If a producer had to book the estimate of the allegations that an apocalyptic event is most likely to get rid of the human race, a pandemic would be more likely than any nuclear assault, robot lift or asteroid. Epidemiologists and health professionals around the world agree: despite the efforts of governments and agencies to prepare for the worst, the world is not ready for a global cause of infectious fatal disease. In February 2017, Bill Gates warned that, unless serious action was taken soon, a pathogen that could be airborne and fast moving "could kill more than 30 million people in less than one year. "
Of all the threats that emerge from disease, flu causes the greatest concern, mainly due to the speed it can spread and the virulence that it can kill him. Recent research has shown beyond reasonable doubt that the Spanish flu of 1918, which killed 50 to 100 million people and the most dead in the history of mankind, had originated in birds. Newborns of avian flu today have unprecedented death rates, such as the H5N1 strain that appeared in Hong Kong in 1997, and they emerge more frequently than ever.
The main one of these new threats is H7N9, a flu strip originally found in an old Chinese whose Centers for Disease Control and Prevention (CDC) are currently considering that & # 39 The greatest potential causes a deadly pandemic in case of boring and transmitted by air. The virus was first detected in a human victim in 2013. The figures published last month indicate that the latest cases of H7N9, in October 2016, killed more people in China than the four events previous avian influenza and generated a less vulnerable variation to vaccines.
Although it is clear who is the main doubt, there is a problem in preparing to deal with H7N9 on a global scale. As Dr. Keiji Fukuda, a former head of epidemiology in the CDC, had humanity "had a bullet" fumbled "in relation to a pandemic in recent years. Through a combination of preparation, rapid action and good luck, SARS in 2002, or swine flu in 2009, or Ebola in 2014 did not end in complete pandemics. We do not have many points of reference to the provision of clues or models of how a world could be in the heart of a contemporary mortal cause and how we can prepare for the worst in our associated society.
Irwin Redlener is the director of the National Center for Preparing for Disaster at Columbia University. He and his team have spent the last 14 years studying disasters caused by climate change, terrorism or sick birds. Using computer data and models, they have explored the different situations that may occur after new avian and avian influenza emerges and the results of the extraordinary models such as zombie fiction are read.
In February 2017, Bill Gates warned , unless serious action is taken soon, a pathogen that can be transported to air and moving rapidly "kills more than 30 million people in less than a year"
Say that the virus, which ranges from H7N9, is first detected in a patient that has come into contact with live poultry in one of the country's rural poultry markets in China, The rigor and regulation currently apply to many Hong Kong markets not yet implemented. A week later, three other cases are detected and the patient dies in hospital due to lung infection.
The laboratory that is run by the CDC in Atlanta is the first to examine a sample of blood taken by the victim. The CDC physiologists confirm that they have found a new strain of avian influenza. The Chinese government, with experience of controlling such incidents, orders the closure of bird markets and kills tens of thousands of birds in the province where the first cases were discovered.
However, after a few days, hospitals continue to receive a large flow of new cases: it is clear that the sacrifice or the country's detailed rules to transport live animals are not effective. It seems that this new virus can be spread between people through the air we breathe.
Days later, new cases of disease are reported in neighboring countries of China, although it is not clear at the moment if the virus has spread through lorries that are cross border or by migrant birds during the winter.
Immediately immediately, Redlener predicts, international airports will start closing in an effort to avoid inter-continental transfer. Air travel, where strangers from geographical regions with different levels of vulnerability to disease are forced to stay in an enclosed area for an extended period, is currently the fastest way to travel.
Like the ditches and Spanish canvas hospitals from 1918, an airplane acts as a hatching for a virus and infects passengers who, after falling and scattering, effectively distribute the virus. As Ed Yong recently said in Atlantic, when it comes to spreading diseases, "crossing the air in a number of aircraft, we transform small fires into big global fires."
Closing the airport is too late to prevent the spread of the pandemic. In today's world, disease from a rural village can be transported to any big city in 36 hours, faster than any government could implement a flight ban policy. The first cases are reported in Europe and, soon afterwards, in the USA. In the first few weeks, anonymity varies, as during the Ebola case in 2014, when fake reports worsened the virus easier. In cable news channels, some experts suggest that the causes are due to irresponsible genetic research in China. Others suggest that it is part of a terrorist plot.
We do not have many reference points to provide clues or models of how a world could be in the heart of deadly contemporary cases and how we can prepare for the worst in our associated society
The first schools are closed. "One of the most important things that can be done in a pandemic that appears to reduce infections among children," said Redlener. However, the operating models show that this precaution solves the same number of problems that it creates. "Who looks after children at home?" Redlener asks. "What happens if the parents are infected and what happens to the economy when the parents can no longer work? How do people buy food if not? Do they have income? "
Supply chains begin to fall as the first local and regional local pandemic economic results appear. "Who supplying our daily supplies of food and medicine and everything we need if people are infected everywhere?" Ask Users "Do we go to allow passage trucks between states if doing so increases the risk of spreading the disease?"
