Watch the Birdie

May I interrupt the Rovian food fight long enough to mention a threat to America that could dwarf 9/11? Flying under the headlines, avian flu A (H5N1) has killed only 54 people so far (and an awful lot of birds) in Asia, but the World Health Organization and assorted scientists are worried that the virus could lead to a pandemic that would kill at least 500,000 in the United States, many more world-wide. "Unfortunately, the United States is woefully underprepared to respond in the event of a pandemic outbreak," Senate Majority Leader Bill Frist (R-Tenn.) is quoted in an AP story. There is no vaccine, and U.S. hospitals would be hard-pressed to treat the estimated 2.3 million Americans who would need hospital care.

Our "normal" flu already kills some 36,000 Americans per year, but if we want to know what a pandemic is like and why we need to be prepared, Dr. Richard Feldman helpfully provides the historic view in an op-ed in the Indianapolis Star. Spanish flu in 1918 "killed nearly 700,000 Americans and nearly 40 million worldwide," many more than died in World War I.

Because of the massive numbers of sick, hospitals were overwhelmed and there was a serious shortage of doctors and nurses to care for so many victims. With the massive numbers of dead, bodies literally piled up because of a shortage of coffins and morticians.

H5N1 won't necessarily turn into a pandemic. So far, all cases of human H5N1 occurred in people who caught it from infected birds. The problem -- the big question -- is whether the virus will mutate into a form that could be transmitted between humans. An excellent story in today's Philadelphia Inquirer discusses the evolution of the virus.

Unlike previous pandemics, where a virus underwent a major genetic overhaul all at once, [Michael] Osterholm [director of the Center for Infectious Disease Research and Policy at the University of Minnesota] said the avian strain has been changing gradually since it was first identified in 1997. He believes the virus will continue to transform, increasing the likelihood it will ultimately lead to a pandemic.

"We haven't done much to eliminate the source in Asia," said Osterholm, a former bioterrorism special adviser to the current Bush administration. "And there is a dynamic mutation laboratory over there. I see nothing to slow down the mutations."

Though no one has yet made the connection, perhaps the threat of a mutating (i.e. evolving) virus causing a pandemic will help stamp out the epidemic of rampant stupidity in my home state. As if it weren't bad enough that one school board in Pennsylvania's Lancaster County wants to teach "intelligent design" along with biology, now a legislator from Bucks County wants to inflict it on the entire commonwealth, according to The Intelligencer. "Can you tell me one thing true about evolution?" Rep. Paul Clymer is quoted. Evolution isn't some phenomenon that happened long ago, Cly, it's an ongoing process of nature. That's why we need to prepare for new kinds of flu virus every year.

(Full disclosure: I serve on the board of one of the chapters of the ACLU involved in the lawsuit against the Dover School District about the teaching of "intelligent design." I believe in not only evolutionary theory, but also gravitational theory and the Copernican theory, the controversial view that holds that the planets revolve around the sun.)

Editor's note: The most interesting story of the week on this subject was The Washington Post's report that the Chinese used one of the two most powerful antibiotics that might work against this virus in a wholesale dosing of their chickens, thereby helping the virus (you should pardon the expression) evolve a resistance.