October 9, 2005

Preparing for a Flu Outbreak

Carroll Andrew Morse

The numbers don’t make sense to me. On the one hand, I’m reading about a government report that says an outbreak of avian flu could kill about 2 million people and cause irreparable social disruption…

"Social unrest occurs," the plan states. "Public anxiety heightens mistrust of government, diminishing compliance with public health advisories." Mortuaries and funeral homes are overwhelmed.
I'm also reading that the government is buying vaccine to prepare for an outbreak. I keep seeing $100,000,000 reported as the amount spent on vaccine doses, but that, at best, $100,000,000 protects 20 million people -- less than 10% of the population – and that is the optimistic estimate.

Here is where I get confused. The government reports that the limited number of available vaccine doses plays a major role in the “social unrest”, as people riot to get the scarce vaccines, and those unable to get vaccinated refuse to leave their homes. So, given the potential harm, why not spend more on vaccines? $100,000,000 is not a lot of money in Federal government terms. This year, the Federal government will spend $49,000,000 -- about half of what has been reported for avian flu response -- for bike paths and conservation land in the state of Rhode Island alone.

I’ll let somebody else write the theories about how this is a government plot to decrease the surplus population and try to come up with a rational theory of why the government is attempting to prevent the apocalypse on the cheap. Maybe the spending on avian flu vaccines is only twice the spending on Rhode Island bike paths because the Feds realize there is a good chance, in any one year, an avian flu vaccine will never be used. If I understand properly, flu strains mutate from year to year. A vaccine against H5N1, the strain of flu causing worries today, might be worthless against an outbreak next year. Therefore, you have to hedge your bets, and not blow all your resources in any one year, because the big outbreak may not happen until next year.

To understand if this is the case, and to develop a more effective response to flu epidemics, the body politic needs to understand the answer to the following questions. What is the bottleneck in the vaccination production process? How can we prepare to work around the bottleneck in an emergency? Would building more production facilities help? Are there existing industrial facilities that can be rapidly converted to vaccine production in an emergency? Is there a problem with obtaining raw materials? What can we buy now to speed up our ability to produce vaccines in the future?

With the answers to these questions, we can start to determine if the relatively small amount spent on flu vaccines makes sense, or if it is another case of misplaced spending priorities.