The dictionary defines the word convergence as “To come together from different directions; meet.” This past week there were two disparate articles that raise both our hope and our concern about pandemic diseases. Each, standing alone, was not particularly significant. But, when read together they are disconcerting.

The first article was one of hope. This article, “Deep in the Rainforest Stalking the Next Pandemic” was written about Nathan Wolfe, a 38-year-old visiting professor of epidemiology at Stanford. Dr. Wolfe states, “Before, the best thing you could do was develop a vaccine, but now people are recognizing that’s not going to be enough.”

“If you find diseases before they’ve really emerged,” he continued, “you can control them early on, before you get a major epidemic.” The article continues, “With the goal of identifying more of these “little sources” — new disease-causing pathogens — and choking them off, Dr. Wolfe started the Global Viral Forecasting Initiative this year. If new disease strains could be culled before they had a chance to take hold in humans, he reasoned, health organizations would have to spend less money and energy on developing expensive vaccines and treatment drugs.”

The second article was a report from Lloyd’s of London. Their Emerging Risks Team issued a new report on the threat posed by a global pandemic.

The report, “Pandemic – Potential Insurance Impacts” focuses on the threat to the global business community and, in particular, the insurance markets of a global pandemic.

The report concludes that a pandemic is inevitable; explaining that with historic recurrence rates of 30-50 years it is prudent to assume that a pandemic will occur sometime in the future.

Trevor Maynard, Manager, Emerging Risks, at Lloyd’s and the report’s author says: “The significant message is that society should not optimize to one particular scenario as a worst case. Much has been said of the 1918 Spanish Flu epidemic, which is said to have killed up to 100 million people worldwide. While Avian Flu is seen as the most likely next pandemic, we have to ensure we are prepared for other types of pandemics that may require different responses and pose different challenges —some of which may well have higher rates of mortality than flu.”

Maynard goes on to say, “The threat of pandemic to the global economy cannot be underestimated.” He explains. “If you look at the example of a recent limited pandemic, such as SARS, the regional economic impact was severe and a repeat of the 1918 Spanish Flu outbreak, even without the current economic conditions, would be expected to reduce global GDP by between 1% and 10%.”

These two articles of warning and prevention are a reminder that pandemics remain a constant and extraordinary threat. The world population in 1918 during the Spanish flu pandemic was 1.8 billion people. Today, according to the Population Reference Bureau, in 2008 the world population is 6.7 billion: 1.2 billion people live in regions classified as more developed by the United Nations; 5.5 billion people reside in less developed regions. “We will likely see the 7 billion mark passed within four years,” said Carl Haub, PRB senior demographer and co-author of this year’s Data Sheet. “And by 2050, global population is projected to rise to 9.3 billion. Between now and mid-century, these diverging growth patterns will boost the population share living in today’s less developed countries from 82 percent to 86 percent.” Over half live in urban environments. Never in human history has the available supply of fuel for a pandemic illness been greater.

According to USA Today, the threat posed by infectious diseases is of growing and immediate concern to infectious disease experts. A soon-to-be released report by the non-profit Trust for America’s Health asserts, “infectious diseases from the developing world are anything but “a back-burner concern.”

The report, “Germs Go Global: Why Emerging Infectious Diseases Are a Threat to America,” cites National Intelligence Estimates that conclude outbreaks of new and resurgent infectious diseases, many of which “originate overseas,” kill more than 170,000 people in the USA each year.

The death toll would climb much higher in the event of a new global pandemic or bioterrorism attack. Infectious diseases, the report concludes, have become “a matter of national security.”

In his brilliant Pulitzer Prize winning book, Guns, Germs, and Steel, Jared Diamond “seeks the root answers to why European societies (and their American offspring) became the dominant powers on Earth in terms of wealth and power. He traces the proximate causes–the development of deadlier weapons technologies, immunity to germs, superior metal working, and writing systems–to the ultimate cause of the way food production varied in human societies and then looks at geographic variations and impediments that affected food production and the spread of technological innovation in all regions of the world.”

Dr. Irwin Sherman, a professor emeritus of biology at the University of California Riverside, in his book, Twelve Diseases That Changed Our World, also describes how bacteria, parasites, and viruses have swept through cities and devastated populations, felled great leaders and thinkers, and in their wake transformed politics, public health, and economies.

The US Center for Disease Control, The World Health Organization, and King County’s Department of Public Health have undertaken surveillance and preventive measures to protect the public from pandemic illnesses. Those investments must remain an international, national, and local priority. All of these agencies face the daunting challenge of developing measures to identify and prevent the spread from numerous germs that have the capacity to change human history. In an age of limited resources, the agencies must remain a key priority. We must commit to the robust funding of early warning systems. We must continue to remain vigilant about the microscopic life forms that with great swiftness and determination can change our world. If we don’t do these things, we are at peril.

A fool too late bewares when all the peril is past.
-Elizabeth I

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One response to “Converge

  1. I remember when SARS and Asian Flu were growing concerns: it was encouraging to see the success with which health professionals met in dealing with the situation.

    Thank you for addressing this issue.

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