Jakarta Pandemic, The (67 page)

Even if the food reserves were accessible, no coherent rationing plan existed, and in any event, on-hand reserve supplies would not last for more than a few weeks. Once the food and water distribution capacities are interrupted, even families who lived within a few miles of several major food stores would find it nearly impossible to procure safe food or water.

The situation in the developing regions of the world was even more desperate. With no national food reserves, and in many cases a near complete dependence upon food importation or aid shipments, the populations of many developing nations would face an immediate food and clean water shortage, worsened case fatality rates and vastly increased nourishment-related deaths. Once aid shipments ceased, survival in a region currently threatened with severe drought or famine would be close to impossible for both infected and non-infected alike.

Within these regions, ISPAC experts calculated that the death rates would catapult many regions into disastrous civil disorder. Given the likelihood that most national, regional and local civil protection capability will also be drastically diminished, an incendiary situation could develop, further adding to the chaos of the pandemic environment.

ISPAC experts pointed to examples of civil chaos seen during the 2008 avian flu pandemic, specifically in Pakistan and Yugoslavia, where a near complete loss of civil order occurred in vast geographic areas, creating nearly impossible environments for local, national and WHO pandemic efforts. In both Yugoslavia and Pakistan, casualty rates rose drastically when flu cases quickly overwhelmed the health system capacity, further rising when a near complete loss of essential services followed. ISPAC predicted that the disasters seen in Pakistan and Yugoslavia would likely be repeated everywhere in the world, even in the most modernized nations, in the face of a severe pandemic.

With their cautious and foreboding predictions, ISPAC representatives worldwide promoted a pandemic awareness and preparedness agenda that reached past WHO-supported measures. Although not diametrically opposed to WHO efforts, ISPAC dogma criticized the WHO’s monopoly of pandemic preparation and response. Since the apparent success of WHO efforts during the pandemic of 2008, the WHO billed itself as the sole provider of pandemic planning, preparedness and response for the world. As a result, many major nations decided to simply pay large financial sums to the WHO, letting them bear the burden of preparing for the next pandemic.

ISPAC firmly believed that WHO involvement in the next pandemic will be critical to mitigating fatalities and fighting the pandemic on a large scale. However, given the frightening prognosis of a deadlier pandemic flu, ISPAC officials projected that the next pandemic would quickly render WHO plans irrelevant and ineffectual. They maintained that the bulk of the pandemic readiness and response will need to stem from individual households, municipal and regional governments, and the private service sector. In effect, the WHO plan acts like a shield to prevent or slow the flu’s breach of a region, but once the shield is overwhelmed, WHO plans provide little capability to fight an internal battle against the flu because WHO plans can’t be effectively reduced to smaller scale.

Even worse, most nations allocated nearly all of their authorized pandemic preparedness funding to the WHO, leaving little funding left to seriously implement a domestic plan. Most nations had committees and departments that developed pandemic plans at all levels, but few countries empowered these entities to implement the plans and prepare. Unfortunately, ISPAC’s efforts to augment WHO plans met with considerable resistance by the WHO and the international community. The WHO sought to maintain their international pandemic planning monopoly, which yielded generous funding, and most nations had little interest or motivation to assume responsibility for further pandemic planning costs. It was easier for governments to write a check and pass the responsibility on to the WHO. After all, memories of the 2008 pandemic had long faded from the headlines and resurrecting them proved unpopular to voters worldwide.

Field Resources Available in 2008

In 1995, sponsors at Emory University, with International Society of Travel Medicine (ISTM) and CDC collaboration, established a system called GeoSentinel, which served to monitor emerging infections of potential global impact. Currently utilizing 41 GeoSentinel sites and 145 ISTM clinics on six continents, CDC and WHO officials can track the introduction and progression of diseases with pandemic potential. Since 2005, the main focus of the GeoSentinel system has been the detection and tracking of H5N1 virus strains. GeoSentinel forms the backbone of the WHO’s Global Outbreak and Alert Response Network (GOARN).

In 2005, the World Health Organization created specialized Forward Liaison Teams (FLT) to quickly respond to detected threats. Their purpose was to help host-country health officials to immediately develop and implement a grass-roots-level detection and reporting network beyond GeoSentinel, to further track and study the emerging threat. The network utilized national and local level representatives, comprised of health service providers and government service officials, to extend the surveillance capability within their area of responsibility. Once an effective system was developed, the FLTs would either remain in place to further develop host capabilities, or be re-deployed to another area of interest.

In mid-May 2008, the WHO assembled and officially introduced the Rapid Response and Surveillance Team (RRST) to the world. The RRST’s operational capability was one of the key contingencies formulated between 2005 and 2008. These teams tirelessly scoured the planet, investigating potential virus outbreaks and reporting the findings to the WHO for immediate asset allocation. Typically, an RRST was deployed within hours of a credible virus report. The RRSTs operated under the full support of the United Nations’ military enforcement arm. Likewise, admittance and full cooperation with the RRST by the host governments was mandatory and noncompliance was decreed by the UN to be an immediate, hostile action against world safety and security. With the full weight of the UN members backing the WHO, the RRSTs operated unhindered.

Once the RRSTs entered, if the H5N1 virus was detected, rapid mobilization of the host nation’s resources was implemented in accordance with WHO pandemic containment and treatment plans. These guidelines accounted for the various stages of economic and industrial development found throughout the world, and served as a baseline for immediate action. Quickly following the activation of the host nation’s resources, Rapid Response Assistance Packages (RRAPs) were deployed, sometimes in several stages, containing vaccine, medical augmentation material, and additional WHO personnel. The RRAP personnel provided education and pandemic plan implementation expertise to the host nation’s government and health services infrastructure, and in extreme cases, simply assumed control of all efforts to fight the pandemic.

