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"The second thing is, no one really knows for certain the actual capacity of the Internet system today if everybody were to use it for primary [communication]."
This is something that I had not thought through. Can you just imagine Millions of people at home logging on to the net? Can anyone hear the crash?
A thing long expected takes the form of the unexpected when at last it comes. Mark Twain
Your life during a pandemic - Audio - Michael T. Osterholm
Your life during a pandemic
by Nikki Tundel, Minnesota Public Radio
Audio
<table border="0" cellpadding="0" cellspacing="0" width="100%"><tbody><tr><td valign="top" width="14"></td><td valign="top">Your life during a pandemic (feature audio)</td></tr></tbody></table><table border="0" cellpadding="0" cellspacing="0" width="300"><tbody><tr><td>Countries around the world are trying to come up with ways to limit the impact of a potential bird flu pandemic. (MPR Photo/Lorna Benson)</td></tr> <tr><td></td></tr> </tbody></table> <!-- Begin Intro Paragraph --> Even if you survive a bird flu pandemic, life won't be easy.
<!-- End Intro Paragraph --> <!-- Begin Paragraph --> St. Paul, Minn. ? President Bush is expected to approve a national response plan in the next week that will detail how government agencies should respond in the event of a bird flu outbreak.
<!-- End Paragraph --> <!-- Begin Paragraph --> The H5N1 virus is not yet able to spread from person to person and remains primarily an animal disease. But researchers, epidemiologists and government officials believe the virus will eventually mutate, resulting in a bird flu pandemic among humans.
<!-- End Paragraph --> <!-- Begin Paragraph --> If bird flu can be passed from person to person, experts like Michael Osterholm say we could see up to 360 million deaths worldwide.
<!-- End Paragraph --> <!-- Begin Paragraph --> Reporter Nikki Tundel talked to Osterholm, the director of the Center for Infectious Disease Research and Policy, to find out how daily life could be affected by a bird flu pandemic.
<!-- End Paragraph --> <!-- Begin Paragraph --> Osterholm says that even in the worst case scenario, 98 percent of the population will survive a pandemic. And, therefore, it's vital to have plans in place to keep societies from falling into chaos.
Re: Your life during a pandemic - Audio - Michael T. Osterholm
Audio
<table border="0" cellpadding="0" cellspacing="0" width="100%"> <tbody><tr><td valign="top" width="14"></td><td valign="top">Your life during a pandemic (feature audio)</td></tr> </tbody></table>
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<table border="0" cellpadding="0" cellspacing="0" width="100%"> <tbody><tr><td valign="top" width="14"></td><td valign="top">On a wing and a prayer</td></tr> </tbody></table>
More from MPR
<table border="0" cellpadding="0" cellspacing="0" width="100%"> <tbody><tr><td valign="top" width="14"></td><td valign="top">Officials say they need full funding for avian flu prep</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">The ethics of bird flu (12/02/2005)</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">Pawlenty outlines bird flu strategy (11/03/2005)</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">Mixed reaction to Bush's bird flu strategy (11/01/2005)</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">Warning to businesses -- prepare for flu pandemic (02/14/2006)</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">Ready for a pandemic?</td></tr> </tbody></table>
Resources
<table border="0" cellpadding="0" cellspacing="0" width="100%"> <tbody><tr><td valign="top" width="14"></td><td valign="top">About Michael Osterholm</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">Center for Infectious Disease Research and Policy</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">WHO: Avian influenza</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">Preparing for the Next Pandemic</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">Economic Impact of Avian Flu</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">Plans for Adressing a Pandemic</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">State Pandemic Plans</td></tr> </tbody></table>
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<table border="0" cellpadding="0" cellspacing="0"><tbody><tr><td valign="top" width="14"></td><td valign="top">Discuss or comment on this story in Your Voice</td></tr> <tr><td></td></tr> <tr><td valign="top" width="14"></td><td valign="top">Help us cover this story
CLEVELAND - A worldwide influenza outbreak will happen. Millions -- maybe even hundreds of millions -- of people will die.
