Bird flu fight must start now

David Lazarus
Lazarus At Large Archives


President Bush asked Congress this week for $7.1 billion to prepare for a global flu epidemic that health experts believe may be imminent and would likely kill millions.

"A pandemic is a lot like a fire -- a forest fire," Bush said in a speech at the National Institutes of Health. "If caught early, it might be extinguished with limited damage. If allowed to smolder undetected, it can grow to an inferno that spreads quickly beyond our ability to control it."

Regina Phelps, a leading San Francisco emergency-management consultant, said she appreciates the president's belated attention to the matter. But she isn't encouraged.

"I don't know if our government is going to be able to do what it needs to do to meet this challenge," Phelps told me. "In light of what's happening in Iraq and the recent hurricanes, we can't look to government to save us from this.

"Businesses are going to have to rise to the occasion," she said. "It's going to have to happen on the private-sector level."

H5N1 avian influenza -- "bird flu" -- has caused 122 known human cases since December 2003. At least 62 have been fatal.

The deadly virus has already reached Europe from Asia. It's expected to arrive soon in this country. If bird flu adapts (as experts say is likely) to make human-to-human infection more common, a worldwide pandemic could erupt within months.

"I think a pandemic is inevitable," Phelps said in the cool, detached tone of someone who spends a lot of time thinking about the unimaginable. "Pandemics happen only about three times every 100 years. It seems likely that H5N1 will be the next one."

She said she's increasingly being asked by companies to help lay the groundwork for a pandemic response. She's also instructing corporate clients to begin planning now, before it's too late.

Phelps' clients include the likes of Visa, Levi Strauss, Intuit, Macromedia and the World Bank.

In 2003, she worked with Stanford University on a training exercise that simulated an outbreak of highly infectious pneumonic plague on the Palo Alto campus. The elaborate drill was meant to prepare for a terrorist attack or a flu pandemic.

In the United States, Phelps predicted an outbreak of bird flu among humans would kill between 500,000 and 2 million people. Globally, perhaps as many as 200 million could die.

Phelps' projections for U.S. fatalities are in line with figures released by the White House on Wednesday.

"We could be facing the greatest disaster of our lifetime," she said.

50 million died

By comparison, the 1918 Spanish flu pandemic killed an estimated 50 million people worldwide, including 550,000 in this country. And this was before air travel allowed viruses to hop continents in just a matter of hours.

Sherry Cooper, chief economist at Toronto investment firm BMO Nesbitt Burns, said in a report last month that ordinary flu outbreaks each year cost the U.S. economy as much as $12 billion in medical expenses and lost productivity.

A flu pandemic, she warned, would have an economic impact of up to $167 billion on the United States and perhaps a more disastrous financial impact on other nations.

"The repercussions on global trade would be devastating," Cooper wrote. "Given that virtually all major economies have a surplus with the (United States), trade disruptions would shutter manufacturing plants and curtail global demand for most commodities."

Meanwhile, the Asian Development Bank said Thursday that a flu pandemic could kill 3 million people in Asia and cost regional economies almost $300 billion. "Growth in Asia would virtually stop," the bank predicted.

So what should we be doing?

On the individual level, health experts strongly advocate proven methods to fight the spread of viruses: frequent hand washing, along with routine cleansing of surfaces and equipment shared by others.

For companies, Phelps is warning clients to prepare for as much as a third of their workforce being out sick at any one time. Similar absenteeism will be experienced by vendors and other business partners (not to mention multitudes of customers being stricken or avoiding stores and other public places).

Phelps says employers need to closely monitor workers' health to stay ahead of a fast-moving outbreak. If a pandemic appears likely, face-to-face meetings should be all but eliminated in favor of conference calls and online discussions.

Companies will need plans in place to deal with a worker who becomes seriously ill on the job and to disseminate information among employees as rapidly as possible.

Working from home

Ailing workers must be required to stay home. But for companies to remain operational, Phelps says all "mission critical" employees must be provided in advance with desktop computers in their homes, broadband connections and all necessary supplies.

She knows that few companies have either the financial resources or the wherewithal for such a move. But Phelps says the contingency of what she calls "robust work from home" can make all the difference in allowing a company to ride out a major emergency.

"It's a great strategy if we're trying to recover from an earthquake," she said. "It's really great if we're trying to recover from a pandemic."

As it stands, Phelps believes the disruption to business caused by a pandemic would almost certainly plunge the world into a global recession.

"There are going to be a lot of companies that won't survive this," she said.

Phelps acknowledges that there will be people who won't want to even discuss the prospect of a pandemic because of the enormity of the consequences. Denial is a common response in her line of work.

"I have a pretty bizarre job," she observed. "I spend my time thinking about things that horrify people. But I work on what to do about them."

Should we be frightened?

"We should definitely be frightened," Phelps replied without hesitation. Then she reconsidered.

"Maybe that's too strong a word," she said. "Fear prevents activity. It renders people impotent."

Well, at least the president has requested billions of dollars to help us get ready.

Phelps was silent a moment.

"I don't know if $7 billion is going to be enough," she said softly. "We have so much to do."