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WASHINGTON -- Some good news, sort of, popped up here like the Easter Rabbit just before last weekend. The developments drew great attention in the nation's capital because they have a connection to terrorism, and that subject has given us precious little to smile about for half a year now.
The revelations involve germ warfare, a complicated topic, so maybe the best way to do this is a Q-and-A format.
Question: So, what's the good news?
Answer: Actually, there are three separate angles to it, all of them diminishing somewhat the nightmare possibility of a smallpox contagion that could be unleashed if bioterrorists got their hands on the deadly virus that was once thought to be eradicated across the globe.
Q: What's the first one?
A: The federal health structure thought we had about 15 million still-usable doses of smallpox vaccine left over from the height of the inoculation effort a half century ago. Last week, a French pharmaceutical firm discovered it has an extra 80 million doses or so stored in freezers in Swiftwater, Pa. -- and the forgotten vaccine appears still to be potent. The firm, Aventis Pasteur, says it will give the found vaccine to the government for American usage.
Q: And number two?
A: On the heels of that find, Health and Human Services Secretary Tommy Thompson happily announced that tests show if you dilute those 15 million vials we knew we had, you can still get viable immunizations even if you weaken the dosages on a 10-to-1 basis. In a pinch, that could give the country 150 million smallpox inoculations instead of 15 million. Add that to the newfound Pennsylvania stuff and you have about 230 million shots. If you dilute the found Pennsylvania doses by a 5-to-1 basis, as HHS plans to do, you get 300 million doses instead of 80 million. Add that to the 150 million on hand, and you get 450 million shots available. Then, factor in the 210 million new doses that HHS ordered from a British vaccine maker after Sept. 11, delivery expected by the end of 2002, and you have maybe 660 million vaccinations at the ready for a smallpox attack -- a volume which would cover the national population, and allow mounting of a workable defense against germ warfare if the tricky logistics could be mastered.
Q. And number three?
A: A researcher at the Veterans' Affairs Department medical center in San Diego has come up with an anti-viral compound called HDP-CDV which appears to inhibit reproduction of the smallpox virus. In other words, a pill one could take if exposed to the extremely contagious disease. Food and Drug Administration approval -- if tests prove successful -- is a couple of years off, of course, but it's a start.
Q: What did you mean, "sort of," when you first mentioned good news?
A: People forget, many doctors included, that the smallpox vaccine -- unused since the disease was pronounced eradicated 25 years ago -- itself packs a wallop and is very reactive. The shots can cause disfiguring rashes and encephalitis (brain inflammation), and scientists predict anywhere from 100 to 700 deaths from the vaccinations alone if the entire population were give inoculations. That figure, of course, pales against the tens of thousands who might die if a big city were exposed.
Q: Any other "sort of" qualifications here?
A: Yes. Since the '50s and '60s, we know a whole lot more about the human immune system, and its ability to ward off disease. If that system is suppressed by anything -- say, cancer treatments, AIDS, organ transplants, burgeoning chronic disease, etc. -- administering a powerful vaccine like the smallpox shot could put such individuals into life-threatening territory. Scientists at the Centers for Disease Control in Atlanta, for instance, estimate there are as many as 275,000 Americans infected with HIV who don't even know it. Since the proven federal tendency -- even in matters of health -- is to kill a mosquito with an elephant gun, giving the smallpox shots to the entire population indiscriminately, and without attempts at determining predisposition to reactions, could produce a calamitous problem of its own.
Q: What do you mean?
A: The Working Group on Civilian Biodefense has estimated that if the 280 million Americans in our population all received the smallpox shots, there could be about 70,000 with reactions severe enough to require treatment with VIG (vaccinia immune globulin). The World Health Organization says, "The risk of adverse events is sufficiently high that vaccination is not warranted if there is no or little real risk of exposure." Even HHS Secretary Thompson, in all his ebullience, said Friday, "We do not believe we need mass vaccination for smallpox."
Q: Does everyone agree with him?
A: No. Some public health experts fervently believe we should start a mass vaccination program with the smallpox shots as soon as possible. One rose-tinted theory is that this high-profile campaign would forestall terrorist attack with the biowarfare weapon -- even if the megalomaniacs had it in their possession. Presumably, the terrorists would consider their efforts thwarted before they began.
Q: Do we know terrorists have the smallpox virus in deployable form?
A: No, but the free world intelligence agencies are growing increasingly convinced it is likely. The Soviet Union for decades produced about 20 tons of the stuff annually and stored it in Zagorsk, a little 14th-century church town northwest of Moscow. Since the fall of the Berlin Wall in 1989, the West (and even Moscow) lost track of many jobless Soviet scientists with access to it.
Q: Is the federal government prepared to force the vaccine on all Americans?
A: Bet on it. About half the states are already quietly considering legislation based on a federal model that would allow state governments to use their militias to arrest, imprison, or quarantine anyone who refused the shot -- suppressed immune system or no. That doesn't mean this will happen automatically, but expect a big congressional debate soon.
Q. Was there any particularly bad news regarding terrorism over Easter weekend?
A. Well, besides the terrorism involved in the bloody and escalating war between the Israelis and Palestinians, there was a buried bit of news anyone paying close attention to homeland security will find shocking.
You know those fighter jets that have been making us feel secure by patrolling over major American cities since the Sept. 11 disaster? Part of the reason they're swooping around is the dire prospect they may have to shoot down a hijacked airliner before it plows into a building.
That's not the shock.
This is. The public and politicians alike have been assuming in case of such a crisis, the fighter pilot would communicate constantly by radio with the commercial airliner's captain to avoid the catastrophic blunder of taking out a plane that wasn't actually being hijacked.
Turns out for many of the warplanes, this is not possible.
If you're driving an F-15 Eagle, despite its impressive technology, you have to talk and listen to the airliner via ground controllers -- an arduous and ultimately risky process.
That's because your fighter jet radio is on UHF band, not the VHF used by commercial airliners. Cost to fix this possibly fatal oversight on almost 600 fighter jets: Close to $40 million.
| Niagara Falls Reporter | www.niagarafallsreporter.com | April 2 2002 |