Faced with growing frenzy about the possibility of pandemic flu, President Bush reached back into the politician’s bag of traditional “solutions” this week and proposed that taxpayers pay an additional $7.1 billion to prepare for the possibility of an outbreak.
The president attempted to justify his proposal in large part by raising the specter of the 1918 influenza pandemic, which he noted “killed over half-a-million Americans and more than 20 million people across the globe.”
Spending that kind of money to avert that kind of catastrophe may sound reasonable, but in this case, it’s misguided.
First, it’s quite possible, if not likely, that no pandemic will occur any time soon by the current bird virus-of-interest, called H5N1. The virus has remained largely confined to birds for years. Only about 120 people in Asia have been hospitalized due to the virus. Although 60 deaths have been attributed to the virus, infectious disease experts know that no pandemic is likely to result from a virus that apparently kills such a high percentage of its hosts since the hosts will have less opportunity to spread the disease.
There is much unknown about H5N1. Given that uncounted numbers of Asian poultry and other birds have harbored the virus, it’s quite likely that many people have been exposed to H5N1 but haven’t been made ill or at least haven’t required hospitalization. It doesn’t appear that mere exposure to the virus necessarily leads to illness. No one knows why some people are sickened after handling diseased birds but others aren’t.
The virus is not known to be transmitted human-to-human — a requirement for pandemic status. H5N1 would have to acquire significant genetic mutations before that could become a possibility.
Only much more scientific research will unravel the mystery of H5N1. Without better understanding of the virus, public health officials ought to be cautious so they don’t waste limited resources.
Next, let’s take a deep breath before we draw parallels to the 1918 pandemic. That tragedy came on the heels of World War I. Much of the world was starving and physiologically stressed at that time, thereby making the world’s population much more vulnerable to illness.
Even if a pandemic strikes now, it’s unlikely to be anywhere near as tragic, since today’s standard of medical care far exceeds that of 1918.
As pointed out in a Nov. 1 letter to the Wall Street Journal by Dr. Edward H. Livingston, chairman of Gastrointestinal and Endocrine Surgery at the University of Texas- Southwestern School of Medicine, “In 1918 care of the flu patient was limited to rest, providing aspirin, oxygen and other supportive measures. The primary cause of death was pneumonia resulting from bacterial infection of lungs injured as a result of the flu. Lacking antibiotics, there was no effective way of treating the pneumonia… Today’s antibiotics allow for the successful treatment of all but the most resistant bacteria causing pneumonia.”
“Modern hospitals have far greater bed capacity than they did at the turn of the century, are climate controlled and have intensive care units allowing for the care of the sickest patients. Replacing lost fluids with intravenous therapy is performed as routine today, but was virtually nonexistent in 1918,” added Dr. Livingston.
Dr. Livingston urged the avoidance of panic about the flu, since “There is little likelihood that the flu will have the same impact on the population that it did in 1918.”
Avoiding panic ought to include not simply throwing more taxpayer money into the federal bureaucracy.
The federal government has budgeted about $67 billion in discretionary spending in 2006 for the Department of Health and Human Services, including about $7.5 billion for the Centers for Disease Control and Prevention, the federal agency responsible for managing disease outbreaks, and another $28 billion the National Institutes of Health, the federal agency in charge of medical research.
It would seem the federal government already has enough money at its disposal to address the flu threat without hitting up taxpayers for more. Sure agency budgets might need to go back to the drawing board, but shouldn’t that be the first option rather than simply resorting to milking taxpayers?
Protecting the public against infectious disease like the flu is already part of the mandate of the federal public health establishment. Despite recent media attention, the flu pandemic threat is not new. Why should taxpayers pay more for protection that should already exist or, at least, have long been under development?
Public health bureaucracies, of course, will resist a reallocation of funds from pet programs to the sort of flu protection that President Bush says we need right now. But perhaps less important programs should be put on hold to prepare for a flu pandemic.
Virtually all individuals, families and organizations have to prioritize how they spend their limited resources. Why shouldn’t the government be held to a similar standard?
The president has called for stockpiling $1.5 billion in influenza vaccines. But because we don’t know the precise strain of virus that might cause a pandemic, it’s quite possible that stockpiled vaccines would be entirely useless. Resources would be better spent developing technology to rapidly produce vaccines — a longstanding bottleneck in vaccine production that should have been addressed years back rather than now in the heat of the newly sparked flu frenzy.
Panic spending to stem a hyped, but so-far hypothetical disease outbreak is dubious public policy. So is asking taxpayers to pay for protection they should already have.