Sunday, May 20, 2007

Pandemic flu, Meet Peak Oil.

Miranda and I are hard at work on some minor revisions and an FAQ for the 90% down project, but I wanted to direct your attention to a recently released Pentagon report on the military's preparations for bird flu. I think this is important for several reasons. Here's a summary of the report: http://news.yahoo.com/s/afp/20070510/pl_afp/healthfluusmilitary_070510181445 - a link to the direct report is contained within.

The military is preparing for a sustained, recurrent epidemic of avian flu, with a mortality rate of about 1 out of 100, major societal and economic disruptions, and to see our medical infrastructure totally overwhelmed, and many of us in effective quarantine. There are two reasons why this is important. The first is that this could actually happen - every account I've seen suggests that at some point our bodies will come into contact with a flu variant we've not got much immunity to, and the results will be disastrous. For example, even allowing for the possibility of many unrecognized cases, the mortality rates of avian influenza in humans are extremely high, especially among young children. This is, to say the least, worrisome.

Now it is also unlikely to happen in any given year. This essay is not intended as scaremongering - the likelihood of the virus mutating quickly is comparatively small. The issue here is prudence - is it serious enough to be worth thinking about? I think so. And are the intersections of avian flu likely to affect other factors, that is, to bring about some kind of crisis? I think for that we have only to look at Hurricane Katrina - to the New Orleans still not rebuilt, to the refugees who remain refugees two years later. Our society has proved its inability to cope with a localized, if severe disaster. Why on earth would we believe it could handle a national one?

An article in Foreign Affairs (which is not a hype-driven source) estimates that worst case scenarios suggest up to 20% of those affected could die - 16 *million* people. Now that is unlikely, and extreme - the military is expecting the death rate to be much more in line with CDC averages - about 1 in every 100 people. But that's an awful lot as well. The Foreign Affairs article is here: http://www.foreignaffairs.org/20050701faessay84401/laurie-garrett/the-next-pandemic.html, and it is worth noting that its estimate of the economic costs is sky high - 166 billion dollars just for medical care, not including vaccination (a vaccine for a specific strain will require a minimum of 6-9 months, if it is possible at all - and remember, viruses mutate - by the time we have one, it may not be the same virus). There is no firm estimate of the national or world economic costs, but think about it.

All transport between communities is restricted. That's it for the travel industry for the duration. Schools are closed, as are entertainment venues, churches, mosques and synagogues, malls and all non-essentials. And this could last for 18 months or longer - how long before widespread unemployment leads to basic, structural breakdowns in the economy. And given that our economy is already stressed by high energy prices, inflation, housing problems and currency difficulties, it wouldn't take long to push the US over to a major recession. Think about the lines for basic goods, or the shortages of things you rely on - food, water, clothing, tools. Think about nutritional imbalances likely in food distribution, and the way information is likely to fail to travel.

During periods of influenza outbreaks, how many of us believe that we'll be hard at work on adapting our infrastrucutre to climate change and energy depletion? How many of us will be at community meetings, or at our jobs keeping the grid in order or helping people reinsulate their houses? How much time will be lost to illness and quarantine, and when things level off, will we be able to get started again? I'm not much for fast crisis/crash scenarios, but this one seems like it really could deeply affect our long term ability to deal with economic and energy crises (not to mention climate change).

The healthcare infrastructure will likely be overwhelmed - millions of people, 50% of those affected, are expected to be treated in hospitals. Given that medical personnel are likely to contract the disease early, those facilities will likely to be totally overwhelmed. Estimates of hospitalizations are listed here: http://www.globalsecurity.org/security/ops/hsc-scen-3_flu-pandemic-deaths.htm. Which means that everyone with a brain will want to stay as far away from medical care as possible whenever possible - because if you go in to the hospital or pharmacy to pick up of a prescription or deal with a broken arm, nearly everyone is likely to have the flu around you. So there will be corrollary casualties, and a real need to be able to meet your own health care needs.

Now my rural area has nothing like enough beds, hospitals or medical care to tend the sick, and neither does any region I'm aware of. So we should translate the Pentagon's plans to quell rioting and guard hospitals as "even if you are very sick, you may not get any medical care." The US has very minimal stocks of flu relieving drugs, and as we mentioned, a vaccine may not come quickly. We have seen in Hurricane Katrina and with the response to the recent tornadoes that the military tends to be most concerned with "securing" an area, rather than actually helping anyone. That is, if the military comes to your region, there is every chance that they will be there to point guns at people who want to do things like travel for medical care or to help out family, and less chance that you will find them helpful. The references to rioting probably mean scared, sick, hungry, desperate people who would like to have a better situation, and the military who will probably try and stop them from things like taking food out of stores. Perhaps this sounds cynical. It probably is. It there is also a decent chance it is accurate.

