Doctor criticizes public health, talks of bird flu

A Pitt expert said Monday that the public health system might not be able to cope with the… A Pitt expert said Monday that the public health system might not be able to cope with the fallout from widespread avian flu infection.

“Today’s talk is not going to be your usual influenza talk. I hope to guide you through a realistic appraisal of what the effects of a serious pandemic would be,” Sam Stebbins said.

Stebbins, a doctor and the director of the Pitt’s Center for Public Health Preparedness, addressed an audience in Alumni Hall on the risks associated with avian flu.

“I don’t think that we as a society know how to conceptualize the effects of a pandemic. I just think we make too many assumptions and we think two-dimensionally in graphs and numbers,” Stebbins said.

“For situations such as pandemic flu or a large-scale bio-terrorism attack, we must think four-dimensionally both in space and in time while considering the entire world. We must also be aware of secondary and tertiary effects, not just how many people will die from the flu,” he added.

Stebbins referred to the influenza pandemic that swept the world in 1918 when he noted the change in interdependency during the last 100 years.

“A lot of Americans still lived on farms or in small towns. They had their own food supply, fuel supply and transportation. Methods of communication were very, very basic. Nowaday any broad-scale attack will affect all of us.”

The influenza pandemic of 1918 killed between 40 million and 50 million people around the world and was considered to be one of the deadliest disease outbreaks in history.

If the avian flu was to reach the level of the 1918 influenza pandemic, Stebbins predicts that 90 million or more would be infected with more than 2 million dead. He said that hospitals would be completely overwhelmed and there would be massive economic disruption.

Stebbins emphasized the importance of public health in developing a way to cope with a pandemic.

“Public health is really living in the 19th century in large part. The vaccine processes are largely out of date. The distribution systems for vaccines are unsophisticated, incomplete, inefficient and prone to break down. Public health advice is worrisomely similar to what you would have heard 80 years ago during the last pandemic,” he said.

According to the World Health Organization, avian flu is not one but many different influenza viruses that principally infect birds. Rarely these viruses can affect humans and other animals.

Avian H5N1 is a strain of influenza with the potential to infect humans at the pandemic level. To reach pandemic status, a large portion of the world’s population across a wide geographic area would have to become infected with influenza.

“No human has ever been exposed to this before except for a small number of chicken and duck farmers. This is very, very worrisome because it means we have no innate resistance whatsoever. This is won out by the fatality rates that we are seeing that are at about 50 percent,” Stebbins said.

“It’s probably impossible to eradicate in the wild bird population. This is important because to the extent that those birds interact with domesticated birds, pigs and humans, it will be possible to spread and never fully go away,” he added.

Currently the World Health Organization ranks avian flu as a three on a six-level scale of danger.

“One and two, there’s really nothing going on. Four, five and six is more and more human-to-human spread. Three is really that level where you are standing at the end of the diving board just before you go into the pool,” Stebbins explained.

Stebbins also offered advice to college students after his lecture.

“Don’t smoke. It has no relation to the flu that I know of, but in terms of kind of things that will kill you, cigarettes are No. 1. And please look both ways when you cross the street. I have almost run down any number of students just driving down Fifth Avenue,” Stebbins said.

With regard to his speech, Stebbins said, “Being informed is the most important thing. Things usually don’t turn out in the worst-case scenario. It’s important for people to be informed and stay in between ignoring it and panicking.”

The seminar was the 10th in a series designed to promote Pitt’s research on emergency preparedness.

The next seminar in the series will be on Feb. 9, and will cover the social and psychological consequences of terrorism.