Laurie Garrett — senior fellow for global health at the Council on Foreign Relations, is the Pulitzer Prize-winning author of The Coming Plague — in a new article in the International Herald Tribune [Unless We Act Now, Bird Flu May Win; also on CommonDreams]; describes some intelligent public health measures that should be taken to help prevent a human avian flu pandemic:
Instead of simply sitting back and watching nature take its course, the global community should be proactive. Being ahead of the virus is akin to being ahead of the migrating birds. Instead of waiting for dead birds, and even dying people, to turn up in new areas, political leaders should heed the warnings from science and act accordingly – as, apparently, Sweden and the Netherlands are doing. The Swedes and Dutch looked at their maps, plotted the movements of infected birds, and last week ordered farmers to bring their flocks indoors, out of harm’s way. In poorer regions of the world, where indoor facilities for animals may be unaffordable, simple nets and fences can radically decrease contact between wild and domestic birds, and mass public education campaigns warning people to avoid contact with sick birds or carcasses may decrease the likelihood of avian-to-human transmission of H5N1.
One of the best untapped resources in this epic battle against influenza is bird-watchers, who are among the most fanatic hobbyists in the world. The major bird-watching organizations and safari clubs ought to work with the World Health Organization and OIE, the World Organization for Animal Health, to set up Web-based notification sites, where birders could report sightings of groups of dead birds, and the movements of key migrating species.
Ornithologists and climate experts should immediately sit down with pandemic planners and virologists, creating lists of known H5N1 carriers and plotting their most likely global movements. As the birds appear in new regions of the world, birders and professional wildlife surveillance personnel should issue alerts, which should be swiftly confirmed and form the basis of government response.
When carrier species are sighted in a region, swift action should be taken to minimize contact between the wild birds and their domestic kin. In such a way, it might be possible to limit avian deaths to susceptible wild birds, such as the dying swans of Europe.
While the H5N1 virus remains an avian killer, wealthy nations and biomedical companies should work hard on developing a rapid, simple method of diagnosing flu infections in people. Currently, many of the delays in reporting human cases around the world are due to the tedious laboratory procedures necessary to diagnose H5N1 infection. We urgently need a quick infection test that can be performed by nonprofessionals.
Rather than waiting for a tide of H5N1 to wash over the world’s birds, mutate, and then move in a tidal wave over humanity, we should create lines of defense that start with the wild animals, move next to protect poultry, and then rely on rapid screening of human beings to determine who is, and is not, infected with the virus.
In the absence of these sound footings, everything else is just wasted billions of dollars.
The basic point is that prevention is far-and-away the best strategy to use against this potential danger. Once a human pandemic breaks out, there is far less that can be done. A policy emphasizing stockpiling Tamiflu is a potentially wasted effort in the developed countries and is one that simply consigns those in the less developed world to wait to die.
February 27th, 2006