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When a recession and a pandemic collide


I was going to call this particular blog "We don't need a pandemic to show us the economic consequences of one." In it, I was going to talk about how the current recession -- and a possibly worse description lurks in the wings -- is mimicing how the global economy would recoil during a pandemic of any severity.

One look at the economic numbers draws a striking parallel. GDP in the US is down by about half the Congressional Budget Office's estimates for a severe, 1918-style pandemic. The CBO estimated (along with the World Bank, the IMF and just about every other financial entity) that a 1918-severity pandemic would reduce global GDP by 5% to 6%, and most of that would come in a huge shockwave with a 20-week duration.

Well, it's the first quarter of 2009, and the US GDP has declined by an estimated 3.8%, adjusted annually. And again, most of it happened in a very condensed timeframe.

The key difference? This recession will be with us for a long time. Comparatively rosy estimates of a 2010 or even a 2011 recovery are going by the boards. In the government sector, no one can seem to get the declining revenue numbers right.  (My advice to them is to take their most pessimistic estimates and reduce them another 20% and budget from there.)

Now imagine what would happen if the Next Pandemic were to occur just as the global economy attempts to restart its engine; say, in 2011. And imagine if this pandemic were as severe as 1918's. Imagine a 5% to 6% drop in global GDP on top of an annual 3% to 4% decline in 2009, 2010 and 2011.

This is enough to cause even the most optimistic among us start to head for the proverbial hills.

Making matters worse is the lack of funding to prepare for the first pandemic of the 21st Century.  Any pretense -- any possibility -- that the private and public sectors can adequately stockplie and purchase items for that event is now out the window.

But not for all. In Britain, even though its government is also dutifully doling out billions of pounds Sterling to banks and other institutions, its government has declared it is doubling its stockplie of antivirals -- and (wisely) increasing its reliance on the inhalant Relenza/zanamivir for prophylactic use by first responders and law enforcement/military.

What do the Brits know that we don't know?

I read the federal government's recent assessment of the fifty states' preparedness for a flu pandemic, and I am sorry, but I don't believe a word of it. It's not that I think anyone is lying, but I refuse to believe any state is truly, look-in-the-mirror-prepared for a killer pandemic with a mortality rate close to 1918's.

Why? I do not see any state moving beyond the 25% antiviral purchase goal. I see many states meeting their share of that 25% goal, but none really exceeding it.

Why? I see no state embracing innovative solutions, such as the co-administration of probenecid to effectively double the supply of Tamiflu.

Why?  I don't think the feds can plan their way out of a wet paper bag.

Why? There is no emphasis on information technology data center and network professionals as among the first to need antivirals, particularly those in the public sector's own front lines of defense -- namely social services, law enforcement and unemployment assistance. Nowhere, in any federal pandemic document, do I see anything other than a cursory reference to "critical infrastructure" as even acknowledging the essential role that government data center and application developer and system engineer and network engineer and cybersecurity professional employees will play in a pandemic.

Why does this matter? NOTHING is done on paper anymore. Further, try to move back to paper! You will fail, and fail miserably. You want to see civil unrest and civil disturbances? You want to see blood in the streets? Watch the computers fail and watch people already bone-weary from years of a severe recession lose their subsistence lifelines because a pandemic hit and the mainframes shut down. The quickest route to civil discord is if/when the mainframes fail during a severe pandemic.

Why does this matter? Computers will route the information that is needed for people to make decisions and move resources. Computers will tell us who is sick and where (look at the Google plan to match search expressions with geography and, in their plan, be able to predict where a pandemic has broken out). Computers will tell us how much of something is left and how much to ration. If data center people get sick (and because they work in enclosed spaces, they work in very close physical proximity to one another and they WILL get sick in disproportionate numbers to the general population), you will have staffing problems and you will have maintenance postponements and database reorgs gone undone and then you will have system failures. Big system failures.

Recently, I wrote a blog saying Nature has a way of hitting humankind when it is down.  Look at 1918 for confirmation of that fact.  War builds stresses within the system.  So does famine.  So does pestilence.  So does economic uncertainty and calamity.  Everything is interconnected.  The 1957 pandemic was facilitated by American servicemen returning home from tours of duty in Korea and elsewhere in the Pacific theatre. 