In a few weeks, supermarkets' shelves are empty. The queues at gas stations extend along the roads, at least during the few days when gasoline is still.
The vulnerability of all high-refinement mechanisms that guarantees the comfort and ease of contemporary life in the richest countries is exposed slowly and completely. The global health crisis is changing from "being on the list of things that nobody wants to do to be the only task on the list of things that I did to many people," said Bill Steiger, who headed the Office of Global Health Affairs during the administration of George W. Bush, Washington Post in April when preparing for a pandemic.
Although the CDC publishes everyday recommendations (staying home, clog your mouth if you're coughing), President Trump responds with an incredible incredible rhetoric. This time, however, rhetoric leads to even stronger measures. The US borders with Canada and Mexico have been closed, martial law has declared and sick Americans are placed in quarantine (and placed in detention camps if they get cut against curfew). Using a public feeling about these epidemic conspiracies, Trump starts a commercial war with China.
As the pandemic continues, we begin to see inability of nations to respond. Hospitals, medical personnel and medicines are tested using unexpected methods. "The United States has had little improvement in the ability to treat those affected by a pandemic," said Redlener. "We do not have enough anti-virus agents, we do not have enough mechanical aircraft, it's very hard for us to know if we would look after the people who need their hospitals if there was a pandemic and in what way we would feeling silly at the time at the time. "
This is where the complexity of a pandemic situation is revealed: consider the ethical issues that will arise among a disaster. What happens, for example, when hospitals run out of mechanical aircraft? Can a doctor tell a parent that an inhaler will be seized as the chances of surviving their child are less than those of a young adult? "There is no guidance on how we should control the huge shortage, we will see in the health system if there were a pandemic," said Redlener.
Regardless of whether these theoretical situations are unlikely or exaggerated, Redlener believes that the results of any pandemic are beyond the scope of the present considerations of many catastrophic planners. The models can show how fast a virus could travel around the world, but they do not explain the implications of the collapse of society in the middle of a deadly pandemic. The whole world, says Redlener, is "completely inappropriate."
Redlener and colleagues are not just those who come to these apocalyptic collections. In 2011, the World Health Organization introduced a global initiative of the Pandemic Flu Preparedness (PGP), a program designed to prevent or delay pandemic flu in its initial appearance and avoid the type of global disaster set out above.
As part of the PGP, a network of more than 150 laboratories worldwide known as the Global Flu Surveillance and Response System controls flu cases, examines blood samples from newly infected patients and monitor pharmaceutical sales of medicines used. to treat the symptoms of the disease. This research indicates that the vaccine is created against seasonal flu, whose new versions are being developed twice a year and provide the basis for the advice that the Health Organization The World gives governments to help prepare for a pandemic.
Many countries have developed their own specific plans. The United Kingdom created, for example, the Identifiable Bird Disease Management Strategy, which sets out the procedures to be followed in case of an emergence of a disease that could turn into a pandemic on the island. However, the World Health Organization is working to co-ordinate better efforts and strategies among nations based on Spanish flu experience in 1918: you can not fight a pandemic by treating patients individually. They believe that a modern pandemic is being defeated by treating the world in an interconnected way only and not by separate countries.
"A pandemic is a global event," said Sylvie Briand, director of the Contagion Risk Management Department as part of the recently created World Health Organization emergency program. "It has to be managed nationally and internationally, there is no disease at any boundary." Pardis Sabeti, a leading infectious disease researcher at Harvard University, said the same Atlantic At the beginning of the year: "Viruses are global threats to humanity, they are a common problem, in a way, they're the only threat that I can unite."
Still, the type of threat the flu does differently depends on the country from which it comes from. "The problem is that flu is seen as a disease from rich and temperate countries to date," said Briand. "Not so, flu is everywhere, but in many tropical countries, where there is a high mortality rate of respiratory diseases, most of the time that do not even know it is due to & # 39; r flu. "
In 2014, Obama's administration promised to put one million dollars into a new society created by the Global Health Security Agenda. The aim of the program is to help prevent the spread of fatalities by strengthening basic public health systems in less developed countries whose aim is to fight epidemics. He has provided training in epidemiology for health professionals in Mali, for example, and has helped governments to develop emergency plans to deal with cases of avian influenza. Over 30 countries have taken part in assessments to determine their ability to detect and prevent cases (results, even negative consequences, made public). However, the progress is "still fragile" and "continuous funding is required," according to internal CDC analysis.
