Bird Flu is nothing to balk at…..

Prudent or Paranoid?
By Melinda Liu
Updated: 2:06 p.m. ET Oct. 26, 2005
Oct. 26, 2005 – The deadly H5N1 virus is creeping closer to China’s teeming cities—and to me in Beijing. On Wednesday, Chinese media revealed yet another outbreak of avian influenza, the third report in little more than a week. Over the summer H5N1 killed thousands of birds in four outbreaks, but they were all in the remote hinterland of western China, in the Central Asian enclave of Xinjiang or near the Tibetan plateau.

Last week, though, the virus hit closer to home. Thousands of chickens were declared dead in Inner Mongolia, less than a day’s drive from Beijing. Then came Tuesday’s report of dead geese in Anhui province, on the bustling east coast. Wednesday’s news was an H5N1 outbreak among birds in Hunan, a populous southern province.
China has yet to report any human deaths due to bird flu. But a lot of people are betting the fast-mutating H5N1 virus, which is endemic in China, will find a way to spread between humans here. I’m not taking any chances. My husband and I have purchased more than $600 worth of Tamiflu already, enough to treat the entire NEWSWEEK staff in Beijing. Tamiflu is the antiviral medication that experts tell me might lessen the severity of avian influenza in humans, if taken within 48 hours of exposure.
Some of my friends think I’m crazy to stock up on a drug that may or may not help me survive a flu pandemic that may or may not be able to spread among people here. On the other hand, I sat next to a Western television journalist at dinner recently who said he’d purchased thousands of dollars worth of Tamiflu, and was having more shipped in from abroad. Meanwhile, in Hong Kong pharmacies, Tamiflu and another antiviral drug, Relenza, are flying off the shelves.
When my husband picked up a couple more 10-pill courses of Tamiflu yesterday, the pharmacist took pains to tell him the pills should be taken only after exposure to the H5N1 virus, or when exposure is imminent. Some entirely healthy people are popping Tamiflu already, the pharmacist said.
This is not good. If a healthy person has taken Tamiflu over a period of time, and then becomes infected with influenza, there’s a better than 10 percent chance of the virus becoming resistant to the antiviral. If the person is later exposed to avian influenza, resulting in genetic mutation, the result could be an especially malevolent flu virus resistant to Tamiflu.
Instead, the treatment helped alter H5N1 genetically to create a more virulent, amantadine-resistant strain of the virus. “We’re more and more concerned that [amantadine] might not be that useful any longer,” says World Health Organization (WHO) representative Henk Bekedam in Beijing. That’s why so much hope is now pinned on Tamiflu and Relenza, even though they’re much scarcer and more expensive.

It’s not like I relish the thought of living in or near what many people think will be the Ground Zero of bird flu. I’m not sure I have much choice. If the virus begins human-to-human transmission, border crossings around the world would start slamming shut—between nations, between provinces, between cities, maybe even between neighborhoods. A few days ago a Chinese health ministry official declared his nation would seal its borders if even a single case of human-to-human H5N1 transmission is found.
That sent jitters throughout the expat community here, and on Tuesday Foreign Ministry officials tried to calm such concerns by calling the report “inaccurate.” Still, don’t bet on open skies and porous borders for long—except maybe for the migrating wildfowl who currently function as an airborne Influenza Express. If and when this thing becomes a pandemic, hopping on a plane to fly to the West may not be an option for me. What government will welcome an arriving planeload of passengers from China, the place where experts believe the H5N1 virus was born?
The whole question of shutting down borders would become irrelevant very quickly at any rate. WHO’s Dr. Julie Hall in Beijing tells me one Western government recently war-gamed what would happen if it closed its borders to slow the advance of a bird flu pandemic. “It delayed things by just three and a half days,” she says. “If there’s a large cluster [of human deaths] many countries will close their borders, but that may not do much good.” Hall gave China high marks for improving its surveillance system in the wake of the 2003 SARS disaster, when authorities tried to cover up the severity of the crisis that eventually sickened 8,000 people worldwide and left 770 of them dead. But a flu pandemic will be much worse than SARS. She warns against complacency: “We can’t just say, ‘Ah, we did OK during SARS so we’ll be all right in the face of a flu pandemic’.”
The pandemic crisis wouldn’t restrict itself to overflowing hospitals and dying medical staff. Widescale absenteeism, illness and death could disrupt everything from food supplies and transportation to garbage collection and mortuary services. SARS was a medical problem, albeit a serious one. A flu pandemic could tear the fabric of societies and economies around the world.

