Facing the flu

10/21/2005

THE progress of bird flu, which is now on Western Europe's doorstep, and the fact that it exists among migratory fowl, are rightly provoking concern among Americans.

The latest is that varieties of the disease have been found in birds in Turkey and Romania, to the degree that the European Union has forbidden imports of poultry from those countries. The Europeans are also consulting extensively to figure out what to do next.

A few background facts are relevant. First, the flu so far exists largely among birds. Second, although types of the flu have been transmitted from birds to people, causing some 60 deaths so far in Asian countries, there has so far been only one case of person-to-person transmission.

There is little confidence that the virus, described as "smart," will not strengthen its capacity to pass from person to person, thereby greatly increasing the possibility of a human pandemic.

Another critical point is that no vaccine has yet been developed against bird flu. People are being advised to get the regular annual flu shot for other reasons, but there is no evidence that it is effective against bird flu.

The other troublesome part of the bird flu picture for Americans is that there is not a lot of confidence that the Bush Administration will do what it needs to do to protect the American population. Last year's flu shot drama was an un-reassuring case in point. There wasn't enough to go around; we got lucky in the event and there weren't tons of deaths, thus making it a comedy, as opposed to a tragedy, of errors.

Now we are told that the President has put Stewart Simonson, assistant secretary for public health emergency preparedness at the Department of Health and Human Services, in charge of meeting the bird-flu threat.

The title sounds right but there is also a disquieting possibility that Mr. Simonson, a Republican political appointee, may be another "horse guy," comparable to former Federal Emergency Management Agency head Michael D. Brown, and basically unqualified for the job. Mr. Simonson has no medical or public health management experience; he was formerly a lawyer at Amtrak, as in trains. We would not want to find out the hard way that Mr. Simonson isn't up to the task.

Short prescription: Although the administration recently called a meeting of the world's top flu vaccine makers, it still needs to develop a plan for how to get the hoped-for vaccine in the hands of Americans.

A pandemic might not happen. On the other hand, if it did and America's response to it bore a painful resemblance to New Orleans after Katrina, the results could be truly catastrophic.