Suspected human-to-human Avian Flu H5N1 transmission has occurred in Vietnam, and is the kind of trigger news that could launch the epidemic/pandemic "event" noted in The flu season not yet underway and uncomfortable signs that 'when, not if' is shifting to 'soon, not when'. Worse, the lack of reliable or widely available tests may be masking other cases. H5N1 is vastly more fearsome than SARS (Severe Acute Respiratory Syndrome).
In the case of SARS and now Avian Flu, governments are voting short term economic gains, reducing the flow of accurate infection information, impeding inspection by foreign epidemiological staff, and forestalling destruction of infected fowl, thereby blinding themselves - and us - to the tipping point of a pandemic.
Independent actions by local, regional, and national governmental entities effectively conspire to make the situation opaque. Vietnam, Thailand, and China are now repeating news suppression and denials in avian flu animal-to-human and human-to-human transmissions.
For all the interruption and destructive capacity of the SARS epidemic - the worst economic crisis in Southeast Asia since the bank failures and currency devaluations - one must remember that in comparison to Avian Flu, SARS was much more difficult to affect contagion. An Avian Flu pandemic will massively accelerate the SARS timeline. Containment is problematic.
During the SARS epidemic, we built a hierarchy of events in real-time so as to predict supply chain impacts before they occurred. If we have to dust it off for Avian Flu, the progression speed will be frightening in comparison.
Following is a sanitized event hierarchy for SARS that flags items that effectively worsen, impacting revenue and life. It does not include items that increase, or respond to the situation, such as the foreign (offshore) rise in teleconferencing (including audioconferencing, videoconferencing and Web conferencing), and host nation sales of autos and motorbikes (to avoid mass transit).
Two variables quickly emerged:
- Primary variable: duration (as opposed to number of affected industries)
- Secondary variable: continued/lingering fear
Hierarchy of Impact is divided into three sections:
- "Pre-event" hierarchy: events leading up to the Asian (PRC and Hong Kong) breakout of major economic and health effects.
- Host nation (PRC and HK) "Public" or core event hierarchy: events causing regional disruption, death, and economic loss
- "Post-event" hierarchy: aftermath and mop-up events
- Anecdotal communications among healthcare providers, CDC (Center for Disease Control), and WHO (World Health Organization)
- Host nation suppression of news and entry of foreign disease control personnel
- Unexplained disease reports of "acute respiratory syndrome" in neighborhoods, local hospitals, and health workers
- WHO confirms disease as "worldwide health threat"
- Air-transit leaps of disease (ex: Canada, Taiwan, Germany, US)
- Foreign (offshore) travel warnings (ex: Canada) cause immediate travel, convention, tourism, service industry impacts, and airline revenue impacts to affected areas
- WHO issues South East Asia travel guidelines
- Foreign disease control personnel fall ill (insuppressible news event)
- WHO recommends postponement of all non-essential travel to Host nations (PRC and HK)
- Foreign (offshore) quarantine commences
Suspected human-to-human bird flu transmission in Vietnam
17:15 21 January 2005