Take the problem of maintaining social order. Even without a pandemic on their hands, Chinese leaders are obsessed with keeping the lid on escalating mass protests. I’m sure that’s why domestic Chinese media is under orders to downplay—or outright ignore—news of the recent H5N1 outbreaks. There’s a name for this tactic, nei jing wai song, meaning the government takes the problem seriously but isn’t conveying its worries to the public. To tell it like it is “could easily lead to panic,” says Zhong Dajun of the nongovernmental Dajun Economy Research Center. “It would be terrible.”
The fact is, many Chinese are hopping mad already about what they perceive to be unsatisfactory health services. In three quarters of Chinese hospitals, angry patients or their relatives have actually beaten doctors and staff to retaliate for shoddy treatment or exorbitant fees. One disgruntled patient stabbed a well-known doctor to death at a clinic in Fuzhou—and many Netizens who commented on the murder in Internet chat rooms wound up siding with the killer. Hospitals have hired bodyguards to fend off such attacks. Even Health Minister Gao Qiang recently admitted that doctor-patient relations in China are “tense” and unlikely to get better anytime soon. So how much worse would things get when Chinese citizens discover that hospitals don’t have enough respirators to go around? Or that some authorities have been trying to cover up the severity of the crisis? Or that cadres have been hoarding Tamiflu and now stocks have run out?
As Hall puts it: “the only thing that spreads faster than viruses is panic.” To plan for both the medical and nonmedical challenges ahead, I asked my husband, a retired Australian diplomat, to help draft a bird flu contingency and business continuity plan for the NEWSWEEK bureau. He conducted research on the Web and consulted friends in the business of corporate security—who themselves were busy crafting bird flu contingency plans for their clients.
Now I have a meaty 17-page business continuity scheme for the office, and I’ve briefed my staff on the plan. It explains everything from the basics of personal hygiene to how to take Tamiflu properly; from how we might work from home to the procedures we’ll use to decide when to stop working altogether—and start focusing on sheer survival.
I’ve started stockpiling canned tuna, dried noodles and other staples. The contingency plan calls for storing a couple month’s worth of food. Two weeks ago, about the time we bought our first batch of Tamiflu, my husband and I also got inoculated for routine seasonal flu. Nobody wants to become the “mixing vessel” in which H5N1 and human flu viruses mix and match.
All of this has become the target of some good-humored ribbing from friends. This whole bird flu thing is overblown, they say. After all, H5N1 has been around in China for years—maybe much longer—and so far only birds are dying on the mainland. They point to the latest news reports speculating that Southeast Asia, which has seen the most human deaths, will wind up being the front line of any human pandemic. I hope they’re right and that I’m just being paranoid.

Are you Chicken?

Just in case you forgot, I am in Hunan province. And if this doesnt sound like the virus is spreading, well, I would speculate its only a matter of time. I do, however, believe that it has crossed over, but like the SARS incident, the Chinese government are not going to admit until they realize they can’t stop it alone.

