Day 24: C’mon Over, the Water’s Great

The little woman across the street plays piano while the man gazes at a screen, light flickering across his gleaming face. She plays classical stuff I hear faintly if I watch very closely. Her bald guy can’t hear it because he’s wearing earphones. Is rudeness a new avian flu symptom?

I shall now respond politely to some questions.

OY VEY, WHAT'S A NICE CATHOLIC BOY DOING HERE?First, we all speak a little Yiddish in New York, the world’s biggest Jewish city. It’s lively and expressive. You need to know what people are calling you. Even a hick like me learns some. TV viewers everywhere do, too: Tell me you don’t know a schlemiel from a schmoozer, spiel from schmaltz. (Jewish humor was born amid a three-year massacre in Ukraine in the 17^th century, according to a Berkeley professor.)

As a child, my closest exposure to Jewishness was playing Joseph in the Christmas Pageant. (It sounded like a big role.) So yeah, I was raised Catholic and I’m entitled to make cracks about the Pope. I earned the privilege on my knees, serving mass.

Third, I love dogs. Nor is my “absorption” with my cat unhealthy. Enough!

Fourth, I’m not “rooting” for bird flu to kill anyone. I don’t need calamities to sustain my ego. I’m spreading information that can help people survive, whether or not they buy anything from me.

Fifth, the emails that do not threaten me display an unexpected and unwholesome interest in my personal life and views.

Still, I’m grateful for the positive reviews of my report about bringing my old friend some protective gear. I haven’t been able to reach him since. I‘m not sure he ever got home. I think it must be easier to buy narcotics than legal drugs. (Wrong powder, dude!)

I did write short stories in college. My teachers admired them. Friends and family were enraged. (Of course I changed their names!) I thought it best to learn a proper profession. Now look at me, antagonizing my customers.

To the nice ones, I apologize, as always. For the man who asked for my personal information, I reiterate that my lover is a woman. For the woman who asked for my personal information, flattery will get you nowhere. See above.

For the woman who said she’d rather see her lungs dissolve in bloody paste than put a penny in my pocket, I’ve sold 256 masks since you hit send. I hope you survive.

More practical readers inquire about safe drinking water. In the best of times, that’s a scary topic. You should know that 49 million Americans were exposed to significant levels of dangerous substances in their drinking water from 2004 to 2009. Few water system operators were exposed, let alone punished. A 2010 study found hexavalent chromium, a probable carcinogen, in the drinking water of 31 out of 35 American cities sampled.

If your tap features arsenic (even ‘acceptable levels,’ as many do) you should consider that mice have been shown to be more likely to catch influenza after drinking water with arsenic exposure equivalent to what’s found in many private wells in New Hampshire.

A Swimming Pool in Every Tap

Some municipalities have been declaring turbidity alerts. When your system tells you to boil water, it’s breaking down. Take it seriously—especially if it’s one of those that now recycle sewage, as they do in Orange County, California.

I barely notice these issues. New York City’s water isn’t perfect. Our showerheads tend to contain “a particularly high dose” of a tuberculosis-related microbe that can cause hot tub lung, lifeguard’s lung, and Lady Windermere syndrome, according to the New York Times.

Like water all over the country, my tap water arrives brimming with medicines and toxins. Still, it’s plentiful and it runs downhill from the Catskill Mountains. Raw water will reach my apartment even during a long blackout. My toilet will affirm civilization with every flush.

I also use a reverse osmosis home filter system, which clears most contaminates found in municipal systems—even the omnipresent weed killer, atrazine—but people in areas short of water shouldn’t get one because RO wastes an enormous amount of water.

Power is the biggest vulnerability. Most U.S. towns and cities need electricity to get water delivered. Power stations stock only a three-week fuel supply. Thirst, catastrophic fires, and dangerously bad hygiene are a few possibilities.

Surface water is full of bird droppings, dead fowl, human sewage, and Tamiflu. H5N1 can survive in it. Chlorine kills H5N1, but many water plants stock only a week’s worth of it. Factories that generate chlorine can fail. Transport can break down.

Will we always know what’s in our water? Let’s drink to our iodine pills and hope we’ll never need to eat them.

Day 25: Turn On, Tune In, Terminate….

My theories on religion struck a legion of nerves. Excellent!

I’ve been wondering if our ideological frenzy dates to the 1960s, when hippies and New Leftists brought a kind of religious fervor to movements against war and for broader rights. Did conservatives then apply that ferocity to religion?

WOULD THAT BE HOMER OR SIMPSON?

