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The End of the World pt 1

by Cath Murphy

December 22, 2011

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Donate 2011 has the distinction of being the year when the world ended, not just once, but twice. Many were convinced that the End of Days, the time when God would conclude his vast experiment in world building, was predicted by the Bible to be scheduled for 21 May 2011. This time was called the Rapture, because in a gigantic version of Spring cleaning, God would select the faithful and take them up to Heaven leaving only the impure of spirit to suffer the torments set out in the Book of Revelations. When we all woke up on the 22nd to find Donald Trump still walked the earth, a hasty adjustment of the prophecy told the faithful that the selection period was actually going to last 5 months. The end of the world would therefore come in October.

And yet, here we still are almost at the end of 2011 and just as sinful as before.

Even a real life catastrophe - the tsunami in Japan, with the concomitant melt down of the Fukushima nuclear plant - failed to bring the world to a screeching halt. We suffered an earthquake in Turkey, floods in Thailand and the departure of Manchester Utd from the Champion's League, but the Earth still spins on its axis, leaves still grow on trees and even reports that The Simpsons was heading for wherever it is axed series go proved to be premature with the announcement that Bart and Co would be with us for at least another two seasons.

But there are plenty of people out there who believe that we can't go on forever like this; that the dinosaurs won't go down in history (whoever ends up writing it) as the only ones to suffer a mass extinction. Humans - greedy, selfish, shortsighted — are bound eventually to go the same way as the Yangtze Dolphin and the Western Black Rhino. It's not so much a matter of when, but how, claim the doomsayers.

So how then? What will end the world? The list of potential candidates which could cause an apocalypse is long — viruses, nuclear war, global warming, reality television rotting our brains — there's a whole slew of hazards out there, waiting to make us an exciting find for some future archeologist. But before we break out the survival rations and bid our loved ones a tearful goodbye, let's take them one by one and apply a little skepticism to each. It could be we'll find the end of the world is further off than we think.

The End of the World pt 1: Bird Flu

In 2005 the WHO convened an international conference in Ho Chi Minh city, Vietnam. The three day event had only one subject under discussion: the H5N1 virus, better known to most of us as bird flu. The findings of the conference were not optimistic. "We at WHO believe that the world is now in the gravest possible danger of a pandemic," was the statement from Dr. Shigeru Omi, the WHO's Western Pacific regional director and although the gathered experts agreed that more evidence was needed about how infectious the virus was in humans, all were agreed that another influenza epidemic, similar to the outbreak of Spanish flu which killed between 50 and 100 million people in the period 1918-1920, was now overdue. This prediction was repeated later that same year by the WHO's David Nabarro in a press release which again explicitly drew links between the outbreak of Spanish flu and the potential for bird flu to cause a pandemic of similar scale.

But here we are, five years on, and the promised holocaust has so far failed to materialize. Far from the deaths of millions, the WHO's own figures show that between 2003 and 2011, there were 573 confirmed cases of avian flu infection in humans, probably less than the total number of people who died falling out of bed. So what alarmed the experts so much about this strain of what is a common but generally fairly benign disease? The answer lies in the same set of figures. Of the 573 cases, 336 ended in death for the person infected. That's a mortality rate of around 58%, close to the widely reported 60% for the disease. Compare that to the Spanish flu mortality rate of between 10 and 20% and you can begin to see why in 2005 the WHO felt that a cluster of new cases of avian flu in China meant a warning to governments to be on their guard was appropriate. Avian flu might be very hard to catch — there are very few confirmed cases resulting from human to human contact — but when you do catch it, the chances are you're going to die.

So why is bird flu so hard to catch? Generally, we think of viruses as highly infectious — like LOL cats only more amusing. The reason for the low transmissibility of the virus lies in the fact that it typically binds to a set of galactose receptors which are common in the respiratory tracts of birds, but in humans only occur deep in the lungs. This means that droplet infection of H5N1 via coughing or sneezing, which is how the Spanish flu got around, is not impossible but very unlikely. A study in 2000did find evidence of person to person transmission, but rates were low (3.7%). Despite some claims to the contrary, so far, epidemiologists agree that the best way to catch bird flu is to get up close and personal with a sick bird. This means that when an outbreak of the disease does occur, it's relatively easy to identify the source of the infection and impose a quarantine, limiting how far and how fast it can spread.

But all that might be about to change. Deep in the dark recesses of a Dutch laboratory, researchers have now discovered a way to mutate the bird flu virus - presumably by altering the receptors it binds to - and thus make it droplet friendly. This new strain of H5N1 works exactly the same way as the respiratory tract viruses we're familiar with, like colds. This bird flu doesn't need a bird as a vector — a discarded Kleenex or poorly timed handshake could do the trick just as well.

It's actually a ground breaking piece of science and the culmination of many years of work, but the reaction has been far from ecstatic. The main fear seems to be bioterrorism: the team who made the discovery want to publish a paper describing the mechanics of the procedure, but the US Government's National Science Advisory Board for Biosecurity has advised that key parts of the publication be redacted, lest terrorist organizations decide to undertake a spot of reverse engineering and produce their own version of the virus. And, once again, scientists are in little doubt that this new "super bird flu" has the potential to cause a pandemic and kill tens of millions of people. Just like the Spanish flu. Just like the WHO predicted back in 2005.

So should we all hold our breath (literally)? Are aerosol-wielding terrorists going to spray death into the faces of hapless victims? Or — in the scenario of the film Contagion which neatly combined the twin evils of agribusiness and extra marital sex — will Gwyneth Paltrow catch a mutated strain on a visit East and spread it all over the US by dint of an illicit tryst during a stopover in Chicago?

Dr Fouchier, the head of the Dutch team, doesn't comment on these possibilities, but he does point out that the research in fact paves the way for a vaccine against the disease and also warns researchers about which mutations to be especially alert to if an outbreak occurs. He seems to think that our prime threat lies in nature, which is quite capable of creating mutations all by itself, without the need for bioterrorists to lend a hand. Viruses mutate all the time, without prompting; contacts between species lead to new combinations. Given that the number of modern day instances of bioterrorism stands at three and the number of fatalities at five the chances seem much higher that an avian flu pandemic will occur because of a natural mutation than through deliberate infection, in which case Dr Fouchier's work will probably be our salvation, not our downfall. And here's a last thought about avian flu. Even that high mortality rate isn't beyond dispute. Some researchers contend that a milder form of the disease is not only possible but is in fact prevalent. As this article points out, mortality estimates are subject to a huge sampling bias, because they are based only on those patients who end up in hospital — who are severely sick in other words. It could be - and there is evidence that - there are many other people who become infected by the disease (perhaps that low transmission rate isn't so low after all) but display less severe symptoms. These people never come to the attention of the medical authorities and are therefore never included in the mortality statistics.

The outlook isn't that gloomy. Although Dr Shigeru Omi, quoted at the beginning of this article, also stated that with a gap of 40 years since the last outbreak, the world is now overdue for an influenza pandemic, there's no indication that our next mass encounter with the disease is going to involve H5N1, or be any more than business as usual. As for bioterrorism, until someone works out how to limit the spread of an infection to a target area, it's hard to see why terrorists should move from those traditional weapons of the gun and the bomb to something which might kill them as well as us.


by Cath Murphy

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