Fallacies take flight in bird flu scenario

The premise

IN “Fatal Contact: Bird Flu in America,” which aired Tuesday night on ABC, a businessman returns to the U.S. from Hong Kong, where he has unwittingly picked up a newly mutated strain of the H5N1 bird flu from being coughed on by a factory worker.

Back in Virginia, he becomes weak and feverish and collapses with a severe nosebleed. Public health officials are called in quickly. Dr. Iris Varnak (Joely Richardson) of the Epidemic Intelligence Service leads a coordinated response with Health and Human Services and the Centers for Disease Control, but despite their efforts and a barbed wire quarantine instituted by the governor of Virginia (played by Scott Cohen), the virus spreads throughout the U.S. and the world, killing 12.5 million by the end of week 12. Food and supplies grow scarce, a subway station is converted into a makeshift hospital, and bodies are dumped by truck into mass graves.

France has the only vaccine, and is reluctant to distribute it here. The few doses that arrive are contested for by street gangs who attack the truck laden with vaccine. Just as the pandemic seems to be ebbing, news comes that an entire town in Africa has succumbed overnight to what appears to be a newer and more lethal subtype of H5N1.

The medical questions

DO flu viruses mutate so rapidly that a bird flu can be transformed to a human killer flu overnight with a second, even more sinister, change occurring a few months later? And is the H5N1 bird flu virus close to mutating to a form that can go from human to human and cause the next pandemic? Are we so defenseless to flu that we will require mass graves when the next pandemic hits us?

The reality

ALTHOUGH flu viruses mutate rapidly, the changes necessary to cause even a mild pandemic would take at least several weeks and several steps as a newly evolving strain attempted to adapt to a human host. The idea that H5N1 could transform instantly from a bird virus to a human virus, jump to a businessman who becomes “patient zero” and spreads it throughout the U.S., is dramatic hype, not science.

And, according to recent studies, the current H5N1 bird flu virus appears to be multiple mutations away from becoming the next pandemic strain.

Though our highly mobile society does not have the hospital surge capacity or the food, energy or medicine independence to handle the kind of monstrous pandemic that the film depicts -- and though our country’s current vaccine-making capacity is terribly out-of-date -- this sort of scenario is made much less likely by the technology we do have (antibiotics, vaccines, antivirals, treatments for secondary illnesses that could kill flu sufferers).

The film is also riddled with smaller medical inaccuracies. Paper masks are not actually effective barriers to the virus; the risk of spread by touching is limited; noses are unlikely to gush blood; and corpses most assuredly won’t be dumped in mass graves. And although the film flatly states that the antiviral drug Tamiflu doesn’t work, in real life it would likely have some effect.

In a coincidence, however, the medical journal Lancet just published a French study announcing a somewhat successful vaccine against H5N1 in humans.

Dr. Marc Siegel is an internist and an associate professor of medicine at New York University’s School of Medicine. He is also the author of “False Alarm: The Truth About the Epidemic of Fear” and “Bird Flu: Everything You Need to Know About the Next Pandemic.”

In The Unreal World, he explains the medical facts behind the media fiction.