaccine and Drug Development Act of 2005. Alarm bells are ringing. The Bush administration wants to fund bioweapons research under the smokescreen of developing an influenza vaccine.
But, let's address the logic of George Bush's argument for a moment. If a highly lethal, human transmissible form of the H5N1 virus ever does emerge, the first line of defense would be local hospitals and local health clinics that are already struggling to handle a flood of emergency room visits by people with no health insurance and no primary care doctors. Add a disaster on top of that and you have, well, something that looks a lot like New Orleans after Hurricane Katrina: the haves fleeing to private hospital beds while the have-nots are left to lie on cots in drafty school gymnasiums without enough nurses, food, or medicines, and forced to line up to use overflowing toilets. It could be 1918 all over again, to our shame and our government's willful indifference.
There's a crying need for reform throughout the entire US healthcare system, but it has nothing to do with avian flu, biodefense, or vaccine development. It has everything to do with making healthcare affordable and accessible to everyone, and ensuring that modern medicine stays modern, relevant, and effective for everyone. The Bush avian flu plan just makes that goal harder to achieve.