Time will (cough cough) tell.
Hunan girl’s death ‘not linked to bird’By Wang Zhenghua and Tao Li (China Daily)Updated: 2005-10-28 05:41
Health authorities yesterday refused to link the death of a 12-year-old girl who had flu-like symptoms with the bird-flu outbreak in Central China’s Hunan Province.
Initial tests turned out negative for the virus, but the result has to be confirmed, some media reports said yesterday.
A health worker vaccinates a chicken in Xiangtan, Central China’s Hunan Province Thursday October 27, 2005. [Xinhua]
The report of the girl’s death came the same day that three people on a French island off Africa were being tested for suspected bird flu – the first suspected human cases outside Asia.
A health official with Xiangtan County – the third place in China to report an outbreak caused by the H5N1 strain in a week – said He Yin’s death on October 17 could be a “coincidence.”
The girl and her 9-year-old brother He Junyao, natives of Wantang Village, fell ill after the family ate a chicken that died of an unspecified disease earlier this month.
“The province sent experts to investigate,” the official told China Daily. “But the results of laboratory tests didn’t show the girl died of bird-flu infection.”
Without disclosing what exactly caused the girl’s death, the official – who did not want to be identified – said his department dealt with the incident “according to procedures” and the situation in the county is “well under control.”
No other person has been reported ill in the village.
Both the health and foreign ministries said yesterday that no human infection has been reported in China so far.
“The Chinese Government has already taken … decisive measures to prevent bird flu and to share information with the international community,” Foreign Ministry spokesman Kong Quan told a regular news briefing yesterday.
Earlier, Premier Wen Jiabao said the government “was taking effective measures” to prevent the spread of the deadly H5N1 strain of the virus.
Vice-Premier Hui Liangyu urged local governments to take strict measures to curb the disease when he visited farms in Southwest China’s Chongqing on Wednesday.
French Health Minister Xavier Bertrand said of the people being tested in the Indian Ocean island of Reunion: “The three travelled to Thailand and visited a bird zoo where they had come into contact with birds.
“Initial tests have been done there and these came out positive,” he said.
In Hunan, the dead girl’s father, He Tieguang, told China Daily yesterday that the family cooked the bird after two dozen chickens and ducks began dying of an unknown disease on October 6.
“In the next few days, my girl became weak and pale,” said the farmer. The family took the girl to the local hospital only when she had a fever and cough.
After being shifted to several hospitals, she died in the intensive care unit of the children’s hospital in Changsha, the provincial capital.
“Doctors said my girl died from lung infection, as X-rays showed her lungs were totally infected,” the father said.
His son, who started showing flu-like symptoms only after the girl’s death, was quarantined in the same hospital yesterday. The father said the boy was in a stable condition.
Following the outbreak, health workers sterilized the whole village and regularly tested the family’s temperatures, the father said.
The poor farmer spent more than 10,000 yuan (US$1,200) on his children’s treatment; and the hospital said he still owed 6,000 yuan (US$740).
A World Health Organization (WHO) official said yesterday that humans show pneumonia-like symptoms after they are infected with the bird-flu virus.
“But there’s no evidence that humans can get infected through the air or eating properly cooked chicken,” Alphaluck Bhatiasevi of the WHO Beijing Office said.

The Winter Blues

I have been quite busy and bored at the same time these last couple of days as winter begins to make its move on the China that I have grown to love. I will be adding more in the next couple of days..
The times has managed to send a reporter out here from Washington and although I am not a big fan of what she has been writing (its like suburbanites for China), she was nice enough to put my comments up on her comments page, which is here….

She is discovering a lot of things that I am coming to terms with–her latest posting says the token statement here in China: “This is China.” Until you have been here, you really have no idea what this really means but it serves as a good reference point when things go astry as they always seem to do here.

I will be heading to Guilin next week and she stayed there for several days–have a look at some of her pictures. I am sure my experience will be much different than hers…. time will tell.

The Warming Trend

The lecture has been rescheduled for next week in order to allow for sufficent time to heal from this cold that I have aquired. It isn’t too bad of a cold, but I didnt want to do a two hour lecture on American Culture outside of my normal classtime, so they decided to put it off for a week.

I am hopped up on meds and reading the DaVinci Code, but just wanted to invite you to check out the new “My Morning Jacket” album, which sounds just awesome. Check them out at . If you do a web search, you will see that they just did a special on NPR’s All Music Considered, which I am listening to right now and it is just awesome. I am quite impressed. If you don’t know that much about them, your dumb and lame.
They are playing at the showbox in November for those of you in Seattle–make it a culture day and go check them out. They are a really interesting bunch of musicians and specialists in the art of reverb….

Things here are okay. Winter is setting in with a quickness, but the guy came in this afternoon and turned my air conditioner into a heater, so I am satisfied.

…taking time off

I will more than likely not be updating this site for the next couple of days. I have been asked by the University to prepare a lecture for the student body on American Culture–a lecture that will take place on Wednesday afternoon and there will be more than 2,000 students present at the lecture.
They will pay me quite well for the lecture and I am looking forward to it, but I am putting together a powerpoint presentation for the lecture, so I’ll be working on it for the next few days. If you have any suggestions of things to include, please email me at

–I also have a cold. The weather has has changed significantly.