add to my original work, Mr. Secretary,” Beck said. “The question is, do we have an emerging epidemic here? To a society, epidemics are the biological equivalent of nuclear war. In extreme cases, as the disease spreads through the population, social systems break down. Plagues cause a social meltdown. The network of services and supports that civilization depends on fail, in varying degrees.”
“Based on what?” HHS asked.
“Ironically, based on the technological level the society has attained,” Beck said. “Historically, the more complex the civilization, the worse the collapse.”
“Specifics, Doctor,” the senator said.
“Specifically, Senator, the values that bind humans together progressively dissolve during an epidemic,” Beck said. “This was the case during Europe’s Black Death in the Middle Ages; the same effect occurred in 1918, the last killer-flu pandemic.
“In the beginning, a plague engenders fear, most commonly a sort of xenophobia. People begin to view ‘outsiders’ as the enemy, as potential disease vectors. They pull away—for example, by ignoring people who collapse on public streets. As the outbreak expands, they build walls to keep the disease outside—and I mean that literally, in many cases. If you read Poe, his ‘Masque of the Red Death’ could well have been written as journalism rather than fiction. Extremes of behavior begin to occur—everything. Riots. Drunken orgies, group suicides. Fanatical religious fervor, complete with doomsday messiahs.
“Inevitably, as the plague expands and family members sicken and die, the social contract breaks completely. Parents are too frightened to care for their children, spouses abandon their dying mates.
“By then, of course, essential public systems are decimated. Health care is overwhelmed, both through the sheer volume of cases as well as the fact that many physicians and nurses have themselves contracted the disease. Fire or police protection is virtually nonexistent. And with all due respect to the representatives of our armed forces here, the military is no better off than the rest of society. They’re usually worse off, in fact; living in barracks or on a ship is tailor-made for widespread disease transmission.”
The senator snorted. “The Black Death. Edgar Allan Poe. There’s a big difference between medieval Europe and the modern world.”
“Not so different,” Beck said, “if you’re dealing with a disease you can’t cure, or even prevent.” He looked around the room. “Anybody here know how to keep from getting the flu?”
“Which raises the question of a vaccine.” The SG spoke up. “We’ve been making influenza vaccines for years. Mass immunization has been around since the polio years.”
“Assuming that this particular strain of H1N1 lends itself to development of an effective vaccine,” Carson said, “we’re looking at an immunization program that is unprecedented.” He nodded in the direction of Krewell. “CDC’s SpecialPathogens Branch has the figures. Dr. Krewell, what is your assessment? Is such a program possible?”
Krewell remained seated.
“Of course it is possible,” he said. “We have a great deal of experience in developing flu vaccines. We do it annually, once we’ve analyzed which flu strain we’re facing for the year. But H1N1 is not merely an evolutionary mutation of a virus we’re already familiar with; it’s a different animal entirely, and so there will be some time lost in our learning curve there.
“The key word is ‘time,’ ” Krewell emphasized. “If we have enough time, we can dissect H1N1, decode any genetic mutations, develop and test possible vaccines. If we have enough time, the pharmaceutical firms can gear up to produce the two hundred and fifty million doses we’ll need in this country alone. Given some breathing room, it is possible to set up a mass immunization in every city, town and one-stoplight crossroads in the country.”
“In your
“Based on what?” HHS asked.
“Ironically, based on the technological level the society has attained,” Beck said. “Historically, the more complex the civilization, the worse the collapse.”
“Specifics, Doctor,” the senator said.
“Specifically, Senator, the values that bind humans together progressively dissolve during an epidemic,” Beck said. “This was the case during Europe’s Black Death in the Middle Ages; the same effect occurred in 1918, the last killer-flu pandemic.
“In the beginning, a plague engenders fear, most commonly a sort of xenophobia. People begin to view ‘outsiders’ as the enemy, as potential disease vectors. They pull away—for example, by ignoring people who collapse on public streets. As the outbreak expands, they build walls to keep the disease outside—and I mean that literally, in many cases. If you read Poe, his ‘Masque of the Red Death’ could well have been written as journalism rather than fiction. Extremes of behavior begin to occur—everything. Riots. Drunken orgies, group suicides. Fanatical religious fervor, complete with doomsday messiahs.
“Inevitably, as the plague expands and family members sicken and die, the social contract breaks completely. Parents are too frightened to care for their children, spouses abandon their dying mates.
“By then, of course, essential public systems are decimated. Health care is overwhelmed, both through the sheer volume of cases as well as the fact that many physicians and nurses have themselves contracted the disease. Fire or police protection is virtually nonexistent. And with all due respect to the representatives of our armed forces here, the military is no better off than the rest of society. They’re usually worse off, in fact; living in barracks or on a ship is tailor-made for widespread disease transmission.”
The senator snorted. “The Black Death. Edgar Allan Poe. There’s a big difference between medieval Europe and the modern world.”
“Not so different,” Beck said, “if you’re dealing with a disease you can’t cure, or even prevent.” He looked around the room. “Anybody here know how to keep from getting the flu?”
“Which raises the question of a vaccine.” The SG spoke up. “We’ve been making influenza vaccines for years. Mass immunization has been around since the polio years.”
“Assuming that this particular strain of H1N1 lends itself to development of an effective vaccine,” Carson said, “we’re looking at an immunization program that is unprecedented.” He nodded in the direction of Krewell. “CDC’s SpecialPathogens Branch has the figures. Dr. Krewell, what is your assessment? Is such a program possible?”
Krewell remained seated.
“Of course it is possible,” he said. “We have a great deal of experience in developing flu vaccines. We do it annually, once we’ve analyzed which flu strain we’re facing for the year. But H1N1 is not merely an evolutionary mutation of a virus we’re already familiar with; it’s a different animal entirely, and so there will be some time lost in our learning curve there.
“The key word is ‘time,’ ” Krewell emphasized. “If we have enough time, we can dissect H1N1, decode any genetic mutations, develop and test possible vaccines. If we have enough time, the pharmaceutical firms can gear up to produce the two hundred and fifty million doses we’ll need in this country alone. Given some breathing room, it is possible to set up a mass immunization in every city, town and one-stoplight crossroads in the country.”
“In your
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