Numerous experts agree that a flu pandemic is not only likely, but inevitable. When one takes into account that the Bush administration is guessing that 1.9 million Americans could die if a pandemic hits (Reinberg, 2005) and that the value of a statistical life is around 7 million dollars (Viscusi & Aldy, 2003), it is clear that a significant amount of money and effort needs to be put into dealing with this potential pandemic. Not even mentioning the expected 450 billion dollar impact the pandemic will have on the economy because of hospital costs (Reinberg, 2005), the U.S. should feel a significant amount of pressure to do whatever it can to stop the pandemic, not merely slow it down or keep it contained once it gets here. Clearly the question becomes, can the U.S. stop a flu pandemic? A close look at the major ways of dealing with a pandemic:

Antiviral Drugs

     Antiviral drugs seem, at first, to be our best option to stopping a pandemic. According to many experts, this will be the best defense against the virus and therefore the flu pandemic. In his paper, “Influenza Drug Could Abort a Pandemic”, Graeme Laver, (2005) describes what he believes to be the best possible stopper of the flu. Making Tamiflu an over-the-counter drug in local pharmacies where a rapid and accurate flu diagnostic test could be taken is what he prescribes. A person with flu symptoms would come into the pharmacy, take the quick flu test, and if it is positive, be immediately given the antiviral drug.
      A different strategy, but still using the same drug, is given by another group of scientists. Balicer, Huerta, and Grotto (2004), offer the idea that the drug should be given to a “ring” of people around where the initial outbreak occurs. If the ring was wide enough and the drugs given fast enough, this could prevent the virus from spreading, stopping the pandemic.
      Other evidence seems to support the idea that antivirals would be the answer. In his paper, Butler (2005) adds to the proponents of antivirals saying that a rapid deployment of antiviral drugs could stop a local outbreak from turning into a pandemic. The doubts already start to creep in however, as he adds that this would have to be done very quickly. Given all the above evidence, are antivirals America’s solution to the potential pandemic? Not even close.
      If antivirals are going to be involved in stopping the pandemic, then they must be used at the source. Butler (2005) tells us that the virus would have to be detected quickly, it would need to move fairly slow, that the drugs would need to be in place within a couple weeks of sustained human-to-human transmission, and the drugs would need to be deployed massively around the outbreak’s epicentre. Given what we know about the virus, and its history, the source will not be in America, but more than likely in an Asian country. It would be difficult for these conditions to be met in this country, but the chances of them occurring elsewhere are even less promising.
      Given the strict requirements around how the antiviral drugs could be effective, Thorson and Ekdahl (2005) say that not only will the drugs not be enough to avert the entire pandemic, but they will not even be enough to avert the consequences of a pandemic in a given country. At best, they will prevent a large number of people from all being sick at the same time. While potentially being extremely helpful, antiviral drugs will not cut it if the U.S. wants to stop the pandemic.

     While antiviral drugs might be more specific to the virus at hand, other more general techniques are available to potentially stop the pandemic. These include quarantines, travel restrictions, and other similar measures like school closures and cancellations of large gatherings. According to ABC News, the Bush administration discusses the use of some of these tactics in their pandemic preparedness document (Reinburg, 2005).
      Even though these tactics have been used in the past and will be used again if a pandemic begins, there is little support for the idea that these techniques have any chance of stopping a pandemic from happening. Thorson and Ekdahl, (2005) do tell us that these tactics, if done swiftly by every level of government, will limit the community spread. In the U.S. these measures will only have use once the pandemic has spread around the globe and is threatening to come into the states. Since America will most likely not be the source, using quarantines and the like in this country will not help stop the pandemic in any form or fashion.
      Although they are advocates for these tactics in general, Thorson and Ekdahl (2005) do admit that relying on measures such as quarantines and school closings in the middle of a pandemic will be useless. Ultimately, “School closure, quarantine, travel restrictions and so on are unlikely to be more effective than a garden hose in a forest fire” (Laver, 2005 pg. 821). Again, since America will probably not be the source of the outbreak, the use of these tactics in the U.S. will not play a role in trying to stop the pandemic.

