Edge of the Abyss - The Monster at Our Door: The Global Threat of Avian Flu - page 53

ASEAN health ministers, who promised regional coordination in an intensified fight against the poultry
plague; however, no concrete commitments emerged dealing with live-animal markets, vaccine develop-
ment, or the stockpiling of antivirals. 229
Many researchers and activists wondered if the WHO was not being too meek in sounding the tocsin.
In particular, they worried that WHO's influenza czar, Klaus Stohr, had been deliberately underselling the
menace of H5N1 in order to safeguard the organization's credibility in the face of skeptical governments.
When asked about possible mortality, Stohr routinely referred to a U.S. CDC study that projected 2 to 7.4
million deaths globally, but CDC health economist Martin Meltzer had derived these figures by extrapol-
ating from the mild 1968 pandemic; most influenza experts actually feared that H5N1 could become as
deadly as the 1918 virus. Michael Osterholm, the respected director of the Center for Infectious Disease
Research and Policy at the University of Minnesota, characterized Stohr's cautious estimates as “rather
ridiculous.” 230

Table 9.1.
How Many Might Die?

1957 mortality 2 million

1968 mortality 0.7 million

1968 extrapolated (Stohr) 2 to 7.4 million

1918 mortality 40 to 100 million

Omi's estimate 7 to 100 million

1918 extrapolated 325 million (maximum)

H5N1 mortality extrapolated 1 billion

Most of the scientific community, therefore, was heartened when the WHO's Shigeru Omi evoked
the 1918 precedent when he warned the press on 29 November: “We are talking at least seven million
[deaths], but maybe more—10 million, 20 million and the worst case, 100 million.” (Omi was still being
conservative: an direct extrapolation of maximum 1918 mortality to today's world population would be
325 million dead.) The cat was out of the bag, and top experts, like Malik Peiris at the University of Hong
Kong, rushed to defend Omi's figures as “consistent with current research.” Scotland's Sunday Herald,
moreover, in mid-December printed frightening excerpts from a leaked UK government study that projec-
ted a near-breakdown of British society during a pandemic. “A minimum of 25 percent of the population
will become ill over each six- to eight-week period. . . . Mortality is likely to be high—estimated at 1
percent of the total population.”
The WHO ultimately bowed to majority opinion and, over Stohr's objections, revised his previous
estimates as “a best-case scenario”; 50 million dead was now officially the “worst case.” Yet a few epi-
demiologists think even 50 million dead is wishful thinking. Extrapolating from the current lethality of
GenZ rather than from 1918 mortality (i.e., 72 percent versus 2.5 percent), they reminded officials that
the true worst-case scenario, in fact, was more in the range of 1 billion deaths. 231