# 1370
The news out of Pakistan has been erratic at best, with confusing, often contradictory reports from the field.
Right now, we don't know if this outbreak is over, or if it still continues.
We also don't know how many people have been infected, although the numbers released so far indicate less than a dozen. And we don't know if this outbreak involved H2H (human to human) transmission, although it does appear likely.
What we do know is that the WHO was officially notified on the 12th of December, several weeks after this outbreak began. If this had been the start of a pandemic, a delay such as this would have been disastrous.
Any chance to contain a pandemic is predicated on the WHO getting on scene in the first two weeks, and instituting a tamiflu blanket. Even then, the odds are long. But if an outbreak is allowed to fester, hidden from view, for weeks or a month or more, then any opportunity to stop it is lost.
We also know that an American flew to Pakistan last month to attend the funeral of one of his brothers who died from bird flu. He flew back last week, and feeling unwell, called his doctor.
This account of those events from Helen Branswell of the Canadian Press:
Family cluster infected in Pakistan's 1st reported bird flu cases
(excerpt)
Meanwhile, U.S. public health authorities have confirmed they conducted H5N1 testing on a man who had recently visited Pakistan and was complaining of mild respiratory symptoms. The man, who officials will only identify as having a link to the cluster, is said to have been concerned he might have been infected.
"The individual went to his private physician after returning from Pakistan, and discussed this with his physician," said Claire Pospisil, a spokesperson for the New York State department of health.
Pospisil said the doctor contacted the local health department in Nassau County, where the man lives, and they collected samples for testing. The tests came back negative.
This proves how easy it would be for someone infected with the H5N1 virus to board a plane, and be anywhere in the world in a matter of hours. Luckily, it didn't happen this time.
It was, what some might describe, as a `near miss'.
But this wasn't a near miss.
This was a near hit.
And we are damn lucky not to be in crisis mode today here in the United States.
The question before is an important one.
If the situation in Pakistan stabilizes, and this outbreak is contained or dies out of its own accord, what lesson will we take from the past week?
Will we accept this reprieve as a warning, and begin in earnest to prepare for a pandemic? Or will we simply forget about how close we came, and go on oblivious to the dangers?
If this crisis passes, will we simply go back to sleep?
Currently our health infrastructure is incapable of handling a pandemic. Our Emergency Rooms are already abysmally overloaded, nurses are over-burdened with patient loads and paper work, and we fund our public health entities with shoestring budgets.
The call to all Americans to prepare for a pandemic has fallen largely on deaf ears, with very few taking the threat seriously. Few small to medium sized businesses have a workable pandemic plan, and many communities have yet to address how they will deal with a crisis.
For most communities, businesses, and individuals, pandemic planning is on the back burner, if they think about it at all.
After two years of warnings we remain woefully ill prepared to face a pandemic, and should one erupt, we will learn a bitter lesson about decades of misplaced priorities.
The price of not being prepared is far higher than anything we could spend to ready ourselves. It will be measured in lives lost, not just dollars.
Hopefully there is still time to change the system before a pandemic strikes, still time to prepare our society and beef up our infrastructure (primarily public health departments) to cope with a medical crisis.
No, it won't be cheap or easy. But it is necessary.
But none of this will happen unless we wake up now and realize just how vulnerable we really are. We can't count on getting an infinite number of warnings.
Meanwhile, the clock is ticking, and the next pandemic draws inexorably closer.
It's not a matter of `if'. It's a matter of `when'.
And it will come, whether we choose to be ready or not.
