Table of Contents:

Foreword

Introduction

I. Storm Gathering

1. 1918

2. Master of Metamorphosis

3. H5N1

4. Playing Chicken

5. Worse Than 1918?

6. When, Not If

II. When Animal Viruses Attack

1. The Third Age

2. Man Made

3. Livestock Revolution

4. Tracing the Flight Path

5. One Flu Over the Chicken's Nest

6. Coming Home to Roost

7. Guarding the Henhouse

III. Pandemic Preparedness

1. Cooping Up Bird Flu

2. Race Against Time

3. Tamiflu

IV. Surviving the Pandemic

1. Don't Wing It

2. Our Health in Our Hands

3. Be Prepared

V. Preventing Future Pandemics

1. Tinderbox

2. Reining in the Pale Horse

Topics

References 1-3,199

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Population explosion

A pandemic today could be many times worse than the pandemic of 1918, the world’s greatest medical catastrophe. In 1918 we were, as a nation and as a people, much more self-sufficient.565 With the corporate triumph of free trade, just-in-time inventory management and global supply chains now characterize all major economies and business sectors.566 Economic analysts predict the pandemic would cause a global economic collapse unprecedented in modern history.567 With the global population at an historical high, this could lead to unprecedented human suffering.

A short 100,000 years ago, all members of the human race lived in eastern Africa.568 The 6.5 billion people alive today represent roughly one out of every nine people who have ever inhabited the Earth.569 In 1918, cities like London were smaller, with just over than one million residents. Today there are 26 megacities in the world, each with more than ten million people.570 With this kind of tinder, experts like the WHO’s Klaus Stöhr predict the pandemic will “explosively” hit world populations “like a flash flood.”571

“The rapidity of the spread of influenza throughout a country is only limited by the rapidity of the means of transportation,” explained the 1918 New York State Health Commissioner.572 Back then, the fastest way to cross the world was by steamship.573 In the past, a trip around the world took a year; today we and our viruses can circle the globe in 24 hours.574 The number of human globe-trotters now exceeds one billion people a year.575 AIDS left Africa on an aircraft. So too may H5N1 leave Asia, only a plane ride away.

Between record population levels and the unprecedented current speed, volume, and reach of global air travel, any pandemic virus could wreak unparalleled havoc.576 H5N1, though, promises to be more than just any pandemic virus. In all of his more than 40 years working with influenza viruses, Robert Webster can state unequivocally, “This is the worst flu virus I have ever seen or worked with or read about.”577 At a congressional briefing, Gregory A. Poland of the Mayo Clinic and the Infectious Diseases Society of America tried to get members of Congress to imagine the unimaginable—an H5N1 pandemic. “I want to emphasize the certainty that a pandemic will occur,” he began. “When this happens, time will be described, for those left living, as before and after the pandemic.”578 The top virologist in Russia attempted to tally the worst-case scenario potential human death count: “Up to one billion people could die around the whole world in six months…. We are half a step away from a worldwide pandemic catastrophe.”579