Sunday, October 02, 2005

Give or take a few million deaths

Last week has seen renewed fears about the possibility of a global avian flu epidemic. The United Nation’s new coordinator for avian and human influenza, David Nabarro, said on Friday that if a mutated form of avian flu develops which is transmissible between humans, it would cause between 5 and 150 million deaths. “It's like a combination of global warming and HIV/Aids ten times faster than it's running at the moment,” he told the BBC. Perhaps we should all be glad Dr. Nabarro did not add the Holocaust, Rwanda and the Black Plague to drive his point home.

No sooner than Nabarro’s words hit the press, the WHO issued a counterstatement. No, they assured, it would really not be that bad. Dick Thompson, the WHO spokesman on influenza, cheerfully claimed that only between 2 and 7.4 million persons would perish in the event of an avian flu epidemic. But when further pressed, Thompson admitted that all mortality projections concerning the avian flu were speculative. "You could pick almost any number. There is this vast range of numbers, absolutely. One of those numbers will turn out to be right. All of this is guesswork, nobody knows."

If the numbers are based on guesswork, it is worth asking why these ‘mortality estimates’ are publicized by global health authorities, rather than having them say that an avian flu epidemic would be really, really, really bad. Why the big numbers at all? It is not good enough to say that the high figures are publicized to ‘raise public awareness’, since the public itself can do little to protect itself against a deadly flu epidemic anyway. Public awareness is compatible with mass death. We largely depend on governments and public health authorities to take measures to protect populations against the spread of deadly disease. It is not a do-it-yourself project.

Who knows? Maybe after Hurricane Katrina, Dr. Nabarro’s high mortality range is based on an expectation that the governments and public health authorities won’t be up to the task. This raises an interesting question: besides the usual factors, shouldn’t political incompetence, neglect and corruption be factored into epidemiological models and their mortality estimates? Or is it in bad taste to suggest that the actions and inactions of governments may be causes of citizen death?

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