But that's about all Michael Osterholm, an international flu expert, could say with certainty in a speech at Case Western Reserve University on Wednesday evening.
Will the pandemic grow from the H5N1 flu strain circulating in birds across the globe? Maybe, maybe not.
Will avian influenza spread to birds in North America this summer? Maybe, maybe not.
When the pandemic strikes, will it be as deadly as the 1918-19 pandemic that killed 50 million to 100 million worldwide? Again, maybe, maybe not.
``Influenza pandemics are like earthquakes, hurricanes or tsunamis -- they've happened before, and they will happen again,'' said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. He has written about avian flu for the New England Journal of Medicine and talked about it on The Oprah Winfrey Show.
He has also earned the title of ``a consistent voice of doom'' from the St. Paul Pioneer Press.
Osterholm acknowledged as much at the beginning of his talk Wednesday, saying ``elements of this presentation will make you want to find the nearest bar.''
In June, Osterholm was quoted in U.S. News & World Report as saying that if the pandemic hit today, ``I don't know what we could do about it except say, `We're screwed.' ''
Not much has changed since June. Plans to deal with such a public health crisis are lacking, if they're in place at all. ``Hope and despair are not strategies,'' he said. ``Comprehensive and serious planning is not optional.''
The medical community can't even do a decent job of handling annual flu epidemics, which infect 5 percent to 20 percent of the population and kill 36,000 on average each year, he said, so how could it handle a pandemic? ``For that,'' he said, ``we are ill prepared.''
The World Health Organization counts 196 human cases of avian flu, with 110 deaths. The first two months of this year saw more human cases (52) than did any six-month period in the past three years.
There has been no continued human-to-human transmission of the disease, but the fear is that the flu virus infecting birds will mutate, allowing human-to-human spread, sparking a pandemic.
That could happen in one of two ways, Osterholm said.
One possibility is known as reassortment, in which the avian virus mixes with a human virus and swaps genes, making a hybrid virus of sorts.
However, he said, ``if it hasn't done it by now, I don't know why it would happen in the future.''
The other possibility is a mutation of the avian virus in which it retains its avian characteristics but attains the ability to infect humans.
That, he said, ``scares the devil out of me'' because the human immune system would offer no protection against an avian virus, making it extremely deadly.
Or neither could happen. The virus could remain in birds and burn itself out.
``We don't know,'' he said.
What's also scary, Osterholm said, is that out of thousands of flu viruses, only two had a particular ``protein tag'' in their genetic code: the H5N1 avian flu virus, and the virus that caused millions of deaths in 1918-19.
What that means, of course, is still not clear.
It's still moving. It's still floating. It's still changing
"My head is spinning as to what we will do," said Charles Schoenberg of Hoffman Estates is response to a town hall meeting Thursday night in
Crystal Lake on the subject of pandemic influenza.
<TABLE cellSpacing=0 cellPadding=5 width=300 align=right border=0><TBODY><TR><TD> </TD></TR></TBODY></TABLE>Dr. Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota and expert in pandemic influenza spoke about the possibility of a catastrophic flu epidemic, as well as the necessity for preparations.
"I'm here to tell you that the likelihood of a pandemic is one in one, it's going to happen," said Osterholm adding, "The question is not if but when."
During the meeting from 7 to 9 p.m. at Crystal Lake South High School Osterholm, also the associate director of the U.S.
Department of Homeland Security's National Center for Food Protection and Defense, outlined his belief that a future worldwide flu epidemic is inevitable and that any effective response to such an epidemic must come from local authorities rather than relying on federal or even state-level support.
"All response to a pandemic is going to be local even though it is a global issue," Osterholm said. "People in Washington won't be making the decisions, I don't even think people in Springfield will."
A pandemic flu is different than seasonal flu in three aspects: It is a new strain of influenza; there is a lack of preexisting immunity in the human population; and the strain has an increased ability to kill, Osterholm said.
