THERE IS mounting criticism that the Government has failed to take adequate steps to do as much as should be done to prepare for an avian flu outbreak. Other Western countries are stockpiling vaccine against it; we are not. Flu viruses are always unstable so that there is an argument for waiting until there is a proven outbreak — and that it is coming our way — so that the exact nature of the virus is known.
This is the counsel of perfection, but when there is a possibility — no more than that — that the world might suffer a pandemic of the type of flu that last year caused the death of four fifths of those who caught it (compared with the last avian flu outbreak which killed “only” one in three), it calls for a policy based less on the textbook and more on reality.
The Government advice to wait and see could mean that a few priority groups have an ideal vaccine, lucky old them, while the rest of us do without, even though present statistics suggest that four fifths of those who catch the flu could perish.
Cynics — even leading academics who understand all about the vicious H5N1 strain of avian flu and the other slightly less sinister variants such as H9N2, H7N2, H7N7 and H7N3 — are beginning to wonder if financial considerations might have biased the British decision to take a different, and possibly more risky, policy line from other countries. Could it be that what is holding back the Government is the fear that if it stockpiles one type of vaccine now, but later has to dump it if the nature of the virus drifts appreciably, it will find the cost unacceptable?
If the country is left with no appropriate stockpile and Western Europe is affected by a pandemic of avian flu capable of spreading from person to person, what can we do? It is unlikely that we can raid the supplies of our more cautious allies.
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The discovery that avian flu may ravage organs other than the lungs and upper respiratory tract doesn’t surprise all our experts. They, and even GPs, have long known that the presence of avian flu is determined by detecting it in the faeces of the host, the domesticated poultry whether chickens or ducks, and wild waterfowl. If the virus can be found in the faeces of an infected duck, there is every chance it can be found in the faeces of an infected human.
If avian flu reaches us public life, as we know it, will end. A local meeting, a wedding, a visit to the cinema, theatre, or concert, however joyous, will not warrant loss of life. Schools will be closed, and airports, air travel and public travel, except by car, will become unfashionable. Hygiene will become all important.
When working in a VD clinic, now known as a genito-urinary medical clinic, I washed my hands about 75 to 100 times in a day with an antibacterial soap, as well emptying packets of rubber gloves. In an avian flu outbreak we would all have to be as careful as this. We would learn not to touch our faces, rub our eyes, scratch our noses, and to wash our hands when coming indoors and before eating. We would learn to watch the hygiene of cooks and waiters with care. Long nails would be out, as would Nigella Lawson’s touchy-feely style of cooking. Masks would help, but they would make life safer rather than safe.
Flu and other respiratory tract infections are as commonly spread by contamination picked up on the hand as by coughs and sneezes. Hand shaking in an outbreak would become rather déclassé. Finally, even if the Government is not stockpiling an appropriate vaccine, one hopes it is stockpiling an appropriate antiviral treatment, especially Tamiflu, as this can be taken by children, as well as adults.