So Michael Fumento has issued a challenge to put ‘odds’ on avian influenza, thinking that somehow I’ve stated that an avian influenza pandemic is likely (he’s also accused me, a scientist, of being “anti-scientist” and “alarmist”). Well, I’m not putting odds down because I’ve never said that a pandemic is likely. Then again, one should hardly be surprised when a professional conservative completely distorts what one says.
In fact, in the post, I wrote:
We can argue about public health priorities (avian flu isn’t my top priority personally).
One would think that was clear, but I made the point in several places that spending money on avian influenza would not be wasteful because those resources could be retargeted for the ‘regular’ influenza which ‘only’ kills around 36,000 people per year in U.S. As part of my job (a public health microbiologist, as opposed to a lawyer), I have to keep my ears to the ground in terms of funding priorities. All of the health-related spending over the last six years has been refocused on two things: ‘faith’ (i.e., theologically conservative dogma) and fear (i.e., bioterrorism). So if the only way to get the government to do something about the annual influenza epidemic is to use the money allocated for ‘biopreparedness‘*, so be it.
Since we are governed by an unaccountable administration driven by politcally motivated fear-based policies, avian flu is a good way to build the necessary IT infrastructure, develop better vaccination production technologies, and build flu vaccine surge capacity–all of which can be used for other public health problems too. Unlike conservatives who like to build things like expensive fighter aircraft we don’t need–which at best idle in hangars–these can be used for other, constructive public health purposes. It shouldn’t have to be that way, but then again, the reality-based party–as opposed to the fear and faith-based party, hasn’t been running things recently.
Here’s a dirty lil’ secret about the Mad Biologist: I don’t worry too much about avian influenza. Either it will evolve or it won’t. But it is certain that 30,000 – 50,000 will die from ordinary influenza. It is within our power to save many or most of these victims. When will we do something about it?
A think tank in Australia released a report claiming that an influenza pandemic might kill over 140 million people. So, after spending most of my professional career examining the evolution of infectious disease, I think…I don’t have any idea if a pandemic influenza strain will evolve. Ultimately, we’re trying to anticipate a unique historically contingent event: placing a probability on the likelihood that this would happen is foolish.
Personally, I think a pandemic is a low probability event, but likely enough to worry about….
But like I said, there are too many unknowns to make any robust predictions. However, I can make one confident prediction: by May 2006, ~37,000 U.S. residents will have died from ‘ordinary’ influenza during the previous twelve months. Yes, 37,000. If these deaths were spaced evenly throughout the year, that would be the equivalent of a Sept. 11 massacre every month…
…one of the best ways to prepare for an influenza pandemic is to increase the production capacity of ‘ordinary’ influenza vaccines-the exact same technology can be ‘repurposed’ for avian influenza vaccines (a national handwashing education campaign would save many lives too). Another important step would be increasing the level of vaccination against bacterial pneumonia–about half of all influenza-related deaths are due to secondary bacterial pneumonia infections. There’s nothing magical or pie-in-the-sky about any of this: we simply need the political will to do this.
I do think things might have radically changed now that we are in the post-amantadine era, but if you really want a number I’ll say two percent based on no scientific evidence whatsoever. That is to say, there’s a two percent chance of something really awful happening. Since we’ve invaded Middle Eastern countries based on as much evidence as my guess, I suppose I’m a man of my times.
I’ll save you any further beck-and-call. The reason I don’t worry very much about avian influenza is that we’re completely overwhelmed with the present public health crises. Here’s just a sampling of what you could do with that $3.6 billion:
1) Get serious about vaccinating children aged 5-18, and provide free vaccination through the school. If we vaccinated 70% of children, it’s estimated we could cut the death toll by up to 80%. That’s roughly 30,000 lives per year.
2) Set up an indeminity program to control VRSA outbreaks.
3) Use the funding to help hospitals implement a serious ‘search and destroy‘ program to control MRSA. This, of course, would require leadership, which is lacking.
4) Tackle the problem of the 90,000 per year in the U.S. who die from hospital-acquired infections.
I’m sure you can think of other public health needs.
Fumento doesn’t mention any of those things. In my post, I challenged him to offer alternative public health priorities. Since he hasn’t, I’ll assume he’s just not serious about saving lives through public health interventions. But I was wrong about one thing in my earlier post: I thought Fumento’s agenda was to support his rabid anti-governmentalism. While it is, in part, there’s a deeper narrative he is trying to support: that liberals are anti-science** and “alarmist.”
It brings to mind something Barbara O’Brien wrote about the right:
Much of the Red Scare and McCarthyist hysteria of the late 1940s and 1950s were as much about slapping down liberals and Democrats as it was about national security. See the Kevin Baker article for details. See also Richard Hofstadter’s Anti-Intellectualism in American Life (Vintage/Random House, 1962), in particular pp. 41-42 (emphasis added):
The inquisitors were trying to give satisfaction against liberals, New Dealers, reformers, internationalists, intellectuals, and finally even against a Republican administration that failed to reserve reverse liberal policies. What was involved, above all, was a set of political hostilities in which the New Deal was linked to the welfare state, the welfare state to socialism, and socialism to Communism. In this crusade Communism was not the target but the weapon, and it is for this reason that so many of the most ardent hunters of impotent domestic Communists were altogether indifferent to efforts to meet the power of International Communism where it really mattered — in the area of world politics.
For a brief time the Dems countered with the “tough liberalism” of which Peter Beinart is so fond, but Beinart misses what the political turmoil of the 1950s was really about. The charges about “losing China” and being “soft on Communism” were not at their roots about national security at all, which is why no amount of national security toughness on the part of liberals will ever appease the Right.
Fumento is trying to establish a similar narrative: wimpy, girly, ‘fraidy-cat liberals have their knickers in a twist over some silly pandemic scare, when we all know that serious, manly conservatives
should piss themselves over Barack Obama, a devout Christian with the middle name of “Hussein” are “iconoclastic” and responsible.
Fumento isn’t serious about public health. If he were serious, he would list other, serious health priorities that should be addressed instead. If he were serious, he would have something to say about how preparing for a pandemic would aid the current and real threat of ‘ordinary’ influenza. But he’s not serious. He’s just trying to bash liberals.
*The boondoggle that is ‘bioterrorism’ funding would require several posts. Suffice it to say, most of the money spent would be better spent bringing our public health infrastructure into the last decade of the 20th century (nevermind the 21st).
**Liberals aren’t the ones who are afraid to state that the Grand Canyon is more than 6,000 year old.
Update: There seems to have been some confusion about my “two percent” statement. That number, mind you which I pulled out of thin air, was per year. Obviously, that means over a twenty-year period, there’s a one in three chance of a pandemic. But Fumento did ask about the next 365 days.