Just when you thought it couldn’t get worse… history threatens to repeat itself. It is eerie to note that the last flu pandemic happened just about 10 years before the last Great Depression. If this happens at this time of a Great Recession, it is possible for people to be already so depressed about their state of finances that their immune system has become impaired enough to make them more susceptible to the flu virus. Keep yourself happy sounds like a good anti flu antidote.
Some years ago, I picked up a book on that flu pandemic of 1918-19 written by New York Times medical reporter Gina Kolata. It was a page turner. What made it scary was the feeling of helplessness. People didn’t know what was killing them. Of course we know more about the flu virus these days but experts say we still hardly know enough to avoid feeling just as helpless if and when it becomes a pandemic.
The World Health Organization has upgraded its alarm. But the financial markets shrugged off the threat of a flu pandemic as the markets in general, the Telegraph (of London) reports, have become blasé after years of bird flu scares. Even so, airline and hotel stocks turned South as fears of travel restrictions mounted.
Markets have responded calmly so far, betting that Mexico’s epidemic will prove a false scare. “Fear reflexes kicked in for a few hours but Wall Street was back on its feet by the afternoon, perhaps because so few market players are scientifically literate,” the Telegraph reports.
Because bird flu scares of recent years never came to anything, “people just assume that this won’t turn into a pandemic either. But H1N1 is very different. It is already spreading from human to human and there is a real risk that it will attack populations in countries where Tamiflu is not available,” the Telegraph quotes Stephen Lewis, from Monument Securities.
Lewis further observed that “if this had hit when the global economy was buoyant, it would have knocked us back to where we are now. But at this stage it could have exponential effects, leading to collapse.”
Indeed, a World Bank study in 2008 according to their latest estimate, chronicled by Bloomberg News in October 2008 estimated, “a flu pandemic could kill 71 million people worldwide and push the global economy into a ‘major global recession’ costing more than $3 trillion, according to raised estimates by the World Bank of a worst-case scenario.” Can the world’s fragile banking system survive such a hammer blow?
Maybe the flu outbreak will not be that severe. Quoting the same Bloomberg summary of the World Bank 2008 report:
“A ‘mild’ pandemic, similar to the Hong Kong flu of 1968- 69, could kill about 1.4 million people and cut global GDP by 0.7 percent in the first year...
“A ‘moderate’ pandemic characteristic of the 1957 Asian flu could kill 14.2 million people and shave two percent from the global economy in the first year, the bank said. Some forecasts have estimated deaths during a ‘severe’ pandemic at as high as 180 million to 260 million, the report said.”
The US government’s Pandemic Influenza Strategic Plan – confidential, but leaked – said an outbreak would cause mayhem, with power blackouts and fuel and food shortages. The closure of schools would force parents to stay home. There might be riots at vaccination centers. Parts of the country would be quarantined.
The US Congressional Budget Office reached much the same conclusions, saying 90 million Americans would be infected. A third of the workforce would stay at home to look after their families, or refuse to go to work until the danger had passed. “The virus would spread very widely in a very short time. In any geographic region, each wave could last three to five months,” it said. US losses would be $675 billion.
There is little one can do at this point except to follow the advise of doctors to avoid crowds and practice strict personal hygiene. “Avoid touching, kissing, and hugging,” was the best precaution our leading epidemiologist can advise Filipinos in the wake of an outbreak of this new type of flu virus that has killed a couple of dozen people in Mexico.
The doctors and scientists still know little about this new virus, supposedly a combination of swine, bird and human strains. And even as our health authorities ordered a ban on pork products from the United States and Mexico, they are sure the disease cannot be transmitted by eating properly cooked pork.
From what they have ascertained, this particular virus started as another bird flu strain that infected pigs. “It mixed with two kinds of flu that are endemic in swine and a fourth that originally came from people. The resulting concoction spread among pigs, then recently — no one yet knows where or when — started infecting humans.”
Even as flu research has accelerated since the Asian bird flu spread to humans in 1997, scientists say the more they study it, the more questions they have. “I know less about influenza today than I did 10 years ago,” Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota told the Los Angeles Times.
“We don’t know what this virus will do,” Osterholm said. “It could burn itself out in the next four to six weeks and we never see it again. It could burn itself out over a more extended period of time.” But he said health officials can’t ignore the chance that it could sputter out in the spring and reappear in late summer with a vengeance, as happened in 1918.
According to the World Health Organization, there are no vaccines for the current swine influenza virus. The problem with the flu virus is that it is constantly mutating, so a new vaccine has to be produced each year. The anti-viral drugs get round this by targeting not the virus itself but an enzyme that enables the virus to spread from cell to cell. Provided they are taken within 48 hours of the onset of symptoms they can shorten the illness and reduce its severity.
A lot of hope is being placed on two antiviral drugs, oseltamivir or Tamiflu and zanamivir or Relenza. Initial tests show the virus is sensitive to Relenza, an inhaled drug, and Tamiflu tablets. Governments must make sure they have a sufficient stock of these drugs in case a pandemic breaks out.
The fear of a flu pandemic has already helped Roche which makes Tamiflu and Glaxo Smith Kline that makes Relenza zoom up in the stock market. Roche claims it has the key ingredients in place to quickly ramp up production of Tamiflu. Because of the complicated manufacturing process, it takes about eight months to produce the drug from scratch.
Tamiflu has a shelf-life of five years, so most governments still have ample supply of the drug. If stored correctly, the drug remains effective even longer and in several countries its shelf-life has been extended to seven years after tests confirmed that it remains stable over that period, a Roche spokeswoman claims.
Cipla, India’s second-biggest drugmaker by market value told Bloomberg TV it can supply 1.5 million doses of generic Tamiflu within four to six weeks. But governments who would ask them to produce the drug must take care of any patent rights issues by declaring an emergency. That’s probably something our government should do. Cipla sells the generic copy of Tamiflu in India at 1,000 rupees ($20) for a dose, or 10 capsules. Tamiflu was retailed at P150.50 per at Mercury or P1,505 for a dose of 10 last December when I bought some for my wife.
For now, don’t think I am being a snob if I do not offer my hand for the traditional hand shake next time anyone of you meets me at the mall or in some social function. I have decided to follow the advice of the DOH epidemiologist to just smile, nod or maybe wave.
I am horrified as we should all be. The prospect of a devastating pandemic in the wake of the global financial meltdown is scarier than the thought of Ate Glue staying in power beyond 2010 through cha cha.
Inner peace
Here’s a good one from humorist Dave Barry.
My therapist told me the way to achieve true inner peace is to finish what I start.
So far I’ve finished two bags of M&Ms and a chocolate cake. I feel better already.
Boo Chanco’s e-mail address is bchanco@gmail.com