Thoughts on 2008
Like most people, I do some reflection at this time of year. But rather just look back at the year gone by, I'd like to speculate a little on the year to come.
WHO's cumulative total of confirmed cases offers some room for speculation. If I'd been writing this at the end of 2004, I might be pretty pessimistic: In 2003, we had experienced just four human cases of avian influenza (all fatal), and in 2004 the total jumped by an order of magnitude: to 46 cases, with 32 deaths.
If H5N1 had jumped by an order of magnitude in each of the following years, we'd have seen about 500 cases in 2005, 5,000 cases in 2006, and 50,000 cases in 2007. And we'd be looking ahead to half a million cases in 2008, with maybe 300,000 deaths.
Instead, H5N1 has spread rapidly from Indonesia to West Africa and Europe, but the human toll has been mercifully small: only 98 cases in 2005, 115 in 2006, and a drop to about 86 in 2007. (I say "about" because the recent cases in Egypt have made WHO's December 28 total a bit obsolete.)
Altogether, we six billion humans appear to have suffered 350 cases and roughly 215 deaths, making H5N1 one of the unlikeliest ways for a person to die. If it continues to afflict us at the rate of the past three years, about 100 more people will catch it in 2008, and about 60 will die from it.
So why should anyone fret about such a minor hazard, when they're at greater risk every time they get in the car to go shopping?
Well, no one worried about that minor influenza cropping up in 1917, not when millions of soldiers were dying of shellfire and poison gas. A year later, H1N1 had grown by many, many orders of magnitude in a matter of weeks. People died far from the trenches: in Cape Town, in Fiji, in Barrow, Alaska. Influenza viruses march to their own drummer, and they don't care about arbitrary divisions of time like years.
In February I will turn 67. Not once, in my two-thirds of a century, have I ever been dead. I don't get sick very often; I even survived polio when I was seven. By all logic, I should be immortal.
But the shocking absence of bicentenarians in the human population tells me that I've just been on a hell of a lucky run. Something, at some point soon (and time flies at my age), is going to finish me off.
Something finished off four women in Egypt this past week—three of them young enough to be my daughters. The sheer unfairness of H5N1 is one reason to cover it and thereby try to frustrate it: Young men and women with their lives ahead of them deserve better than to die in a cytokine storm.
H5N1, as Revere observed today, is already a panzootic—a worldwide disease of animals, from barred geese to ducks to tigers. I sometimes marvel that I've been running a business blog for almost three years, covering the sorrows of poultry raisers from the Jakarta suburbs to the industrial operations of Bernard Matthews.
When scores of millions of people make their livings from poultry, H5N1 becomes a political issue. When hundreds of millions depend on poultry for much of their protein, H5N1 becomes a major political issue.
And if governments cannot sustain their poultry farmers, and cannot feed their people, their very legitimacy comes into question. Something worse than Pakistan and Kenya breaks out: the system falls apart, even if no human pandemic erupts to overwhelm the infrastructure.
With all my heart, I hope 2008 will see a further drop in the number of cases. Sixty would be good. Forty would be better. Maybe H5N1, in its patient efforts to mutate into something deadlier, could mutate itself into total failure, make itself a viral has-been.
But at this point it still has the power to frighten not just us, but our governments. If it frightens them enough, they might stop buying so goddam many fighter planes and ICBMs and stealth bombers, and start spending on public-health measures for the people the weapons are supposed to protect.
A robustly healthy population will survive the worst pandemic in better shape than the best-prepared individual household, with its basement full of canned soup and toilet paper. If flu bloggers can help to prod governments into realizing this, before the pandemic hits, then we will have done a service worth doing.
In mid-March 2008 this site will reach its third anniversary. I had no idea what I was getting myself into when I started, apart from trying to educate myself about an exotic and little-known disease. Like all educations, this one continues to teach me how ignorant I am. But as long as it has some value for me, and for you, I will keep at it.
May this new year be, for you, a year of personal happiness and contentment. And may 2008 be yet another year when everyone asks: "Whatever happened to bird flu?"