We all know that we are long overdue for an influenza pandemic. We also know that pandemic fatigue is now itself a pandemic. And we know that there are stresses upon the world's ecomonic system that are impacting virtually every person on the planet in one way or another. 

Governments in this country no longer have the money to buy adequate stockpiles of masks, gloves, and antivirals.  That time has come and gone.  The only things we can do now to prepare are to plan and to educate.  Fortunately, these things cost little money.  They do require time and leadership. 

If governments (and for that matter, the private sector) have no money to stockpile, manufacturers will have no incentive to produce items that are not wanted.  So you will see reductions in the production of masks and other items intended to brunt the effects of a flu pandemic.  This means that if/when a pandemic does occur, the supply chain will be absolutely empty at the first sign of trouble.  We knew that would be the case anyway, but we also figured the manufacturing capabilities of the world's producers would eventually catch up.

We are in worse shape now than we were in 2005, in my opinion. We are no closer to deciding if schools close in unison or not than we were three years ago. We are no closer to making final decisions about quarantine and isolation than we were three years ago.  And while we have made great strides in preparedness and contingency planning, I cannot help but feel we are overconfident and arrogant in our belief that we have done everything we can do to adequately prepare.

And now we have lost our opportunity to further our stockpiles.  We put off those difficult bioethical decisions for another day.  And now, we lack the capacity to buy our way into enforcement of bioethics and pandemic policy.  It's gone, and won't be back for at least two to three years.  Pity, since recent studies point to successes in mask usage, and of course the recent stories of Tamiflu resistance in H1N1 in this country point to a huge need for Relenza that now no one can afford to buy.  This bird flu blogger has been championing the increased acquisition of Relenza and the purchase and use of Probenecid for years. 

Every day that passes brings us closer to pandemic.  Every day that H5N1, or H9N2, or H2N3 human cases are found brings us closer to pandemic.  And we have learned that despite our best international efforts, H5N1 continues to evolve and claim human lives -- and now, apparently, without the deaths of "sentinel chickens" that have warned us of trouble.

While the world's governments have indeed made strides, we are far short of the goal.  So let us take the opportunity to do whatever we can do in this current economic climate to prepare.  That means we educate people like we have never educated them before on this topic.  And also, we must plan, plan and then plan some more.  As Ike said:  The plan's useless, it's the planning that's important.  We should be taking our pandemic plans and stressing them in tabletop after tabletop exercise.  We need to be reaching out and running these plans past citizens and the media.  And we must ask everyone, What have we not thought of yet?

Because one day the worst will happen, and believe me, we will get bitten on the rear end by the stuff no one took the time to find. 

Reader Comments (3)

Excellent post!!!!!

I do wish our leaders will read it, or will hear of it through their advisors.
And I dearly wish they act upon it!

February 5, 2009 | Unregistered CommenterSugarquill

I agree with you. The threat of an influenza pandemic is so great that everything put in place until now appears too little and too late. But the point is: can we hope for more actions by our respective governments and authorities?
I am not optimistic.

February 6, 2009 | Unregistered CommenterGiuseppe Michieli

This is probably one of your best pieces, Scott. Bravo!

You concluded with this question: ‘We must ask everyone, What have we not thought of yet?’

The power of social media is presently being tapped by several US agencies to spread important information related to public health. Social medias have been used to deliver consumers information on Salmonella Typhimurium outbreak, for instance.

The social media outreach effort is being directed by HHS’ new Social Media Center (its mission is to promote the collaborative use of social media tools to better communicate health and human service information).

If these social tools are used not only for spreading information, but also for really LISTENING to what the people are saying, then insights could be maybe gathered to help improve pandemic planning plans and programs.

It is too early in the U.S Gov 2.0 experiment to say if a true dialogue will be established between agencies and citizens.

I agree with you that we should take the ‘opportunity to do whatever we can do in this current economic climate to prepare’. For 2010 and 2011, because of the global situation, economic preparedness might not be really feasible. But social pandemic preparedness could be developed (because it doesn’t require millions of dollars in acquisitions). 2.0 successful experiences could then be eventually used by democratic teams to push for more political preparedness. Other nations might follow US’ footsteps and engage also in a 2.0 experience with their citizens.

Many of us (flubies) realize we might be alone during a pandemic, and that many services could be interrupted. Why not take advantage of the present situation to develop citizen's empowerment?

February 6, 2009 | Unregistered CommenterLyne Robichaud

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