At present, efforts to improve international collaboration are encouraging. However, we can not predict how nations would respond if they were seeking collective support in the theoretical pandemic tumor.
"Where, for example, a great coastal storm in the US north east or something like Katrina in the Gulf region, support usually comes from cities and other regions to the disaster zone," explained Redlener. In other words, those who are not affected usually support those who are. "But a pandemic threatens everyone, everywhere, Boston can not expect to have additional supporters from New York, Washington or Chicago because all those cities will need it." Resources are limited and, at all levels, of the neighborhood to the city and the nation, the human instinct to care for yourself will inevitably have implemented.
"There is a lot of work needed to ensure co-operation exists during an emergency," said Briand. "It is a tendency for each country to build up vaccines and implement its own individual preparation plan, but we need to add a prepared layer of preparation to ensure that the one that has been first affected does not monopolize all the resources. Global event: the rich country will have access to vaccines and the rest will not be. "
Part of the problem to anyone associated with this difficult situation is that it is very difficult to predict problems. Vaccination is the most effective way to defend against a pandemic. However, as Redlener says, capitalism gear and wheels go against research, development, production and storage of vaccines (some of which end in 12 months). "In a private manufacturing, development and research system," he explains, "pharmaceutical companies may not have the ability or willingness to invest large amounts of money in something that will not happen and will not be be able to predict it back. "
In the meantime, the World Health Organization laboratories continue to work to increase the pace of drug preparation in the hope of reducing the time a new vaccine is being developed from six months to four of least. The speed of flu transfer can be fundamental: the 1918 flu has, in particular, killed more people in 24 weeks than AIDS in 24 years.
Today, the World Health Organization has secured 500 million days of general flu photos, but it may not be effective against a new stress of avian flu. These reserves, says Briand, will allow the world to face the first wave of a pandemic. But Redlener, on the other hand, is firm and confirms that reserves will not be inadequate. "We do not have enough vaccines that can prevent a great pandemic of any type of flu and less infectious fatal pandemic."
"The problem is that flu is seen as a disease from rich and temperate countries to date, that is not the case, flu is everywhere, but in many tropical countries, where there is a rate high deaths due to respiratory diseases, most of the time that do not even know it's due to flu "
National and international policies play a vital part in creating new types of collaboration that are necessary to get a potential pandemic. However, as shown by the Brexit and the rhetoric progress of nationalists on the world stage, this collaboration is based on increasingly unstable foundations.
"Donald Trump has been very open about the First American, postgraduate and inappropriate in relation to almost all of the main problems that are" face the world: economy, public health, climate change, "said Redlener. Indeed, during his first few weeks of post, Trump offered significant cuts to government agencies that work to prevent deadly causes at their source.
During the Ebola case in 2014, Trump tweeted that American support workers should not return to North America ("PLEASE HERE!", he wrote), as they did not spread the disease. There is a way of thinking that suggests that Trump would be reluctant to send US aid to help with cases in other nations. "Sharing our countries just increases the threat caused by a bandmic," said Redlener.
For the World Health Organization, the need for ongoing international collaboration is crucial not only in the case of a pandemic, but also in drills and building defenses for such an event. "The preparation needs constant effort," said Briand. "The mechanisms are only strong if you use them often, people change, the guides are changing, so they have to You do simulation exercises on a regular basis to make sure the plan is up-to-date and very easy to deal with the unexpected. "
When can we expect other avian flu to appear? All the experts interviewed for these articles said that an important pandemic is not just likely to appear, but it's just about to happen.
The World Health Organization is currently monitoring a number of avian influenza viruses that, according to Briand, "have pandemic potential". These include the recently discovered H10N8, an unknown source of disease that killed its first human victim in China four years ago. Since then, the CDC has monitored more than 300 cases in 160 countries and tracked 37 dangerous pathogens in the last year.
Obviously, we are not ready. How would we You can not emulate the collapse of society. Global health systems are already experiencing difficulties in meeting the needs of our populations in terms of growth and aging, as well as facing those that would arise after a pandemic disaster. In the meantime, xenophobia and nationalist and other positions are contrary to international politics and collaboration necessary to prevent local causes becoming a genetic.
In his January opinion article, Bill Gates wrote that he felt optimistic and, with little effort, humanity could continue to avoid the worst. "Within a decade, we can be much better for a fatal epidemic if we are ready to give a fraction of what we spend on defense budgets and new weapons systems in preparing for the epidemic."
But that, as Redlener says, "will still be highlighted." Until it shows, we will continue to live under the threatening shadow of birds flying through the gray sky.