Now everyone agrees that the end of human life on earth may be nigh. But they vigorously debate how and why Homo sapiens is doomed.

The Religious Right tends to believe in the End Time, a period of tribulation from which a minority of the best Christians will be chosen by God to escape early. There will be human chaos followed by physical chaos.

The Secular left tends to believe that nature has been systemically overloaded and that civilization will be destroyed in a chaotic, long-running series of ecological catastrophes. There will be physical chaos followed by human chaos.

For Apocalyptic Christians, doom will sweep them off to heaven, where they will finally learn the answer to an age-old question: Do pets join us in the Afterlife? Not to mention an unmentionable curiosity: Does anyone have fun up There?

For Eco-Apocalyptics, there isn’t much to look forward to. Escape isn’t really possible—the best places to hide and maintain a decent lifestyle will become battlegrounds and fascist enclaves against desperate losers. The nice ones hope that some of the species we’ve come to love will survive our self-destruction (even if that entails learning to thrive on PCBs, mercury, and plutonium).

Suddenly I see a giant light bulb glowing over the American educational system. I have an idea! Are we engulfed in conflict over how the end of the world will be interpreted as it happens?

Are all those fights about Darwinism vs. Creationism really just a war over who’s responsible for this mess? Will America’s children be taught that they are doomed by man’s compulsively sinful nature or by man’s compulsively sloppy nature? Sounds like Homer vs. Simpson….

Is the agent of our doom a Supreme Being? Or is it Nature? Who owns the morality of our destruction? Does it matter?

Since bird flu is a passing tribulation, those with protective gear and some luck get to see the next act. Bear in mind that not a single apocalyptic prediction has ever panned out. Yet.

Day 26: The Cool Gang That Delivers

I had a surprise encounter with the Lower East Side Do It Yourselfers. I like that they picked a klutzy name instead of some contrived words to spell an acronym like S.U.R.V.I.V.E. or MERCY. LES DIY sounds like some kind of women’s separatist gang, decked in leather and cool caps and sneers (directed, of course, by Katrina Del Mar).

KATRINA DEL MAR'S 'GANG GIRLS 2000'But the group has plenty of male members (that was innocent, hehe, so I’ll leave it). I’m embarrassed to report that one of them is my best friend (and previously mentioned flu buddy), who’s just begun hosting their daily meal giveaway in his restaurant. I’m proud of him. Let’s dub him Ric because he’s a Bogart fanatic. He’d feel and look at home in Casablanca.

I haven’t seen Ric since he harangued me into letting him drive me to UPS. And I haven’t heard from him since I told him to stop nagging me to support what sounded like a gang of left-wing hipster rabble-rousers. We’re both sensitive. My friend is arguably smarter.

Ric sure listens! Having heard me pontificate for years about the impending emergency, he encountered the LES DIY weeks ago and volunteered to put his assets where my mouth was. Now he and a chef are devising and preparing tasty lunches from whatever is donated by competitors, stores, or individuals. For those who are immune-compromised or unable to walk, the LES DIY will make deliveries.

When he called, I was inspired to emerge from my pit with masks for the active members. (Ric had already gotten some for himself and his restaurant staff.)

The LES DIY is an eclectic crew. Deliveries are managed by an efficient and pretty elf who grinned, wide-eyed, when I turned up with a box of protective gear. Her minions are a lively mix of East Village generations, from undead ex-rockers to indefatigable Sunday School teachers to guys in hats—berets, fedoras, caps, and Stetsons. There are Latinos, Ukrainians, WASPs, squatters, and yuppie workaholics ravenous for labor to perform in a flu-frozen world.

Even in a pandemic, my community feels more like home than my hometown ever did. (Let’s play Santigold’s L.E.S. Artistes in honor of the LES DIY!)

Where I come from, people drive everywhere. The friendly ones honk and wave. In normal times, East Village sidewalks teem with people chatting, arguing, flirting, plotting. Everywhere you see old friends, enemies, lovers—people you met once and liked, but can’t remember why. Memory loss is not uncommon.

Obscure Alarmist Makes Good—Finally

I hope my contribution has answered that local woman who wrote again yesterday, demanding I give money to the LES DIY. I’ve provided something more precious—tools with which the organization can safely pursue its mission. Let’s hope she’s providing more than lip service.

The LES DIY boss generously packed some private-stock Penne alla Puttanesca for me to take home. She even included a dab of pastry! My girlfriend found the entrée too spicy. At least it prompted her to mutter something at me.

