For about the last year now I have been receiving emailed articles from StratFor.com about important global political issues. They have a knack for delving into the source issues of a wide variety of topics that are only indifferently covered in normal news outlets. Earlier this week I received a report on the geopolitics of pandemics. It was a very good discussion of the root causes of the recent flu outbreak.
What was most interesting was their final analysis of the real potential harm of a truly deadly flu pandemic; a large number of dead people, but life and society would go on as they had before. And the actual number of dead people would probably be less than the infamous 1918 pandemic because of general advances in medical science. Then they casually dropped the ‘oh, by the way’ bomb:
“However, should a disease arise that is as deadly as HIV, that spreads through casual contact, about which there is little knowledge and for which there is no cure, the medical capabilities of humanity would be virtually useless.”
If we think back to the beginning of the Aids Epidemic, it was a mysterious disease. Actually the term Aids (Acquired Immune Deficiency) was more a description of the symptoms of the disease rather than the cause of the disease. It took a long time for the medical community to identify the actual virus that caused the disease and even longer to get a consensus in the medical community that the identified virus actually caused the disease.
Fortunately for humanity, if not for those infected, HIV is actually a relatively difficult virus to spread. It does not survive long outside of the human body, so you have to have an actual exchange of significant quantities of bodily fluids to transfer the disease. Now that medical transmission of the disease through blood transfusions has been almost eliminated, the only significant source of transmission is through sex. A faithful monogamous relationship provides virtual protection from the virus.
Flu, on the other hand, is very easy to spread. Flu viruses can live on survive for significant periods of time on surfaces not exposed to direct sunlight. The body sheds live virus through coughing, sneezing, and mucal membrane leaking (sniffles). Contact with any of these discharges, even minute amounts found in the fine spray from coughing or sneezing, provides a route for disease transmission as long as the virus particles are introduced into the mouth, nose or eyes. What’s worse is that people can shed virus particles before they exhibit symptoms of the disease and after they are apparently recovered from the disease.
If a new virus were to come along (and new viruses come along frequently) that survived as well outside the body as the flu, but were as deadly as AIDS there would be a serious problem. First off, the virus would have to be isolated and identified. Existing anti-viral medications would be tried, but it is unlikely that a uniquely new virus (like the HIV was uniquely new) would respond to existing medications. It would take 10 to 20 years to develop a safe and somewhat effective medicating scheme, if AIDS is a decent example of how the process would proceed.
The effects on society would depend on a number of factors. By definition an easily transmissible virus has a high infection rate. Without previous exposure to the virus or a viable vaccine (and we are just now starting to test vaccines for HIV) the only way to prevent the spread of the virus is to isolate those people that are infected from those that are not. If an infected person starts to shed virus before symptoms appear (as in both HIV and flu) isolation of infected patients is ineffective. The only effective method to prevent the spread would be to isolate the uninfected. This is essentially what Mexico tried to do over the last week.
The next factor to consider would be the death rate. A highly transmissible virus with a high death rate could devastate modern society. Extremely high death rates like those seen with the Ebola virus would completely destroy civilization if the virus was highly transmissible and shed before symptoms like the flu. Catastrophic affects on society would be felt at much lower death rates. Even combined infection/death rates as low as 10% (10% of the population dead from the virus) could destroy modern society because of the cascading effects on critical services. This is especially true if significant portions of the society self-isolated to prevent becoming infected.
Another factor to consider would be the degree and duration of the disability during the illness. If large portions of the population required extensive medical care, this could severely disrupt society even if the death rate is relatively low. Not only would hospital services be quickly overwhelmed, but there would be a severe shortage of trained medical personnel. At some point the shortage of trained personnel, equipment and medications will lead to an unavoidable increase in the death rate.
With all of these considerations in their minds, it is no wonder that public officials in the US initially took actions like closing schools and making extensive efforts to inform people how to avoid contracting the swine/H1N1 flue. In hind sight it currently looks like many of their actions were an over reaction. In the long run, however, over reaction is much better than a failure to act. Early actions to limit the spread of a potentially pandemic infection may be the only efforts that can make a difference.