# 2220
Over the past few years the most pessimistic numbers I've seen about fatalities from a pandemic came from Dmitry Lvov, Director of the Ivanovsky Research Institute of Virology at the Russian Academy of Medical Sciences.
Dr. Lvov has suggested (see From Russia With Lvov ) up to 1 Billion people could die in a pandemic. I hasten to add, that is at least 5 times higher than most scientists have been willing to entertain.
Now, quite astonishingly, we have an even higher estimate from Dr. John Graham, chairman of the department of medicine at Sydney Hospital, in an editorial piece that appears today in The Australian.
He speculates that up to 4 Billion people could die in a matter of months during a pandemic.
I confess, I have a hard time taking this estimate seriously.
It presupposes that the attack rate of a pandemic would be 100%, and that 2/3rds of those infected would die. Possible, I suppose, in the sense that `just about anything is possible'.
But not terribly likely.
Granted, he prefaces his statement with a big `if'; `if the new virus retains the same pathogenicity of the current avian influenza virus'. And unsaid, but implied, the attack rate would have to be near 100% as well.
Whether you agree with the numbers or not, it is worth following the link to read the entire editorial.
Australia unprepared for epidemic
- OPINION: John Graham | August 09, 2008
IN February 2008, 10 swans in Dorset, south-west England, were found to be positive for the H5N1 avian bird flu virus. The virus has long since escaped from Asia. Could Australia be next?
Much virological opinion suggests that if this virus is ever to create a human-to-human influenza world pandemic, it will probably have to undergo a recombination mutation inside a human who is already suffering from a transmissible human strain of the influenza virus. In many ways it is a bit surprising that this has not already happened.
Given the magnitude of international air travel and the likely length of the asymptomatic incubation period of any new influenza virus, which would certainly exceed the time taken to fly between any two points on the earth's surface, it is highly likely that the entry of a new virus into Australia is almost unstoppable.
Professor Peter Curson of the Centre for International Security Studies at the University of Sydney has recently highlighted the difficulties facing traditional quarantine measures in an age of mass air travel.
If, however, the first case arriving in Australia is detected and isolated in time, there is still a chance that an epidemic on our continent can be prevented.
The current H5N1 virus has been known so far to have infected at least 385 people around the world, mostly in Asia, and the death rate -- despite all modern available treatment, including all the currently available vaccines and antivirals -- is approximately 63 per cent.
If and when a pandemic next occurs, if the new virus retains the same pathogenicity of the current avian influenza virus, we can expect about 4 billion people to die in the world over a six-month period. And that is how long it will take for a truly protective new vaccine to be developed and produced.