The WHO’s enhanced response capability in 2008 proved effective against the emerging H5N1 pandemic.

Media Excerpts cut from the first draft of The Jakarta Pandemic

Among the first reports -
The Morning View

Late October 2013

“In day two of a tense political standoff between China and the United Nations, China has further tightened travel restrictions into their country, essentially cutting off all foreign commercial air travel into the country. Hong Kong International airport continues operations, but no flights are permitted to continue into the Chinese mainland. Observers described the scene at Hong Kong International as organized chaos, as airport officials and Chinese government workers struggle to maintain order in one of the busiest in the world. Now, let’s talk to Jeff Talon, who is currently in Singapore, only recently released from Hong Kong International airport. Jeff?”

“Yes, Matt.”

“Jeff, could you describe your stay at the airport and the circumstances that led to your stay? I believe you were headed to Hong Kong International from Singapore, when the travel restriction was announced?”

“That’s exactly right, Matt, we were close to two hours out of Hong Kong when the captain announced that the flight would continue to the airport, but that all passengers with continuing flights to destinations within China would not be allowed to proceed. If Hong Kong International was a connection to another country, you had very little hassle upon arrival, but for those of us with continuing flights into China, it was truly unbelievable.”

“How so, Jeff.”

“First, very little information was passed to us. We were simply told to stand in line. We were put onto a bus that crossed the airport and deposited us inside a closed hangar. It was nearly 8 hours before anyone in a position of perceived authority came to gather our information, presumably to arrange transportation out of the country. Even then, they provided no further information regarding our status. From there, it took at least another day, with little to no information, before we were suddenly herded back on a bus and put on a Singapore Airlines flight back to Singapore.”

“Sounds frightening, did they ever give you any information regarding the travel ban?”

“No, Matt. This is what scared everyone the most. None of our cell phones worked at first, presumably because the cell towers and nodes had been shut down by the government. This set off a panicky mood among passengers, especially since we had been whisked away from the terminal with no explanation. We weren’t the only passengers taken out of the terminal. We joined nearly 600 other passengers already in the large hangar, and hundreds more arrived shortly after us. We think they filled several of these large hangars, maybe more. There was some speculation about a war, but these rumors were put to rest by passengers arriving later in the morning. Rumors of a possible flu outbreak began circulating by midday, compounded by the fact that all of the Chinese government and military officials were wearing masks.”

“Jeff, what were the conditions like in the hangar?”

“Pretty awful, Matt, but we were not mistreated, we were just ignored for a long time. I think they had their hands full at that airport. Like I said earlier, it took nearly 8 hours before they started to process our information, and unfortunately, it took nearly this long to get any food or water. The hangar itself was temperate, thankfully, but as you can imagine, it was quite claustrophobic, and the Chinese officials would not let anyone out of the hangar for any reason. I was glad to get out of there the following day, very glad to say the least.”

“That doesn’t sound like fun, I hope you didn’t have to go to the bathroom too often,”
Matt joked.

Alex piped in, “Jesus, that would have been my first concern. Getting to that toilet first, before the other 800 other people decide they have to squat over the hole.”

“They don’t squat over holes in China,” Kate protested.

“They certainly do. Maybe not in the main airport terminals, but any bathroom built for the hangars would be constructed according to local standards, which in my experience throughout Japan and Korea, is very likely to be a porcelain hole in the ground. These things flush, and are nice, but to an untrained westerner, they present a challenge. There are bound to be some missed bombing runs, and…”

“Okay, I get the picture,” Kate said, shaking her head with a look of disgust.

“Yeah, Matt, I’m trying to forget the bathroom situation. Simply unforgettable, especially after about 12 hours in that hangar.”

Alex stated, “I’m sure they ran out of shit-paper after the first 50 guests, probably not high on their priority list. What a nightmare.”

“Thank you, Jeff. Now, let’s head over to our World Health Organization correspondent, Carolyn Davill.”

“Good morning, Matt, I’m reporting from outside WHO headquarters in Geneva, Switzerland, where a considerable buzz has developed since yesterday’s surprise Chinese clampdown on travel into China. There are many theories and speculations, but it remains clear today that China has not released any verifiable information regarding their decision. Sources close to the WHO stated that the primary speculation, and the greatest concern, is a pandemic threat developing in China. However, officials admit they are puzzled by the one-way travel restriction declaration. Flights are still departing China for all regions of the world, exports are continuing, and the importation of raw goods has not been restricted, although it is unclear how much longer this may be the case. Our WHO source claims that there is serious discussion within the UN regarding the institution of immediate travel restrictions with China, similar to those seen in 2008. We have also heard that several nations are possibly hours away from announcing independent travel restrictions with China.”

“Interesting, Carolyn, early reports from our Washington, D.C., correspondents and UN desk indicate that lawmakers on Capitol Hill will be meeting for an emergency session to discuss the events, and we are in the process of confirming that the UN has also declared an emergency session to respond to the Chinese travel ban. Carolyn, the prospect of possibly another pandemic-grade illness in China is a terrifying prospect for everyone. What have you heard from your sources at the WHO, specifically regarding this theory? Have they seen any indication that it may be true?”

“First, let me say, Matt, that the WHO is not releasing much information. We do know that they are in active negotiation and contact with Chinese health and government officials. They have assured us of this. As far as specific pandemic information, our sources told us that they were very unnerved by the fact that all Chinese government and military personnel at the airport were wearing face masks, and that all of the airport personnel were also soon given the same equipment. One rumor persists that several passengers were screened through a medical triage center, where apparently Chinese health officials were very concerned with identifying flu symptoms.”