But there's another reason why we should be concerned about pandemic flu and this military report. Pandemic avian influenza (or some other form of pandemic - a new strain of swine flu appeared recently, although it is rarely mentioned) might not be that big a deal. It may turn out that the high death rates lower as the virus mutates to become communicable. Or it may not be that communicable, giving our bodies time to adapt to it. The reality about flu pandemics is that we're due for one - sometime in the next century. All this worry may be for nothing.

Except, it probably isn't nothing. That is, it is worth noting that pandemic flu is an excellent excuse for instituting nation-wide martial law, limiting basic freedoms, and controlling freedom of assembly, public discourse and access to both information and goods. Now, if we hadn't seen the last 7 years, you could rightly call me a wacko-conspiracy theorist for this. But can anyone who has seen Guantanamo really believe that the current administration wouldn't use a flu crisis to consolidate power? In fact, they might even be right to institute restrictive measures - no one will probably no how severe the outbreak will be until it has been around a while. The question is, how likely will our government be to simply relinquish power in a crisis. Hmmm....

This means we should be worried about two things. The first is that pandemic flu might be a true medical disaster. The second is that it might not be, but it might still result in economic, political and other crises, because it represents a really good way for our government to take power - and it represents something to blame the current concatenation of economic factors on. Flu may become the bad guy for all sorts of problems - which is important to know, because we're very much unlikely to do what is necessary if all the fault lies in the flu.

Now let's add the current situation into the mix, and assume that a human form of avian influenza develops this fall or next. Oil is peaking, energy prices are rising steadily - we certainly expect $4 per gallon gas this year, and potentially even higher prices and gas lines. The economy is teetering as well, as is the housing market which has funded nearly 20% of all jobs, directly or indirectly (that is, not just jobs building houses, but jobs decorating them, and also jobs in travel and shopping which is what people are spending their equity on).

It seems likely that among other things, whether it is true or not, avian flu will be held responsible for whatever crisis occurs (remember that juggling thing?). And that a firm response will have to be taken. Now I don't know what form a firm response would take, but it is likely to put things like climate change and peak oil on the back burner, further delaying our response. It is also not likely to make us happier or freer. And I'd be just shocked, shocked and appalled (I really would be appalled!) to find that it affects the outcome of our elections.

As I've said, I'm not much for fast crash scenarios, and I don't think this is hugely likely. But at a minimum, it offers a model in which things could go from 0 to hell in a very short time, and all our mitigation strategies might collapse underneath us. Again, the problem is that at some point, our ability to cope begins to fall apart.

Are you ready for an economic crisis that begins this fall, restricts your access to basic goods and adaptive tools, and stresses the economy? Are you ready to spend 3-18 months mostly quarantined in your house, with distribution of food, water and information controlled by your military?

On a personal level, knowing that our government is thinking mostly about how to keep us contained, not how to treat us in a medical crisis, we should all be fairly well prepared to deal with things on our own. And that's a problem, because the best possible response to peak oil and climate change is community organizing. And in a quarantine situation, where everyone is struggling to feed themselves and avoid getting sick, our community structures are likely to collapse under us, as is our collective ability to deal with longer-term crises.

Here is what I would take from these materials.

- Be prepared to meet most of your basic needs for an extended period - the timeline is probably 3-5 months for the first outbreak, followed by another within 3-10 months. In a worst case scenario, much of the nation and its economy could be shut down for months, even more than a year. Government unemployment would run out, communities ability to collect taxes from people not being paid would collapse, and health care costs would overrun everything else. So have food, medicine and the ability to handle a sustained crisis at home. Make sure you can live with power outages, because, as the Foreign Affairs article notes, grid crisis is a possible outcome. Store food. Store water. Store basic medication. Get basic medical knowledge together so you can treat medical problems yourself if possible (be careful doing this). Keep healthy - and think hard about what risks you want to take, particularly if you have elderly people, children or the disabled in your house. Ultimately, try and have the means to live without your jobs for a good long time if necessary - you don't want to risk a serious illness because you need to make money to feed yourself.

- Get prepared *NOW* - that is, assume that this could happen as early as this year. It isn't likely, and I don't want people to panic, but it also isn't impossible. So where you are now, and what you have now or can do in the next months is likely to effect you for some time. There's no reason to stop planning a move or a change, but make sure you can meet your own needs where you live right now. Find a way to collect water, store food, start a garden, plant some fruit trees, stock up on blankets and flashlights. It can't hurt, and it might just help someday.

