11/22/2013 12:17 EST | Updated 01/25/2014 04:01 EST

There's a Killer Flu Out There, and We're Not Prepared

I'm sneezing a lot, coughing too, and my box of Kleenex is severely challenged by an amazingly runny nose. I don't think it's flu -- I had my shot, I don't have pain in my joints, and there's no fever -- but I don't like it, whatever it is. Still, it focuses my slightly woozy mind on the next big flu assault, now brewing around the world as the cold weather sets in.

Although recent flus (swine and avian) have not lived up to advance warnings, influenza can be a weapon of mass destruction. Think of it as Mother Nature's biological weapon. In 1918, a flu pandemic -- the "Spanish Flu" -- killed off a hundred-million human beings, including nearly 600,000 Americans, so Mother's weapon can be very effective. That's why the Centers for Disease Control (CDC) in Atlanta monitors flu cases around the world, and especially in China, where more people live in close contact with farm animals than anywhere else.

Tom Frieden, the head of the CDC, reminds us that nothing has the potential to kill more people than influenza.


The latest candidate worth worrying about is an avian flu with a Star Wars-y name: H7N9. It jumped from birds to humans earlier this year, and infected several hundred Chinese last spring. It's a real killer; of the 137 people known to have been infected, 45 died. Flu does best in cold weather, so the bulk of the cases were diagnosed in the spring, and there were virtually none in the warm summer months. Of late, a few new cases have surfaced, even though the Chinese have slaughtered lots of chickens, ducks, turkeys and geese.

The good news is that there's no evidence that H7N9 spreads among humans. Not all flus have that capacity. If H7N9 remains on the farms, we don't have to worry about mass destruction.

On the other hand, it wouldn't surprise any of the experts if H7N9 learns how to jump from person to person and mutates into a fast-moving mass murderer. Indeed, Health and Human Services Secretary Sebelius has declared it a potential threat to national security, and she authorized emergency vaccination tests. Congress took the threat seriously, and appropriated resources. HHS allocated 110-million dollars to fund drug company vaccine development and production. The vaccines have been developed, and the tests are encouraging. So we're ready for it, right?

Not exactly.

The homework's finished, but we're not ready for the final exam, because we haven't manufactured the vaccine in anything like suitable quantities. And there's a considerable lag between the moment when we tell Big Pharma to save us, and the day the assembly lines start to function: roughly 60 days. HHS was supposed to have made the decision on vaccine manufacturing a month ago, but hasn't done it yet. This could be fatal, since flu spreads fast and the first 20 million or so batches of vaccine will not be injected into our shoulders; they'll go to first responders, health care personnel, and active military.

So we could be in a real jam if the Chinese call us up one morning with the bad news that H7N9 has mutated, and has reached one or two of their cities. With airports. With flights here.

As Napoleon famously said, it's better to have a lucky general than a smart one. We've got a surfeit of smart bureaucrats who have identified the threat, taken initial precautionary measures, and are watching the battlefield. But without a substantial arsenal of potent vaccine, we'd better hope they -- and we -- are lucky.