     The next option for the U.S. stopping the virus is the one that has been discussed and debated over the most so far. Despite all the talk about vaccinations, there is not much to say on the positive side of how they might help the U.S. stop a pandemic. Because of the scientific procedures necessary to produce virus-specific vaccines, they would be in short supply during the beginning stages of a pandemic and would not reach large-scale production numbers until a few months into the pandemic (Thorson & Ekdahl, 2005).
      Effective vaccines can not be created before the pandemic starts and therefore have no real use in terms of stopping one. Even if the time of creating a vaccine is significantly decreased, a large number of it is manufactured, and magically the U.S. finds a way to deliver it perfectly, it still will be a bandaid on a broken arm. Trying to obtain a large amount of vaccinations, which is what many countries including America are doing (Reinburg, 2005), is simply a measure to help control and slow the pandemic, not stop it before it becomes one.

     So far numerous options have been discussed as ways that the pandemic might be slowed or the negative effects might be lessened. None of these will help the U.S. stop the pandemic however. In all this darkness, there must be a ray of hope, right? Maybe.
      In a paper titled, “Heading Off an Influenza Pandemic”, Holmes, Taubenberger, and Grenfell, (2005) say that a global influenza surveillance and response network must be in place and must be working rapidly and effectively in order to avert a pandemic. National governments will need to release data quickly and use their own control measures at the first site of pandemic warnings. Not only will this surveillance need to include humans, but domestic animals and obviously wild birds need to be included.
      Thorson and Ekdahl (2005) also support an early warning system in all countries that would allow for signs that the virus has gained the ability to easily transfer between humans. Even Butler, (2005) who earlier in his paper discussed how antiviral drugs were the key, says that there should be resources and training in the surveillance systems of each country, as well as detailed planning and drills where the pandemic is most likely to emerge.
      Given this information, why is this only a potential ray of hope? It is because the best thing that the U.S. can be doing to stop a future pandemic is also the area in which the U.S. seems to be paying the least amount of attention. With all the money that could be put into this effort, the U.S. only spent $25 million last year trying to boost surveillance in Asia (Butler 2005). If the U.S. wants to stop the pandemic, they will have to invest massive amounts of resources in the places where the source of the pandemic will most likely be.

     The costs that America, and the rest of the world, could face if a flu pandemic occurs are astronomical. From the information that is available, it seems like the Bush administration and other governments as well, are gearing up to keep their own respective countries “safe” and are focusing on what to do once the pandemic hits. I clearly disagree with that logic. While it is important to be planning for how to deal with the pandemic once it gets going, the world’s primary focus at this point should be to increase surveillance and data relay systems in the most probable countries of the source. A concentrated effort of all the tactics discussed in this paper at the source of the pandemic may make the use of these tactics in the U.S. unnecessary.

REFERENCES:


Balicer, R.; Huerta, M.; & Grotto, I. (2004). Tackling the next influenza pandemic. British Medical Journal, 328 (7453), p1391-1392

Butler, D. (2005). Drugs could head off a flu pandemic--but only if we respond fast enough. Nature. vol. 436(7051), 614-5

Holmes, E.; Taubenberger, J.; Grenfell, B. (2005). Heading Off an Influenza Pandemic. Science, 309 (5737), p989-989

Laver, Graeme (2005). Influenza drug could abort a pandemic. Nature, 434 (7035), p821

Reinburg, S. (2005). http://abcnews.go.com/Health/Healthology/story?id=1197674

Thorson, A.; Ekdahl, Karl. (2005). Avian influenza – Is the world on the verge of a pandemic? ... and can it be stopped? Journal of Contingencies & Crisis Management,13 (1), p21-28

Viscusi, W. Kip and Aldy, J., (2003) "The Value of a Statistical Life: A Critical Review of Market Estimates throughout the World." Journal of Risk and Uncertainty; 27, p5-76