For a few weeks, my new love and I had a ball behaving like kids freed of supervision. It was fun playing chess and backgammon half-naked in a room full of blues and jazz and smoke, pretending we were marooned in a far-off land. I don’t think I’ve ever been so happy with someone.

Now my place feels all too close, real—airless. Not a complete sentence since I got home. She has a way of exhaling that makes me feel I’ve just been expelled.

Nina hates my blogging, too. I took it up to give her a break. I’ll go surprise her, share a movie, try to stir a pulse.

Day 27: Musical Chairs With Antiviral Meds

We must all be on guard against pharmaceutical panaceas: As John Barry points out in The Great Influenza, desperate doctors in 1918 shot patients up with typhoid vaccine, quinine, even hydrogen peroxide. If half the subjects survived, any abomination was hailed as a breakthrough.

Today every Web hustler is selling antivirals—mainly Tamiflu and Relenza, though sometimes Adamantanes. A lot of people are buying them. Sometimes the stuff is real. Most is for the birds: counterfeit.

What are these things?

A BIRD’S VIEW OF MAN’S PUNY SCIENCEFirst, let’s trash the Adamantanes. Not only are they not members of a trippy New Wave group‘s fan club, amantadine and rimantadine probably won’t even be useful. The Chinese fed them to poultry for so long that H5N1 thinks they’re chicken feed. (I can’t hold back: Here’s Ant Music for you.)

Then there’s Peramivir. This newbie intravenous antiviral took the field during the swine flu pandemic. A mixed record, countered by Washington’s avid interest in the success of anything that would add to the antiviral arsenal, has kept it in the game. Experts haven’t yet cheered conclusively.

That leaves Tamiflu (oseltamivir) and Relenza (zanamivir). Neither kills flu virus, but each can slow it down while your immune system powers up. They can make infected patients feel better, faster—if they medicate at the first sign of sickness.

Tamiflu in particular faces questions about the process by which it was approved. Its use has been associated with some disturbing side effects (detailed below).

Tamiflu is cheaper, comes in pills, and works throughout our bodies. Relenza must be applied directly to the lungs— inhaled as a dry powder through a breath-activated plastic device called a Diskhaler. It can’t be given to small children, as Tamiflu can. Relenza is dodgy for asthmatics and others with diminished lung capacity. It can cause lung problems. If you’re already too sick to breathe well, you’ll never get it down.

Unfortunately for those who need it, avian flu made Tamiflu trendy and then swine flu got everyone to take it. Chinese farmers may have fed it to their poultry. The WHO has been slathering Indonesia with it for years, much the way various states and cities have lately thrown pills and powders at contacts of isolated H5N1 cases.

Tamiflu fever can conceivably be dangerous—particularly for kids—according to the U.S. Food & Drug Administration. Use of the antiviral has prompted scary side effects in young people in Japan, where 25 patients under 21 had died as of 2007. In Britain, 18% of schoolchildren reported "mild neuropsychiatric side effects." The FDA has inelegantly warned about “postmarketing reports (mostly from Japan) of delirium and abnormal behavior leading to injury, and in some cases resulting in fatal outcomes, in patients with influenza who were receiving Tamiflu.”

Resistance to Tamiflu crept in during the 2008-9 flu season, when our old pal seasonal H1N1 suddenly mutated to acquire immunity to it. (Here’s Dr. Racaniello’s technical analysis.) A longstanding theory that influenza would have to give up some bite in order to defeat Tamiflu turned out to be wrong: Resistant seasonal flu proved no less nasty.

Still, when swine flu came, Tamiflu seems generally to have helped. Against H5N1, it shows some signs of faltering. A lot of the Tamiflu stockpiled by governments and corporations has passed its expiration dates.

Relenza: Less Charming, More Effective

Relenza’s cost and complexity may have helped maintain its effectiveness against H5N1. Chickens can’t use Diskhalers. The WHO didn’t hand them out to peasants. Unless you’re pregnant, nursing, or over 65, we still have Relenza. (I know I do.)

Could this antiviral lose its punch? Optimists stress that its molecular structure differs from Tamiflu’s. Because Relenza resembles the very sugars that influenza must target in order to spread, experts hope H5N1 won’t be able to reproduce well if it stops binding with Relenza.

It’s crucial to take it within 48 hours of showing flu symptoms. (The first 24 are optimal.) Refrigeration is unnecessary, but don’t store it over 85 degrees (30 Centigrade).

