# 2105
Dr. Michael .T. Osterholm, director of CIDRAP (Center for Infectious Disease Research and Policy), has never shied away from discussing - in stark terms - the worst ramifications of a severe pandemic.
This bluntness has earned him some critics along the way, but also a great many admirers.
Yesterday Dr. Osterholm appeared at a pandemic conference in Vancouver, where he warned that the deadliest danger from a pandemic will stem from a failed infrastructure and the economic chaos that will follow.
First the article, then some discussion.
Economic chaos will kill more than pandemic, expert warns
Katie Mercer, Canwest News Service
Published: Wednesday, June 25
VANCOUVER - During an influenza pandemic, freighters will be docked, medications will be scarce and people will starve, a leading international expert told a conference Wednesday.
"More people will likely die from this than from the pandemic," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
North American pandemic planning hasn't factored in its dependency on Asian markets, Osterholm told attendees to the "Are You Ready for a Pandemic?" conference.
The impending pandemic will most likely originate in Asia, the "roulette table" for serious H5N1 flu virus genetic mutations that cause pandemics, warned Osterholm. If that happens, trade supply lines will die along with the influenza's victims, he added.
Osterholm's apocalyptic warnings have lauded him the "Chicken Little" of influenza pandemics by some. Panicked and angry e-mail responses to his appearance on Oprah last year single-handily shut down his university's computer server.
But international influenza researchers predict the next pandemic will be similar to the 1918-19 Spanish Flu, which killed more than 40 million people.
The next pandemic will be global in just weeks and will last 12 to 18 months, Osterholm said, although noting that the economic effects will be instantaneous.
The problem is that pandemic planning in North America has been based on all other factors such as trade and electricity being normal, but that won't be the case, said Osterholm.
In the interest of full disclosure, I am an unabashed fan of Dr. Osterholm.
No, I've never met him, but I do admire his willingness to publicly entertain the possibility of a worst-case scenario, and his ability to do so calmly and professionally.
Unfortunately, what Dr. Osterholm has been saying for the past three years are things that many people would prefer be left unsaid.
As a society we like to maintain the fiction that `all's well', and that if a crisis erupts, we will be ready. It's good for morale, it's good for the economy . . . and that's good for politicians.
But the truth is, a severe pandemic - one with a CFR (Case Fatality Ratio) of over 2% and a moderately high attack rate - would put economic and logistical stresses on our world unlike anything we've ever seen.
Dr. Osterholm's warnings are not farfetched under that scenario.
Granted, we could get lucky with the next pandemic. We could see a low CFR, or a low attack rate. It could be a Category 1 or 2 pandemic instead of a Category 5.
But planning for a mild pandemic is about as smart as taking a knife to a gunfight.
Like it or not, we need to seriously consider and explore the worst case scenarios. And we need to do so publicly, not just behind closed doors.
People need to know what they may be facing sometime in the future.
Not because these things are fated to happen, but because we dare not risk everything on them not happening.