- Don't count on government help, including military help. Remember, we had a tough time dealing with one, highly localized tornado crisis, or with the Gulf Coast. Now imagine that there are multiple crises all across the nation. The military is likely to be heavily hit by the flu, simply because they are widely dispersed across the world, and pulling them suddenly out of Iraq or Afghanistan is likely to cause a crisis too. Even the best intentioned government (and when was the last time we had one of those?) is likely to be incompetent.

- Because of the potential economic consequences, I would expect quarantine orders to come in well after it was optimal. That is, we've seen that this government is most concerned with keeping the economy happy, regardless of cost. So I wouldn't wait for your community to close schools or tell workers to telecommute - make your own plans based on your own risks and level of concern.

- We've seen how the mainstream news responds in a crisis. Try and keep real truth moving along - write and talk about what is really happening in your community whenever possible. If we can't gather in person, resist in writing. Don't let this be an excuse to lose what is left of our freedom.

- If avian flu turns out not to be the disaster it could be, we have to keep our eyes on the real problems - on preparing for energy crises and climate change. Keep advocating that we keep our focus.

- Think about how your community would manage its infrastructure if gathering was impossible. Come up with an alternative to the "everyone for themselves" strategy our government is proposing. Consider community food stockpiles, phone trees, local non-electric water sources, virtual town meeting set ups, ways of distributing food, checking on the elderly and educating kids without person-to-person contact.

- The better prepared your community is, the less likely you are to see federal troops on your ground. Remember, your personal security also depends on the stability of your community and the region around you.

- Finally, recognize that although it is not likely, a fast crash scenario is possible - that is, it is possible that a short term crisis like avian flu (or for that matter a widespread natural disaster) could cause enough disruption that when the crisis is over, we no longer have the resources to make major infrastructure changes. Move your timeline up accordingly, although recognize this is not a time for panic, and it is not the most likely scenario. That is, be rational. Be prepared to get along, but also recognize that it will probably be ok.

I'm sorry that this is depressing. But it is better to know than not to.

Sharon

46 comments:

Anonymous said...

In Europe we've been preparing for the avian flu since Winter 2004 and it still hasn't arrived; the death toll among those infected (SouthEastern Asia, Turkey, Egypt)is, in statistical terms, very very low; the virus is only passed on to humans, as far as the medical community has established, through very close contact with sick birds - by very close meaning no hygiene in dealing with poultry raising -; most flu viruses first develope in birds, thus this one is not completely different from previous ones; viruses mutate a lot, and in the case of flu viruses, they seem to lose strenghth, instead of gaining, as they develope.
For all these reasons I'm very sceptic about The Avian Flu as it has been heralded by the media and the governments. I'm an optimist, maybe that explains something. But take a longer thought on this evidence.

Marta from Lisbon

jewishfarmer said...

Marta, I don't actually disagree with you - as I said in the article, I think it is much more likely that avian flu won't be serious than that it will be - and I think there's a good chance it will be used as an excuse.

On the other hand, all the things you say are true...except when they aren't. That is, the death rate of infected has been very high in some parts of southeast asia, and pandemic flu viruses with high mortality rates do happen in some forms of the virus. The fact that it is only transmitted to humans through infected poultry on close contact has nothing to do with the likelihood of it mutating into an airborn infection. No, it isn't totally different than known viruses - neither was teh 1918 virus. 2004-2007 is really a very short time - that is, I don't think that anyone doubts that the odds were against mutation in under 3 years.

Statistically, as I understand it, the odds against pandemic flu in any given year are quite small. The odds *not* having a major pandemic flu in the next century are also quite small. It is, IMHO, a simple matter of prudence to be able to deal with a sudden disruption in your society as well as a slow one, particularly since America is *vastly* less well prepared for this than most European countries, as well as using every political crisis as an excuse for restricting political freedom.

Sharon

Anonymous said...

Sharon, I agree with you, and I do think we should get prepared (politically and medically) in the case it does happen. From what I read in the European media, most countries here have emergency solutions that have been worked on for the last 2 to 3 years, and they involve, amongst other measures, giving the anti-viral medication for free at both medical and institutional centres (schools, homes, prisons, the military, etc)to all populations at highest risk - like you said, the elderly, the children and those in general poor health.
More than this -advising people to lock themselves up with canned goods and the like, like it has been hinted at by the media - seems totally out of proportions to me. That is where, as you say,political freedom might start being curtailed...
As for the stats. There have been, what?, 90 or 100 cases of death by the infection. In densely populated, poultry raising countries as Vietnam, Indonesia, The Phillipines, that is not a lot...

