Crawford Kilian on H1N1

By John Ballard

This commentary by Crof is worth a reprint. This man's blog is the gold standard for picking a subject and staying on task. Of course Avian flu (H5N1) is technically not the same as Swine flu (H1N1) but the current national and global response to the H1N1 global pandemic can be seen as an indicator of how the country and the world might respond to the tragic results of an h2h (human to human) reassortment of the Avian flu virus.

Every morning, around 5:30 or 6:00, I turn on my laptop and start going through some 50 or 60 emails about H1N1 that have arrived since 10:00 the night before. I know I'll get a couple of hundred more before the day is through.

A discouraging number of them try to tell me that this is a bogus pandemic; seasonal flu, they remind me again and again, kills 36,000 Americans every year. (Deaths outside America seem not to matter to these people.)

So why should we care about the illness and death that this "mild" influenza has inflicted on the world since last March?

My answer: Why don't we care about those 36,000? Or the 30,000 Americans killed by gunshots every single year since at least the 1960s? Or the people killed in auto accidents, or from tobacco, or any number of other preventable causes? And shall we get into HIV/AIDS, tuberculosis, malaria, and that smelly killer of millions of children, diarrhea?

La Rochefoucauld, that wise old cynic, long ago observed that we always find the strength to bear the misfortunes of other people.

To bear the misfortunes of seasonal-flu deaths, gunshot deaths, auto accidents, and so on, is not really a sign of strength, but of what Samuel Johnson called "stark insensibility." We are too stupid to care about the avoidable misery around us.

But when a new disease comes along, some of us rouse ourselves from our stupor and make some effort to contain the threat. Meanwhile, others only a little more stupid are asking us why we bother: "Hey, H1N1 isn't killing as many people as seasonal flu does. What's your problem?"

Well, one lesson we might take away from this pandemic is that every preventable death, whatever its cause, is a death we could and should prevent. If we all go back to business as usual when H1N1 fades away, we will deserve the wretched consequences.

In a misguided attempt to make a story out of a non-story, commentators (even editors) waste valuable air time prating about vaccines, underscoring shortages, side effects and dramatic exceptions in efforts to bring drama to an otherwise undramatic story.

In the last week I have heard an increasing number of negative reactions to the national response to the flu. (Remember where I live. I want to think my location has something to do with what I'm hearing, but from the subtext of some national sources I suspect that is not the case.)

• The shots are dangerous.
• Not enough testing
• They have rushed the program
• They have not rushed the program enough
• What we are seeing just shows how bad a government program can be
• I know medical people refusing to get their kids vaccinated
• There was no scientific reason for the president to declare an emergency
• Why didn't they move sooner?
• What's the big deal? It's just like the regular flu.

On and on. It makes me sick to listen.

I want a vaccine that stops ignorance but most of those who need it would refuse to have anything to do with it.

Last night I heard a story suggesting that if more companies had been contracted to produce the new vaccine there would by now be more than enough. Of course they would be using different methods (like growing organic products from caterpillars instead of the old-fashioned method of waiting for the new strains to grow in chicken eggs) but had vaccine production been outsourced to those alternatives, the same sensational reporting would be focusing either on the side effects of a new, ("poorly tested"?) product or the slowness with which it was getting to market. 

As I listen to these reactions, I try to imagine what the same sources would say if this were a mutation with a fifty percent mortality rate. Accounts of the global impact of the 1918 flu pandemic are horrific. John Barry's book about it was a reference point for both Obama and Bush, but as in the case of climate change, great numbers of otherwise rational people are able to imagine that the entire world is being hoodwinked by a sinister conspiracy to manipulate the masses with an unfounded fear.

Comments

[Dick Swift]

One company has developed the virus-like-particle swine flu vaccine...Novavax...using insect cells and GE bioreactors for manufacture. Phase II trials a success and waiting for a foot dragging FDA to fund phase III. The VLP technology is definitely the vaccine technology of the future. Using DNA information (not the virus) from the CDC, Novavax developed the seed to begin manufacture in only 11 weeks. The vaccine is now beginning trials in Mexico and India. Spain is adopting the Novavax/GE plants for future vaccines of all descriptions. The process is not only faster, but cheaper. Novavax has also tested a trivalent flu vaccine and has RSV, Zoster and SARS vaccines in the preclinic pipeline. With EMory University and the University of Alabama researches, Novavax is 6 years into an HIV vaccine.