Bird flu expert says 50% of population could die: WTF??

Great Debates
1

Inspired by this recent thread, I’m guessing GD is the best place for a topic like this. So far all the so called “experts” on bird flu have been understandably reluctant to predict whether H5N1 will actually mutate into the Virus of Doom everyone is fearing. Even fewer will make predictions on the severity of the resulting pandemic. Now, the highest estimate I’ve heard so far is 150 million worldwide, I believe from a WHO spokesperson who later backtracked when people freaked out at the shockingly high number.

Now comes Dr. Robert G. Webster, a renowned flu expert who was recently interviewed by ABC News. In this story, he makes two pretty startling statements: 1) the virus now has a 50/50 chance of becoming a pandemic, and 2) if it does, “50 percent of the population could die.”

That’s right, folks: not 50% of those infected . . . 50% of the POPULATION. We’re talking Stephen King End-of-the-World-As-We-Know-It territory.

Now, normally I would react with a hearty :rolleyes: at a statement like this, because the media does tend to search out the most extreme views they can find on any story and portray them as authorities on the subject. But this guy seems to have real credentials – far from the usual conspiracy nuts and other doomsayers. And still, I’ve read very little commentary on these views. If Webster is right, where is he getting this information? He’s talking about possibilities far beyond the worst case scenarios of any of the other “experts.” If you’re going to do that, shouldn’t you back it up somehow? (I’m not saying he hasn’t, mind you – just that he doesn’t do so in this particular article. If anyone has a link with more info, please post.)

If, on the other hand, he doesn’t actually know any more than anybody else, isn’t it incredibly irresponsible to make extreme statements that could cause people to crap their pants in terror? He claims it’s “my role” to tell people these things, but I fail to see what good it could possibly do unless he’s damn sure it’s accurate information. (Even then I’m not sure what we’re supposed to do about it. Put plastic bags on our heads and wait for the Comet to come pick us up?)

So, I was curious how other dopers would react to this. Do Webster’s dire predictions have any scientific basis? If so, where did he get it? If not, why is he speculating so far beyond what anyone else is willing to say?

Finally, is everyone else as scared shitless by this kind of thing as I am? (And no, I’ve never read The Stand! Honest!) :eek:

2

Without data, this is just some guy talking.

Nope

People saying I was being silly for using the term ‘fear mongering’ with the media over this topic, who’s your daddy now (just kidding with the last statement; but this IS fear mongering by the media).

50/50 chance of mutating into a human borne virus? Maybe it will, maybe it won’t? I’m not even sure what that statistic is tied to, but perhaps that is just me. There is no prediction model that I’m aware of (and again might just be me) that has ANY particular virus having a 50% chance of jumping to a specific species.

3

Many experts are saying that IF it mutates into a deadly human to human airborne form it MAY be extremely lethal given the inter-connected nature of the world. We’ve seen how fatal it is when it does infect humans and a pandemic of any size will soon overwhelm health care systems.

It’s clearly a possibility and given his expertise he’s right to speak out. I hope the world is throwing enough money into research and readiness because we know that sooner or later a pandemic of some kind is bound to come along. Compared to what we spend on pointless weapon systems, attacking countries we don’t like the look of and bridges to nowhere it’d be money well spent.

4

In what area? All you could do at this point is plan.

5

No we haven’t. We’ve seen how fatal it is among people so sick they’ve gone to hospital and been found to have avian flu. By that reckoning, “ordinary” flu is going to look pretty dangerous as well, but it neglects all the people who got sick and got better on their own, and all the people whose immune systems just kicked its ass without displaying any symptoms at all.

This topic has had the Fumento treatment: http://www.fumento.com/disease/flu2005.html

A couple of extracts:

The original article has linked cites to most declarations of fact.

6

The current levels of budget allocation to research in viral diseases is less than the budget of one Hollywood movie about viral diseases.

We have our priorities set, we know what we want.

Anyone who says differently is crying wolf.

It’s obvious.

Tris

[sub]: cough cough :[/sub]

7

Most of medical (and pharm) research isn’t done by the US governement, but rather by the Pharma companies, as far as I can tell ALL of the govermental funding is going to either the CDC (which doesn’t do any drug development itself) or universities (which do purer R&D which is then rolled into drugs).

8

Interesting link Matt, I will definitely give it a thorough read.

9

That is a total worst case scenario assuming everyone on earth is infected and mortality is at 50%. Even if it came true that is the same mortality of the Black Plague and civilization survived that.

10

Well, we do know that H5N1 is devasting poultry and waterfowl as it continues to spread. Israel is now on the hit list and the European Union just banned all poultry imports from Israel. When bird flu finally makes it to North America, what will it do to domestic and wild birds?

Source: http://www.poultryegg.org/EconomicInfo/index.html#production

How much of the $30 billion chicken industy will suffer? If bird flu hits the US this year, will there really be a Thanksgiving 2006?

11

We shouldn’t forget that the swine flu pandemic of the mid-'70s killed hundreds of millions of people.
Well, actually it didn’t. And bird flu could turn out the same way. But that doesn’t make for a very sexy interview.

Preparedness - good. Overwrought panic - bad.

12

Another classic in the genre of “poster name meets congruent subject”.

Collect and save 'em.

13

Between H5N1 and BSE, I’m investing heavily in pork and in vegetarian cookbooks.

14

Indeed. Webster is arguably one of the world’s leading authorities on influenza.