A moderate flu pandemic could potentially result in between 2 to 7.5 million deaths worldwide, while a severe pandemic ? comparable to that in 1918 ? could result in between 180 to 360 million deaths, Osterholm said.
The audience of 170 had to be moved outside during the meeting because of a false fire alarm at the high school, but members asked questions of Osterholm in an impromptu question and answer session in the parking lot.
One audience member asked Osterholm what precautions he and his family had personally taken in response to the possibility of a pandemic.
"We have stockpiled food and we have stockpiled N95 respirators," Osterholm said, referring to high-grade medical masks capable of preventing infection with influenza.
Another audience member asked if there was the possibility of vaccinating people before such a pandemic occurred.
"It's like trying to fill Lake Michigan with a garden hose," Osterholm said, adding that such an effort would have to happen in Asia, the most likely point of origin for such a flu where the costs of such vaccine would be difficult cover by local governments there.
"It the vaccine costs more than a penny, it's too expensive," Osterholm said.
Despite the severity of the scenario Osterholm laid out, he said he firmly believed that the world would survive such a pandemic, even though it would be a long and difficult process.
"We will get through it, just like every pandemic in our history," Osterholm said.
Ten things you need to know about pandemic influenza.
1. Pandemic Influenza is different from Avian influenza.
2. Influenza pandemics are recurring events.
3. The world may be on the brink of another pandemic.
4. All countries will be affected.
5. Widespread illness will occur.
6. Medical supplies will be inadequate.
7. Large numbers of deaths will occur.
8. Economic and social disruption will be great.
9. Every country must be prepared.
10. The World Health Organization will alert the world when the pandemic threat increases.
Source: World Health Organization
Dr. Michael Osterholm's additions to this list.
1. Vaccine and anti-viral drugs will have little impact on the pandemic if it occurs in the next several years.
2. The pandemic will come in waves.
3. Non-pharmaceutical interventions such as quarantine, infection control, social distance, etc. will likely have limited impact on the number of cases.
This is the first time I have seen Osterholm admit that he has stockpiled and that Lake Michigan comparison is a classic.
One audience member asked Osterholm what precautions he and his family had personally taken in response to the possibility of a pandemic.
"We have stockpiled food and we have stockpiled N95 respirators," Osterholm said, referring to high-grade medical masks capable of preventing infection with influenza.
Another audience member asked if there was the possibility of vaccinating people before such a pandemic occurred.
"It's like trying to fill Lake Michigan with a garden hose," Osterholm said, adding that such an effort would have to happen in Asia, the most likely point of origin for such a flu where the costs of such vaccine would be difficult cover by local governments there.
"It the vaccine costs more than a penny, it's too expensive," Osterholm said.
"We are in this breathing space before it happens. We do not know how long that breathing space is going to be. But, if we are not all organizing ourselves to get ready and to take action to prepare for a pandemic, then we are squandering an opportunity for our human security"- Dr. David Nabarro
</td><td valign="top">Your life during a pandemic (feature audio)</td></tr></tbody></table><table border="0" cellpadding="0" cellspacing="0" width="300"><tbody><tr><td>Countries around the world are trying to come up with ways to limit the impact of a potential bird flu pandemic. (MPR Photo/Lorna Benson)</td></tr> <tr><td>
</td></tr> </tbody></table> <!-- Begin Intro Paragraph --> Even if you survive a bird flu pandemic, life won't be easy.
</td><td valign="top">On a wing and a prayer</td></tr> </tbody></table> 
</td><td valign="top">Officials say they need full funding for avian flu prep</td></tr> <tr><td>
</td><td valign="top">Discuss or comment on this story in Your Voice</td></tr> <tr><td>
</td><td valign="top">Help us cover this story
</TD></TR></TBODY></TABLE>Dr. Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota and expert in pandemic influenza spoke about the possibility of a catastrophic flu epidemic, as well as the necessity for preparations. 
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