 When I see the posters for the soon-to-be
released Chicken Little movie, I have to wonder what the lead character would
have to say about the current bird flu craze. Would he say that the sky is about
to fall on him? Or would he come to his senses and understand that even as an
American chicken, he is more likely to be killed by panic than by the
flu?
The American public is profiting the least from the ongoing hysteria
surrounding avian influenza. The drug manufacturer Roche is suddenly in great
demand for its anti-viral drug Tamiflu, which has only been tested against bird
flu in mice, and has no current use, because the virus has not mutated to a form
that can easily be transmitted among humans.
A common misconception--that
Tamiflu is some kind of a bird flu vaccine rather than an anti-viral that at
best decreases symptoms of infection--has led to a lot of impulse buying. As
with the antibiotic Cipro, prescribed to treat anthrax back in 2001, Tamiflu is
becoming a treatment for the fear of a virus, rather than the virus
itself.
It is understandable that our leaders want to protect us, but in
doing so they are sending the wrong message that a theoretical threat is
imminent. The sixty plus people who have died of bird flu over the past two
years have had very close repeated contact with birds. Scientists are rightly
concerned that H5N1, a killer flu among birds since 1997, could one day mutate
enough to routinely affect humans. But in the meantime, we are protected by a
species barrier, and this particular influenza is several mutations away from
directly harming us. Most avian influenzas never change enough to routinely
affect humans. Rather than stockpile billions of doses of an anti-viral drug
with questionable effectiveness, a move that could easily precipitate drug
resistance, a better long term move would be to upgrade our vaccine-making
capabilities using genetic engineering.
Public Hysteria
So why all
the panic over a potential threat? In part the public hysteria is due to the
fact that basic information about this potential pandemic has been misconstrued
or ignored about this potential pandemic, much in the way previous health
threats in the news--anthrax, smallpox, West Nile virus, mad cow disease--were
all magnified beyond their immediate ability to do great harm.
In each
case there is a doomsday scenario that is packaged and sold to the public.
In
the case of bird flu, direct comparisons to the scourge of 1918 may well be
overblown. Many people died of pneumonia during that outbreak of the Spanish flu
because there were no antibiotics to treat it. There were also no vaccines, no
anti-virals, and little in the way of public health or the sanitary conditions
Americans take for granted today. We also have our top scientists and
epidemiologists tracking this avian flu, which was not the case in 1918 prior to
the essential mutation.
Vaccines could take months
Fear leads to a
diversion of resources; our fear of bird flu is being translated into a proposal
for massive stockpiles of perishable drugs and vaccines. Congress could calmly
and rationally designate funds to upgrade our flu vaccine manufacturing
capacity. Instead, our government allows pharmaceutical companies to use an
outdated chicken-egg medium which requires three to six months to develop a
vaccine against a particular strain. This slow process is then a justification
for panicked stockpiles.
Bird flu is better studied in the laboratory
than in a news conference.
This virus deserves public attention only
insomuch as it motivates our government to improve emergency services while
bringing methods of vaccine manufacturing into the 21st century.
Marc Siegel
MD
an Associate Professor of medicine at the NYU School of medicine, is the author of the new book
False Alarm: the Truth
About the Epidemic of Fear.
(Available at Amazon.com)
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