# 1175
UPDATED: Scott McPherson, who happens to know the author of the piece referenced in this blog, has a detailed background piece on Thomas Barnett. I'm a bit chagrined that I was unaware of his extensive background. Calling him a `reporter' was a bit of a gaff on my part. Unintentional, but no less egregious.
Mea culpa.
Since I'm not shy about pointing out when reporters mangle the numbers regarding a potential pandemic, it is only right that I call attention to a reporter who gets it right.
Thomas Barnett of the Scripps Howard News Service writes today about the goals and problems that surround airport surveillance of passengers with fevers, and along the way even manages to get the numbers `right'.
I say `right', in quotes, because no one knows what the next pandemic will bring. But these numbers are `right' in the sense that they reflect the current thinking of federal pandemic planners. They are an extrapolation, based on today's population and using a virus of the severity of the 1918 pandemic.
As to whether airport screening of passengers with fevers is practical, I suppose it depends on what your goals are.
Unlike SARS victims, people infected with influenza can begin shedding the virus up to 24 hours before clinical symptoms (e.g. fever) appears. If our litmus test to determine if someone is `safe' to fly is a lack of fever, this would still allow a great number of potentially contagious people to fly.
Early in a pandemic, I'm sure there will be concerted attempts to keep anyone with a fever from entering or leaving a country. Particularly via air travel. At best, this is likely to be a delaying tactic. It might buy a few weeks, but at some point the virus will find a way into just about every country.
What then is gained?
Presumably time.
Once a pandemic begins, the clock starts running towards developing a vaccine. The longer we can stave off the virus from entering a country, the less time the virus will have to spread before a vaccine becomes available.
Time=lives.
Early on, before the virus becomes well entrenched around the world, I expect to see airport closures, travel restrictions, and the screening of passengers. All of which will be designed to slow the spread of the pandemic, but with little or no hope of stopping it.
There are other considerations as well, particularly for long international flights. Febrile passengers boarding a plane in the far east could easily see their illness fulminate into a full blown medical emergency before they had flown half-way across the Pacific. At least if all of the passengers start the flight without clinical symptoms, there's a better chance they won't present with a medical emergency at 30,000 feet.
Of course, you start yanking people out of line at airports and isolating them for an elevated temperature, you open up a pretty big can of worms. People are invariably going to be detained for reasons other than an infectious disease. Civil liberties will be impinged. At some point lawyers will be involved.
It could get ugly. But it might buy us some time.
A tough call.
The screening of passengers for fevers at airports sounds like a good idea, but then, so did my first marriage. Some hard lessons you only learn after the fact.
Whether or not this will produce the desired results remains to be seen.
By Thomas Barnett
Scripps Howard News ServiceThe White House recently released its new homeland security strategy and, unlike the initial 2002 version, this one focuses far more on natural disasters as opposed to terrorist strikes. That's a welcome change not simply because Hurricane Katrina was a humbling experience, but because globalization's growing connectivity means a naturally occurring pandemic is the most likely mega-disaster we'll face in the near term.
Undoubtedly you've heard about avian flu: long endemic to birds in Southeast Asia, it's gone global over the last half decade. As it spreads, the virus subtype known as H5N1 naturally mutates, leading researchers to conclude it's only a matter of time before human-to-human transmission emerges. Among humans who have so far contracted the virus through extensive contact with infected birds, over half died.
A bird flu-triggered pandemic could easily become the most deadly global outbreak since the 1918 Spanish Flu, which killed at least 20 million people worldwide. In the United States alone, over one-quarter of the population became sick, with approximately 600,000 people succumbing to the virus. Extrapolated to today's American population of 300 million, that yields a potential death count of 1.5 million to 2 million.
The global medical community has already committed substantial resources toward developing potential vaccines, but here's the trick: once the human-transmission strain emerges, it will take months to ramp up production of the corresponding cure.
Flu strains enter the United States in the bodies of sick travelers, so the key here will be our efficient and effective screening of in-bound passengers at international airports. According to Oak Ridge National Laboratory scientists currently investigating pandemic response procedures for the Department of Homeland Security, for every flu carrier who --unwittingly or not-- eludes that envisioned net, as many as 10,000 Americans could suffer exposure within three weeks time.
Consider the sheer volume: over 25,000 passengers arrive through Los Angeles' international terminals on a daily basis. In August, when a software glitch struck U.S. Customs' computers there, 20,000 passengers were stranded for up to 18 hours.
Even if we can quickly screen all passengers while pulling aside the suspected sick, tough questions abound.
Thomas P.M. Barnett is a distinguished strategist at the Oak Ridge Center for Advanced Studies and senior managing director of Enterra Solutions LLC. Contact him at tom@thomaspmbarnett.com. For more stories visit scrippsnews.com
