Friday, May 04, 2007

From The CDC Press Conference On Masks

 

# 732

 

 

Although the highlights have been covered in the news accounts yesterday, one of the items in the question and answer period caught my eye.  This from the CDC transcript of yesterday's briefing.

 

 

HELEN BRANSWELL, CANADIAN PRESS: Thank you very much. Dr. Gerberding, hi. Thanks for doing this. If you had released or the CDC this a year ago or 18 months ago, I think there would have been a run on masks and N95, today I'm not sure if this won't be just greeted with kind of a yawn.

 

I'm wondering if you think that the level of pandemic anxiety has sort of found a more comfortable and sensible medium or if you are concerned that people may now think that the risk has passed or that the risk never really existed in the first place with H5N1.

 

DR. GERBERDING: Let me start with the second part of your question because we are concerned that people are becoming complacent or have removed their focus on the possibility of a pandemic. I think that's very dangerous. We know that a pandemic will eventually occur. We always say it's not a question of if; it's a question of when.

 

There is nothing about the H5N1 bird flu right now that's offering us any reassurance compared to where we were last year and in fact we have some ongoing concerns about the way that virus is evolving.

 

But if it's not H5N1, there are still many other possibilities so we urge people to take preparedness for a pandemic seriously, but in a sense we're also glad that as we've talked more about it and as people are beginning to kind of take their own preparedness into their own hands, that it's beginning to feel more manageable. It's less frightening. People are more action oriented.

 

They are more thoughtful about their decisions and this really is a good time to be thinking about masks because people - many people are at a point where they have looked around and done some of the things they need to do to prepare.

 

But this is always one with a big question mark and we've been, I think, waiting to some extend to try to get the science that we like to have before we issue firm guidelines. But we recognize that people will make decisions for themselves based on their own common sense and that's bound to be an important part of that so we wanted to get this information out and just add one more tool to the toolkit of things that people can do to prepare. I can take another telephone question please.

 

Ms.  Branswell, as always, cuts right the heart of the matter with her question, and Dr. Gerberding gives an sobering reply.  

 

There is nothing about the H5N1 bird flu right now that's offering us any reassurance compared to where we were last year and in fact we have some ongoing concerns about the way that virus is evolving.

 

There are some who maintain that if the virus were going to go pandemic, it would have by now.  But that ignores that fact that the virus is constantly changing, and mutating, and that the timetable of such things is beyond our knowledge.

 

I'm not a virologist, and so I can offer no independent analysis of the changes in the sequences.  But I know many virologists are watching the virus with alarm as it evolves into a more mammalian adapted pathogen. It now infects cats, previously thought to be largely immune to influenza viruses, and of course pigs, and ferrets. 

 

The virus is learning, through trial and error and evolutionary pressures, to expand its host range.  And that is less than comforting.

 

These subtle, though important changes, are why governments are taking the virus far more seriously today than they were two years ago. 

 

Although the science is sparse, anecdotal accounts in medical journals from the early 1900's give us clues that the 1918 Spanish Flu may have taken years to fulminate into a pandemic.   There is evidence that it didn't erupt overnight.

 

The difference today is, we are watching the virus as it evolves, and have had a warning that those in 1918 simply never could have dreamed of.   While we don't fully understand all of the changes we are seeing, we do know they are moving in an uncomfortable direction.

 

As far as how long all of this will take?   No one knows.  H5N1 could need another year or two to mature, or perhaps it never will.  Or it could happen tomorrow. Our understanding of the process is limited. But right now, H5N1 appears to be on a path that would evolve it into a human pathogen.

 

It would be tragic if we simply ignored the ample warning we've been given, simply because we lack patience and understanding.

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