There are
around 300 Intensive Care specialists in Australia and New Zealand
combined, and at least 100 of us had to practise wearing biohazard
suits during the SARS outbreak – SARS really was a big ICU problem. In
Asia a number of ICU staff died. If you present very unwell to a major
hospital anywhere in Australia, and the initial staff who saw you
thought you
were at risk of dying, then one of the things they would do is contact
the Intensive Care Specialist. As Intensivists, our specialist
skill is in keeping people alive, typically with mechanical supports
like ventilators, and with the assistance of very large numbers of
staff. As such, if anybody in Australia dies of avian influenza
(or SARS, smallpox, polio, anthrax or any other potentially reversible
infectious disease) they will pass through an Intensive Care.

Another year, another pandemic coming our way. Remember SARS?
Ebola? Weaponised anthrax from Iraq? This is a prediction: Avian
Influenza won’t be “The Next Big One.” Some people might die of Avian
Influenza, but not as as many as die fishing. Just remember, public
health officials are like the army. They protect their budgets by
reminding us all of risks for which they will surely be needed. If one
risk does not materialise, they move on to a new one.

We
are not very
successful at immunising against influenza because it mutates rapidly;
every season there’s a new strain. But it doesn’t just mutate between
seasons,
it mutates constantly – so the bigger an epidemic, the more chance
there is that a less harmful strain will emerge, and the less harmful a
strain, the better it will spread. The better a strain spreads, the
more it will inhibit the spread of its cousins, and the closer the
cousins, the more they will be blocked out.

Influenza epidemics just have a natural tendency to peter out. They are
more severe in the high density cities of Asia because more people are in
close proximity. Plus, influenza is sensitive to environmental drying – it
spreads better in high humidity. Each new outpost of H5N1 is indeed a
further opportunity for the rapidly evolving virus to acquire a gene or
protein mutation that it needs to become a mass killer of humans. But a
mutation which makes it prolific and harmless is vastly more likely.

Continue reading on the website.

CRIKEY: Journalist Michael Hutak has alerted us to his more pessimistic side of the bird flu story “Death on the Wing” in last week’s Bulletin.