Where Lightning Strikes
by Martin Overby
We all have had the experience of being in a thunderstorm and one bolt of lightning strikes nearby. It surprises us, but we don't seriously think we'll ever be hit, and we probably don't know anyone who's been hit, though we've heard stories. We are insulated ( to use a pun) from such an event -- the very thought seems too remote. We know that each summer there are thunderstorms, and on those days we stay inside and keep off the golf course -- unless we want to test the voltage. To varying degrees we use the same strategy to avoid wars and pestilence -- common sense -- keep well away. Quite naturally, we think that an epidemic or pandemic disease outbreak is about as remote as lightning. We've recently heard stories of Bird Flu, SARS, Anthrax, and Smallpox. And life goes on . The chance of being affected by any on the list except some type of flu seems remote. And regarding flu -- we've had it before! Many get their seasonal flu jab and dismiss it further from their minds. In this instance - we may well be insulated from reality. 1
There are many advantages to globalisation: cheap electronics, household goods and furnishings, and easy access to energy -- gasoline, electricity and `food' (human fuel). Few of these things are locally produced, and we rarely notice where things come from anymore. Many products are on the high seas steaming towards our shores, or winging their way via airfreight. Perhaps 40% of all we consume comes from foreign sources. Ultimately we have to shop to gather our necessities, and that means interaction with store clerks, checkout personnel and our fellow shoppers. Most of us work, so we also interact with our colleagues or our customers. We all push open doors, use gas pumps and stand in line or take elevators, or even go to school. The shift towards urban and suburban living is unprecedented in the world history. The earth's population has tripled in the last 100 years and the urban population density has increased at least a 100 fold. Our Western society is far more dependent on the global market for even basic necessities that ever before.
These urban lifestyles, which are convenient, combined with easy international travel and commerce, are the equivalent of teeing up the golf ball just as the first big drops of rain hit the ground. We circulate through a diverse environment of people and places -- unaware of the reach our immediate contacts have with the rest of the world. It is quite a jump from tranquillity to pestilence, yet the best medical minds of the World Health Organisation (WHO) suggest we should be preparing our defences for a lightning strike of flu. Our sense of security stems from the fact that since World War II we have enjoyed nearly 60 years of Public Health success. Yet, there are always thunderstorms.
It seems odd to forecast a pandemic which will throw the world into major social and economic upheaval, but we had a small taste of it with SARS. But SARS was last year's news and the details of it are becoming sketchy in our minds - the threat has passed. Bird Flu has manifested itself and yet still remains an Indo-Chinese problem. A curious psychology arises when there is a background threat on which no one likes to dwell. Californians have learned to live with earthquake risk -- no one talks about it. More people keep moving there and no one thinks it's an issue. The threat of a serious disease outbreak is similar, if the threat isn't immanent -- it's out of mind.
The stage set - we live in the midst of a highly interactive world -- no way around it. Imagine that a pandemic virus -- flu for example -- got its start in the Hong Kong region of China. (Poultry and farm animals often passively harbour a flu virus which can jump species to man.) If a poultry flu virus is caught by a man, and that man has a human flu virus already, then the two flu's DNA can intermingle and recombine. The result is something new that no one has resistance to. (Scientists have analysed previous outbreaks and expect that just this sort of recombination will happen again.) To make a vaccine for such an outbreak takes six to nine months. A Bird Flu vaccine is currently being developed in England. Considering that a flu virus can be passed around between 20 people in an afternoon and each can pass it around to another 20 the next day -- we can see how quickly things can happen. Presto -- epidemic! If one of those people takes a jet, presto -- pandemic! What originates virally in Asia can spread around the world within a week, as has happened with SARS.
We are in an interesting position now because we can sit back and theorise. History chronicles a number of epidemics. During the Plague in London (1666 2) , the wealthy isolated themselves to survive. Yet even those people depended vitally on someone who regularly risked exposure. Many people shunned human contact and tried to flee London. Some refused hospitality to relatives. Others attempted to alleviate people's sufferings and paid the highest price. Travel was prohibited, food was scarce, and there were no social institutions ( Health & Welfare) for people to fall back on. It is important to remember, our ancestors did survive and that is why we can pause to read this.
Before we all move to Northern Canada, we should reflect that not all flu's are killers -- but some have been. In the event of an outbreak, we may think that we could stay at home and sit it out. But everyone can't stay at home and sit it out indefinitely. Interaction brings risk. Historically, we know these circumstances trigger the rather odd human behaviours of isolationism and flight. (The antithesis of globalisation.) Many governments have passed legislation for `Emergency powers' that will kick in during such an event to prevent social disintegration. These powers include restraint and the use of force to maintain order. (This isn't something a government likes to publicise.) Doubtless, most medical facilities will be stretched dealing with a pandemic, but all hospitals and health services have plans for this type of event.
`Be Prepared' ( the pro-active Boy Scout motto) might suggest we all have money in the bank, vacation weeks bankrolled and a food stocked cabin to retreat to. Yet that is a modern version of an isolationism or flight, which only wants to be around to pick up the pieces. It is not hard to imagine people in our society during such an outbreak who would need help. The elderly for example or a neighbour we hardly know, or even a single mother with lots of kids. We may be the only one who can offer timely assistance, yet not without the risks human interaction brings. It is these times -- when the generosity of one man towards another ` in extremis', reminds us: "there is no greater charity than this, that one man risk his life for another".
Presently we are in the clear, yet if nature, or a terrorist were to pop the lid on Pandora's box -- we would be living in a different world. Will we still be the same people -- after the lightning strikes?
1. 1918-9 Spanish Flu killed 18,000,000 people -- more than WWI
2. Black plague ( Bubonic plague) killed 1/3 the population of urbanised Europe
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