Marta from Lisbon
PS- I love your blog!

Anonymous said...

Could you possibly address issues without making snippy little comments about the current Administration? The current administration is attempting to protect you from terrorists - and a terrorist strike is probably much more likely than your scenario.

mimulus said...

i would add that investing in a homeopathic self care book (Borlands' Influenza can be purchased for just over a dollar at www.minimum.com) and buying the common influenza remedies in advance could be a life saver.

Patients treated homeopathically in the Spainish FLu pandemic of 1918 had much better recovery rates than those treated with conventional medicine.

Michelle in Ga said...

There are very few prescription
antivirals out there. A recent one
was feed to poultry all over Asia,
and the drug became worthless as
resistance developed.
I would suggest echinacea and
goldenseal. These are now growing
in my yard. Experiment at your
own risk with colloidal silver.
I use it, learned how to make it
and give it to my family. Garlic
may boos immunity, but it's not
an antiviral. Good luck
Michelle in ga

Goju said...

The pandemic of H5N1 is coming IMHO. The seeding of the virus through migratory birds and the poultry trade is not stopping. The virus genetic sequences is getting more complex and gaining the ability to infect humans with less difficulty. The only thing that has kept it from going pandemic in Indonesia is the Tamiflu blankets they have been throwing on the outbreaks. At some point either the virus will escape in a superspreader into the international jet system or the virus will evolve (as it did in Egypt) into a Tamiflu resistant strain. Major medical reports have shown that the virus death rate does not have to drop when the virus becomes efficient at transmission. All Gov and health agencies are very worried as are most major businesses. This threat is very real and knocking on our door.

We discuss H5N1 at PFI Forum and several other blogs focused on H5N1 and the effects of a pandemic. We seek ways to mitigate the damage done as this blog clearly points out.

Job well done.

jewishfarmer said...

Anonymous, no, I'm afraid I can't stop making snippy comments about the current administration. I'm neither convinced they are genuinely trying to protect me from terrorism - for example, incarcerating 14 year olds without trial in Guantanamo is not making me safer, nor is the war in Iraq - if anything, the opposite. Nor am I convinced that a terrorist threat that could do harm on the scale that pandemic influenza could do is in any way likely.

Feel free to make any judgement you want of this administration on your blog, but if you want to read mine, you'll have to deal with the fact that I do have my own political opinions and they are fair game here.

Sharon

Anonymous said...

While the medical response to pandemic flu will be important to controlling its spread and limiting its toll, there are considerable non-medical issues related to flu preparedness that are essential for ensuring the continued well-being of the nation's economy. Planning for Continuity of Operations (COOP) and Continuity of Government (COG) is critical to maintaining
the overall viability of society. Thus, while we rightly prepare for the flu, we must be equally prepared to function during the flu.

The Center for Technology and National Security Policy of the DOD's National Defense University has prepared a number of freely-available items which can help civilians be prepared both before and during the flu. "Bird Flu and You" is a poster available in 9 languages with basic information about influenza preparedness. "Weathering the Storm" is a report with information about planning for COOP, including instructions for carrying out "tabletop excercises" with a COOP plan.

Electronic copies of the poster are available at http://www.ndu.edu/ctnsp/Bird_flu.htm. Electronic copies of the report are
available at http://www.ndu.edu/ctnsp/Def_Tech/DTP%2038%20Weathering%20The%20Storm.pdf, and to request hard copies of the report, contact the Life Sciences group at lifesciences@ndu.edu.

Robert E. Armstrong, Ph.D.
&
Mark D. Drapeau, Ph.D.

Center for Technology and National Security Policy
National Defense University
Washington, DC

Anonymous said...

JewishFarmer: Congratulations to you for defending your right to free speech on your own blog! (I was shocked that someone would even try to tell you what you could or couldn't write on a blog that's yours)

Anonymous said...

Just thought i'd add to Marta's comments about the current low death rate. There are currently like 150 out of about 250 cases. In comparison to the amount of people that er probably exposed to those birds, sure its pretty low. but you have to remember that the virus hasn't mutated yet so obviously the numbers are going to remain very low. the problem is that what you are saying is what many people said years before the 1918 spanish flu hit. Its once it mutates that we are going rto have a problem, but do you want to be the person who gets proved wrong the hard way? i also am very skeptic on this, but i'm going to prepare as if its going to for sure happen tomorrow.

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