Know your flu symptoms—the rapid onset of fever, chills, aching muscles, cough, weakness, and fatigue! Memorize that list. Know, too, the common cold, which lacks the flu’s fever, muscle pain, and fatigue.

Beware psychosomatic illness: A hypochondriac with hay fever is a terrible thing to behold. Twice a year, in spring and fall, New York is stuffed with them. I don’t want to see my neighbors inhaling white powder unless they really need it. (Let’s rephrase that: unless it’s really good for them.)

Relenza’s side effects seem less dangerous than those of Tamiflu, which (again) is associated with suicidal impulses and attempts. Reported cases of confusion, delirium, and impulsive behavior among Relenza users—none fatal—may stem more from patients’ reaction to flu than to the drug, which doesn’t easily enter our central nervous systems. Let’s hope none of us ever needs to use it.

Day 28: Progress Does Not Make Perfect

The flu debunkers are back on TV, gracelessly hailing numbers that indicate a lot of old folks are dying. Since pandemics are thought to feature markedly lower mortality rates for the aged, the skeptics claim this proves our global emergency can’t be a pandemic. This is pathological hairsplitting that rejoices in what amounts to terrible news for senior citizens. It proves nothing positive for the rest of us.

H5N1 fatality rates are indeed falling. Avian flu used to kill two-thirds of its victims. Now the debunkers cackle that it’s down to a few percent—mostly fools with underlying health conditions or foreigners who don’t eat as well as we do. No worries! Pass the fructose.

SELF-PORTRAIT OF A GENIUS KILLED BY FLU (Egon Schiele, 1912)Here’s the truth: No ‘flu bugs’ expected H5N1 to keep killing more than half of those who caught it. That would have wiped out more than three billion people. Not that our bird flu can’t do that. It could do worse. It most probably won’t.

The skeptics’ argument goes like this: Because viruses exist only to reproduce, they need to maximize contacts with potential hosts. This is why influenza hides in your system for days while you shed it. (Like a horrible date, a smart virus attacks you after it’s charmed your friends.) So any disease that quickly kills off its vectors cannot thrive.

That’s crap. Smallpox never relaxed. There’s no proof that virulence limits a virus’ effectiveness.

Dying Like Rabbits

An oft-cited example of a virus that quickly moderated its effects is the myxoma virus that almost wiped out Australia’s rabbits when scientists introduced it in 1950 to control the lapine population. Confronted with the prospect that it would have to find a new host, the virus swiftly stopped killing as many rabbits. The optimists rarely explain that myxomatosis moderated its bite only after slaying more than 80% of its hosts. Now it only kills half of them. Are you reassured yet?

A further issue is that influenza isn’t fundamentally a human disease. It began in ducks and reproduces in countless birds and waterfowl. It may be incidental to the virus that it can infect people and certain other mammals—we’re just bonus hosts, easily dispatched. Indeed, all humans that catch flu turn out to be dead ends, one way or another—they either die or develop immunity. Does it matter to the virus which of these takes place?

So of course I welcome that the case fatality rate seems to have fallen to 1.25%. But these numbers are necessarily incomplete in a crisis. Even if the change turns out to be more than a temporary aberration, 1% would be dreadful—10 times greater than normal. And that's just the first wave. Suppose the next, likely-to-be-worse wave registers a paltry 2.5%. That wouldn’t be so bad, right? It’s merely the 1918 pandemic death rate.

I’m assuming half of all Americans will be infected within the next three years, so a 2% case mortality would kill 1% of our population. Click up your address book and reckon how many friends and relatives you’ll miss if the flu erases one of every 100 people in your life—especially the young and healthy. Whom would you least miss? Whom would you most miss? Would your losses be a “non-event?” That’s what one professional skeptic just labeled the pandemic.

A Peace to Start More Wars

The Great Pandemic killed the brilliant Austrian painter Egon Schiele and his pregnant wife in their twenties. Many think it wrecked President Woodrow Wilson’s physical and mental health, causing him to let the Allies sabotage Germany’s economic future after World War I, which paved the way for Hitler, the Nazis, World War II, the Holocaust, and the Cold War.

Pandemic flu famously comes in waves. In early 1918, the first wave moderated so sweetly that most Americans regarded the flu season as a mild one. H1N1 returned globally and very unseasonably in August, grew ferocious in September, killed hundreds of thousands of Americans in October, and tore though November before subsiding. It came back in a third wave in 1919.

Scientists still do not know if people who survived the second wave were immune to the third wave. That’s how little is known about pandemic bird flu.