Left Behinds

The anti-andrewsullivan.com. Or, the Robin Hood (Maid Marian?) of bright pink Blogger blogs.

Thursday, March 02, 2006

Why it matters to be rational, and how you can tell we aren’t.

When I wrote a week ago that Americans are getting less rational, I got some disagreement from my co-bloggers and friends about how dire the situation really was. I want to return to the subject, because based on what I have been reading and hearing over the last few weeks, I believe that the world and our country as part of it currently face two overwhelming threats, one in the long term, the other in the near term.

Neither is terrorism. Certainly neither is as remote as the threat that Dubai Ports World will allow al-Qaeda to smuggle a nuclear bomb into New York in a container. Nor is either as ridiculously remote as the threat that Saddam Hussein will give al-Qaeda his stores of weaponized anthrax, a threat we have so far spent $240 billion to eliminate. And counting.

The long-term threat is global warming, the short-term one, avian flu. I will address the former in a future post, but for now I will say that we have had scientists warning about global warming for 20 years now and have yet to do anything about it, though I don’t know that we can even consider it just a threat anymore. It is a present reality whose consequences are becoming ever more obvious.

To turn to avian influenza: flu pandemics happen roughly every 30–40 years. The last was in 1968, or 38 years ago. In each case they occur when a new influenza virus, one our bodies have no immunity against, jumps from animals to humans. The flu we get shots against every year is a mutated version of the same strain that emerged in 1968.

The worst influenza pandemic of this century, the “Spanish flu” pandemic of 1918, was caused by a strain of avian influenza known as H1N1, similar to the H5N1 strain circulating today. Unlike the ordinary, yearly flu that kills the very young, the aged, and those with weakened immune systems, H5N1, like H1N1 in 1918, mainly seems to kill people with healthy immune systems. The virus appears to hyperactivate the cytokines (a signaling element of the immune system), and in the resulting “cytokine storm” the immune system attacks the body, leading to hemorrhaging and organ failure.

H5N1 has infected 190 humans by passing directly from birds, and of these more than half have died. So far it has not developed the ability to pass from person to person, but it belongs to a class of virus that can mutate and adapt very quickly.

In the 1918 pandemic, 50–100 million people died worldwide; 500,000–675,000 died in the United States. If H5N1 did equivalent damage, we would have 1.2–1.8 million deaths in the United States and 260–520 million worldwide. Although we have better medical care in this country than we did then, much of the world doesn’t, and we are far more interconnected now.

(Many of these facts came from a presentation [PDF] on avian influenza I attended last week. Some come from the question-and-answer period, so they are not in the linked document.)

We have known about avian flu since 2003, but until a major emergency appropriation of $3.8 billion in late December (now that it’s spread as far as Europe and Africa), we had come up with only tens of millions to deal with it. We missed our chance to keep it from spreading all over the world in birds. Everything I heard at that USAID presentation led me to believe that public health officials, while they are doing all they can with what they have, are basically just crossing their fingers that it won’t mutate and develop the ability to pass from person to person; the more it spreads, though, the larger the genetic reservoir and the greater the chance that that will happen, statistically speaking. The other hope we have is to develop a vaccine before human-to-human transmission happens, but it takes time to manufacture and distribute large amounts of vaccine even if we do invent one—again, we’d be in a lot better shape today if we’d started serious work in 2003.

In a rational politics, this would be a scandal, not this dumb-ass DPW business. Actually, in a rational politics we would have mounted a major response two years ago. But it’s not news. (In fact none of this is news. You probably knew it all before. Some people I know are sick of hearing me prate about it.) We didn’t begin dealing with it until now because the same people who believe in ghosts and ESP believe terrists gonna bomb their mini-mall. People cannot distinguish between real threats and fantasy.

For way more information on flu, visit the Flu Wiki.

P.S.: More on dumb Americans (PDF).

P.P.S. [UPDATE]: Of course, invading Iraq wasn't at all about assessing threats rationally.

U.S. intelligence agencies unanimously agreed that it was unlikely that Saddam would try to attack the United States [either directly, or indirectly by working with terrorists] -- except if "ongoing military operations risked the imminent demise of his regime" or if he intended to "extract revenge" for such an assault.

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  • At 12:16 PM, Blogger Coco Seven Mile said…

    Here's a question about H5N1 that I'm embarassed to ask: what exactly is the method of bird-to-human transmission? Does an infected bird peck or bite a human? Does a human hold a (dead? live?) infected bird? Does a human eat an infected bird?

  • At 12:27 PM, Blogger Antid Oto said…

    From the WHO's FAQ:

    How do people become infected?

    Direct contact with infected poultry, or surfaces and objects contaminated by their faeces, is presently considered the main route of human infection. To date, most human cases have occurred in rural or periurban areas where many households keep small poultry flocks, which often roam freely, sometimes entering homes or sharing outdoor areas where children play. As infected birds shed large quantities of virus in their faeces, opportunities for exposure to infected droppings or to environments contaminated by the virus are abundant under such conditions. Moreover, because many households in Asia depend on poultry for income and food, many families sell or slaughter and consume birds when signs of illness appear in a flock, and this practice has proved difficult to change. Exposure is considered most likely during slaughter, defeathering, butchering, and preparation of poultry for cooking.

    Is it safe to eat poultry and poultry products?

    Yes, though certain precautions should be followed in countries currently experiencing outbreaks. In areas free of the disease, poultry and poultry products can be prepared and consumed as usual (following good hygienic practices and proper cooking), with no fear of acquiring infection with the H5N1 virus.

    In areas experiencing outbreaks, poultry and poultry products can also be safely consumed provided these items are properly cooked and properly handled during food preparation. The H5N1 virus is sensitive to heat. Normal temperatures used for cooking (70oC in all parts of the food) will kill the virus. Consumers need to be sure that all parts of the poultry are fully cooked (no “pink” parts) and that eggs, too, are properly cooked (no “runny” yolks).

    Consumers should also be aware of the risk of cross-contamination. Juices from raw poultry and poultry products should never be allowed, during food preparation, to touch or mix with items eaten raw. When handling raw poultry or raw poultry products, persons involved in food preparation should wash their hands thoroughly and clean and disinfect surfaces in contact with the poultry products Soap and hot water are sufficient for this purpose.

    In areas experiencing outbreaks in poultry, raw eggs should not be used in foods that will not be further heat-treated as, for example by cooking or baking.

    Avian influenza is not transmitted through cooked food. To date, no evidence indicates that anyone has become infected following the consumption of properly cooked poultry or poultry products, even when these foods were contaminated with the H5N1 virus.

    Does the virus spread easily from birds to humans?

    No. Though more than 100 human cases have occurred in the current outbreak, this is a small number compared with the huge number of birds affected and the numerous associated opportunities for human exposure, especially in areas where backyard flocks are common. It is not presently understood why some people, and not others, become infected following similar exposures.

  • At 9:50 AM, Anonymous Cite Menu said…

    Its a nice and good information


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