Anticipating the next pandemic
In 2005, Hurricane Katrina devastated the American Gulf Coast, killing thousands and destroying the region’s economy. Such natural disasters cannot be prevented, only prepared for, in hopes of diminishing their impact. Yet the threat posed by a hurricane pales in comparison to that of an influenza pandemic, the outbreak of an especially virulent flu strain with the potential to spread across the entire globe. Even a moderately infectious variant of the virus could cost millions of lives and trillions of dollars.
Essentially inevitable, an outbreak of pandemic flu is the equivalent of a global hurricane, one for which the world must prepare together. While preventative measures to forestall threats to public health, such as a global early-warning system and a rapid containment strategy, are currently being executed, the best hope in case of an actual outbreak is a quick quarantine that delays widespread infection. In the meantime, the United States and the international community must continue preparations by improving public health infrastructure, stockpiling flu vaccines, and improving global collaboration on public health issues.
The Gathering Storm
The global community is increasingly interconnected, with fewer and fewer barriers impeding the free flow of ideas and people. Given the fast pace of international commerce, diseases with even moderate incubation periods possess the capacity to cross continents in the span of a single day. The 2003 demonstration of the efficiency of H5N1, a fast-mutating avian influenza that spread quickly from Southeast Asia to much of Eurasia and parts of Africa via migratory birds, showed that little can be done to eradicate the threat posed by infectious disease. As Dr. Martin Cetron, Director of the Global Migration and Quarantine Office of the National Center for Preparedness, Detection and Control of Infectious Diseases told the HPR, “While the public may be suffering from pandemic fatigue because it hasn’t happened, it is inevitable based on the history of the influenza virus.” Dr. Cetron compares an outbreak of pandemic flu to a “category 4 or 5 hurricane” slamming into an unsuspecting city.
Global cooperation is the first line of defense against the threat of influenza. Preventing widespread dispersion by identifying and containing a disease is imperative. As Dr. Steve Redd of the Influenza Coordination Unit of the Center for Disease Control and Prevention told the HPR, “The CDC is coordinating with the ministries of health in various nations,” and has developed technology to detect influenza strains such as “H5N1 in as few as 6 to 8 hours.” These efforts coupled with the rapid response teams of the World Health Organization, based in their network of regional offices, is the best hope for quarantining influenza and preventing it from becoming a pandemic. As Dr. Howard Zucker, former Assistant Director-General of the World Health Organization, elaborated to the HPR, “Avoiding pandemic flu can only be accomplished through international collaboration.” An isolated national response to a pandemic is not a viable strategy and could endanger millions of lives.
Preparing for the Inevitable
Yet, despite the global and near-inevitable nature of an influenza outbreak, national governments can take some steps to ensure that fewer will perish. The stockpiling of antiviral drugs and flu vaccines is the most practical preparation. Dr. Zucker noted that, on average, only “600 million doses of the flu vaccine” can be created per year. Stockpiling vaccines for immediate distribution is necessary for developed nations, but so is making such resources instantly available to developing nations in case of an outbreak.
Moreover, Dr. Cetron believes improving the infrastructure of hospitals by equipping them with additional ventilators and quarantine units would save lives. Currently, bad flu seasons leave hospitals struggling to cope with the lack of resources and personnel. In a pandemic scenario the sheer number of people requiring attention would overwhelm public health infrastructure globally.
Once an influenza outbreak becomes a global pandemic, little will mitigate the economic and human toll, so the international community must focus its energy on measures to contain outbreaks. As Dr. Zucker indicated, the United States could “demonstrate leadership by coupling diplomacy with medicine in an effort to achieve global health security.” Experts agree that an outbreak of influenza is inevitable; how the world community prepares and responds will dictate whether such an outbreak is a footnote in history or a major crisis precipitated by a lack of global collaboration.