Yes, I agree. He should have, and he didn’t. And as one of the world’s leading authorities on influenza, Webster surely appreciates the fact that the current state of the science of virology does not permit the assigning of any particular number to the probability of the virus aquiring the changes required for efficient, sustained transmissibility between humans. “About even odds” also doesn’t mean much if it fails to include some kind of time frame.

The business about the “possibility of fifty percent of the population dying” is even worse; here, Webster appears to have stepped well outside the bounds of his expertise, and attempted to include deaths due not to directly to the virus, but to the effects of social disruption; interruption of supply chains, etc (and his outlook is pretty glum, too). This is the only explanation I can come up with, since I have to assume that he would know better than to expect an attack rate of 100% and a CFR of 50% (which is the only other way you could arrive at such a pessimistic estimate).

My take on this is that while Webster’s conclusions are based as much on an intuitive feel for the virology as they are on hard evidence, his statements also reflect a certain level of frustration, shared by most experts in the relevant fields, with the continued failure of people at large to take the threat seriously. Restructuring the way entire societies distribute critical goods is not a realistic solution, and it doesn’t take much to see that robust pharmaceutical solutions are years to decades away, and suggestions of military-inforced quarantine are the ravings of the utterly clueless. Whatever the probabilities are, if this virus emerges in a pandemic form anytime soon, and if attack and mortality rates are high, it’s going to be bad. If social disruption is severe, widespread, and lasts very long, it’s going to be REAL bad.

People need to take their own survival into their own hands, and do what Dr. Webster states that he has done: stockpile food and water, and get their heads wrapped around the idea that if this thing breaks, their lives ARE going to be affected.

15

It shoudln’t be worst than the Black Death, then? What a relief!!!

16

Shotguns and barbed wire might come in handy when civilization cumbles.

17

If we want a clearer picture of how widespread the thing is, what we do is what are called seroprevelance studies. That’s where testing is performed to see if others besides the confirmed cases have developed antibodies to the virus (paying particular attention to individuals who are likely to have been exposed either to infected humans or infected birds). As I mentioned in the other thread, not nearly enough of this work has been done --and of what has been done, not all of the results have been made widely available to virologists interested in studying them – and of what has been done, and released, the results are somewhat contradictory.

At this point, it certainly seems less than prudent to simply wave the matter off on the assumption that large numbers of asymptomatic or subclinical cases have gone unreported. (Not only that, but that would actually be rather bad news, because it would indicate that surveillance is even worse than we thought, and opportunities for the virus to reassort even more numerous).

Before the first human cases emerged in Hong Kong in 1997, no H5 subtype had demonstrated an ability to produce serious infection in humans – in fact, of the sixteen subtypes designated H1-H16, only three have done so. The significance of immunological naivete is, not surprisingly, easy lost on those who are familiar with seasonal flu as a mere nuisance for the previously healthy. The introduction of a novel virus means that none of us can reasonably expect to have any aquired immunity whatsoever; and therefore, if the virus remains highly pathogenic in a pandemic form, the amount of time our immune systems will require in order to produce antibodies against it will spell the difference between life and death, rather than whether we will return to our normal activities in a week, or in two.

That’s an excellent point. Development of influenza vaccines is particularly problematic for pharmaceutical companies, because influenza’s constantly shifting antigens render the vaccines useless in a short period of time. The persistence of the urban myth that you can get the flu from the vaccine also reduces demand (and therefore profitability), and when you add to that the worst excesses of tort lawyers, it’s not hard to understand why the US imports half its supply of seasonal flu vaccine.

It’s one of the reasons that epidemiologists are so worried, actually; they are painfully aware of the fact that even once a vaccine is developed, worldwide manufacturing capacities are far from adequate to facilitate the production and distribution of enough doses in time to put even the slightest dent in a pandemic. Since the numbers don’t work out for the pharmaceutical companies, the only hope would be to prop up vaccine infrastructure with public money. Since there’s fat chance of that happening, it looks like hunkering down is about all we’ve got.

18

Humanity mosied on down the road after the Black death and we’d do the same even if half the world died of H5N1. It would be a tradegy the likes of which we can’t imagine, but civilization would go on.

19

On another note, for those who don’t know, it isn’t the avian flu itself that kills you it is your own immune system. When H5N1 gets in your lungs it causes a flood of immune chemicals and signals to flood your lungs, drowning you from the inside out. That is why the flu is so deadly and why it kills young healthy people instead of the old and feeble (whose immune systems are too weak to flood them from the inside out). It is called the cytokine storm.

http://www.fluwikie.com/index.php?n=Science.PrimerCytokineStorm

So the drugs to treat H5N1 are going to be different. Heck, a vaccine may actually kill more people than it saves as that would just intensify the immune response. Supposedly drugs like ACE inhibitors help with avian flu, but I don’t know how.

20

That remains somewhat hypothetical at this point. The H5N1 virus has demonstrated an ability to produce primary viral pneumonia, which will do the job nicely even if cytokine regulation is maintained.

Not exactly. “Cytokine storm” refers to a dysregulation of the innate immune response, which includes a lot of inflammation as well as the targeting of infected cells for destruction. It’s crude and heavy-handed, and serves primarily to hold the line until antibodies can be brought to bear on the virus. A vaccine stimulates the adaptive response, wherein antibodies inhibit viral replication in a much more precise and tissue-friendly manner.