Avian flu. On a wing and a scare

Preparing for an influenza pandemic makes sense. Panic doesn't

FEAR seems to be the dominant mood of the moment. Hurricanes, tidal waves, floods, earthquakes and terrorism this year have all brought with them not only appalling scenes of devastation, death and suffering, but also outrage at the lack of preparations to avoid or cope with these disasters. Now even the birds of the air are a threat, we are told. That migrating flock visible on the horizon at sunset, once a consoling reminder of the eternal rhythms of nature, could be carrying the virus which might soon kill tens of millions of people.

Given the many fingers pointed at governments in the wake of other disasters this year, it is hardly surprising that they are scrambling to respond to the threat posed by avian influenza. After confirmation this week that the H5N1 strain of bird flu, which has been spreading quickly in Asia, had been discovered in Romania and perhaps Greece, European Union foreign ministers convened an emergency meeting. President George Bush, still smarting from a torrent of criticism of his government's clumsy response to Hurricane Katrina, has promised to rush out emergency plans for dealing with an outbreak of pandemic flu which have been stalled for years. Countries around the world are hurrying to stockpile the only current antiviral drug, Tamiflu, which might be effective in saving lives in any pandemic or curbing its spread. The World Health Organisation is calling for an internationally co-ordinated effort. Health ministers from around the globe are due to meet next week in Canada to discuss what steps to take.

Is any of this effort justified? Or are politicians simply helping to feed public panic, and then covering themselves by promising to spend lavishly against a threat which may never materialise and to reduce a risk which they do not understand? To ask these questions is not to counsel complacency, but to apply the kind of test which is required in any kind of disaster planning, not least because the world is an inherently dangerous place and it is impossible to plan against every possible disaster. With the media full of warnings of impending mass death, an overreaction is all too possible.

The case against

A sceptic might point out that measures which sound plausible in the midst of general public alarm can turn out to be counterproductive. This is what has happened with the ill-conceived crackdown on terrorist finance. In the case of this avian influenza, there is even less known of the scale or likelihood of the threat than with terrorism. The threat of a pandemic may fizzle out entirely. Remember all the fuss about the millennium bug? This unlikely glitch in computer software was supposed to bring the world to a halt in 2000, but it caused hardly a ripple. Even scientists who believe that bird flu will mutate into a form highly contagious to humans cannot say for certain that this will happen, or when it is likely to happen if it does, or how deadly such a new variety will be. All the key facts are not known, an exasperated sceptic would say. It could be much wiser to wait. In the 1970s the American government's overly hasty response to a "swine flu" which never arrived ended in humiliation.

These are all legitimate points, and there is undeniably a lot of uncertainty about the possibility of a pandemic. And yet it is also true that governments, companies and individuals regularly have no choice but to plan in situations of uncertainty. The trick is to do this in a way which is rational and proportionate. In the case of bird flu, most of the measures being contemplated so far can meet the sceptics' tests.

The case for

Closer monitoring of poultry stocks and steps to eradicate any avian influenza outbreak by slaughtering birds should be cost-effective even if the virus does not mutate into humans, simply because of the huge economic impact of not taking action promptly, as Britain has recently learned from outbreaks of foot-and-mouth (in 2001) and mad-cow diseases (in the 1990s). Similarly, bigger human-vaccination programmes for seasonal influenza would not only increase capacity if pandemic influenza strikes, but should pay for themselves anyway because the annual costs of lost economic output to ordinary varieties of flu are already large.

Other measures are better viewed not as cost-reducing, but as a kind of insurance policy. Whether or not a catastrophic pandemic will occur is uncertain, but scientists do know enough to say that the risk is real. There were three influenza pandemics in the past century. Many scientists believe another one is overdue, and new knowledge of viruses indicates that this strain of bird flu has acquired some of the mutations it would need to be transmitted easily between humans, which has caused much of the alarm this year. If another pandemic does strike, millions could die, and hundreds of millions would fall ill within a short space of time. The loss in lives and economic output is impossible to quantify precisely, but could be enormous. So formulating clear plans about how to cope with the widespread disruption of a pandemic seems prudent, and should not be hugely expensive in itself.

More costly are plans to stockpile Tamiflu, the anti-viral drug. Most rich-country governments now want to do this, and there is not nearly enough to go around. Increasing output of this drug probably makes sense on insurance grounds, as does spending more money in the longer term on vaccine research which might make the production of new vaccines cheaper and faster, or might someday even produce one against all types of influenza, seasonal or pandemic.

The unpalatable truth is that if the current version of avian influenza turns into a human pandemic in the near future, there is probably not enough time for most countries to stop it from spreading or to cope well with its effects. Panic about this will do no good, and could do a lot of harm. But preparing now for an outbreak of a pandemic at some stage in the future does make sense. Even if the threat from today's bird flu fades, it is plausible to think that another virus, in the not-too-distant future, may pose another threat. In an increasingly inter-connected world, viruses, like people, travel more easily.

Editorial says that preparing for an influenza pandemic makes sense. Panic does not.

• Primary Source