By Dana Milbank
Thursday, October 13, 2005
Halloween came early to the Capitol yesterday, as disease experts lined up to scare the dickens out of lawmakers in a "congressional briefing" on the coming flu pandemic.
The elected representatives missed their briefing, because they were home for their Columbus Day recess, trick-or-treating for campaign checks. But a roomful of staffers, pharmaceutical lobbyists and reporters toured a medical house of horrors in the Hart Senate Office Building.
"This is a nation-busting event!" warned Tara O'Toole, CEO of the University of Pittsburgh Medical Center's Center for Biosecurity. Speculating that 40 million Americans could die -- that's about one in eight -- she warned: "We must act now."
"We and the entire world remain unprepared for what could arguably be the most horrific disaster in modern history," inveighed Gregory A. Poland of the Mayo Clinic and the Infectious Diseases Society of America. Somebody in the audience sneezed, and Poland added: "The clock is ticking. We've been warned."
It was hard to top that, but Constance Hanna, an occupational health specialist, tried. "Let me paint you a little picture," she began. "Twenty to 30 percent of your employees don't show up to work . . . schools are closed . . . transportation systems are curtailed or shut down . . . Critical infrastructure will or may fail: food, water, power, gas, electricity."
"This picture," Hanna added, redundantly, "is pretty scary."
Even before the start, there wasn't much doubt about the answer posed in the briefing's title, "Are we prepared for a Pandemic Flu Outbreak?" After Hurricane Katrina, the answer to any question beginning with "are we prepared" is an emphatic negative.
Attendees were greeted by an ominous poster of a man wearing a mask, followed by welcoming tables piled with boxed lunches of cookies, chips and sandwiches (smoked chicken -- at an avian flu briefing?). Those who did not eat quickly would soon lose their appetites.
O'Toole, a medical doctor and public health specialist, said the bird flu of concern is potentially worse than the 1918 pandemic that killed 675,000 Americans. And this time, she said, the mortality rate might not be 1 or 2 percent, but 40 or 50 percent. "You can do the arithmetic," O'Toole said.
For those keeping score, that's 40 million to 42.5 million dead. And O'Toole's ghost story was not over.
"Suppose the pandemic comes next year," she said, and "a year and a half from now, next winter, you're thinking about today. You were one of the lucky ones: You got sick but you recovered and now you have immunity against the pandemic strain. But one out of four Americans was infected, one of four people sitting here today, and half of them died." Some people looked around: There were about 200 in the room, so about 50 would get the bug, and 25 would die.
On the positive side, this level of mortality would have left enough chicken sandwiches for everybody at the event.
Public-health types are always warning of doom and asking for more government spending, $5 billion to $16 billion in this case. It's possible that the virus will not learn to spread easily among humans, and it's likely the virus will grow less lethal if it does. But the medical experts, well-credentialed all, were alarmingly unified in their alarm. Their dire warnings proved gripping enough to silence the usual back-of-the-room chatter.
"This is real," said Shelley A. Hearne, executive director of the Trust for America's Health, as she kicked off the event.
"Death rates approaching this order of magnitude are unprecedented for any epidemic disease," contributed O'Toole.
This was difficult to top, but Poland tried. "I want to emphasize the certainty that a pandemic will occur," he began. "When this happens, time will be described, for those left living, as before and after the pandemic."
"The key to our survival, in my opinion, and to the continuity of government," he said, is vaccination. And "we do not have a licensed or approved vaccine."
Up next, Isaac Weisfuse, the New York City deputy health commissioner, provided some logistical fears to add to the medical ones. "We'll be inundated," he said. "We have no [antiviral] Tamiflu. We have no vaccine. . . . There is no cache of respirators."
There was little left unsaid for speakers lower in the program. Jeffrey Levi of George Washington University prophesied a panic of "millions and millions of people" trying to get antiviral prescriptions filled. Hanna struggled for superlatives: "We haven't even begun to conceive of, to understand, to comprehend what that may mean for our workplace."
That was ominous, but it did not approach O'Toole's apocalyptic fervor: "uniquely virulent . . . hospitals will be quickly overwhelmed . . . this time of peril . . . quarantine is not going to work."
O'Toole's speech quieted the room. People stopped munching on their smoked chicken. Moderator Hearne took the microphone: "And have a good day, right?"