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  • Welcome, everyone.

  • This is Mike owned.

  • Yes.

  • Yes.

  • My name is Skip Rutherford, and I am dean of the University of Arkansas Clinton School.

  • Public Service.

  • Let me introduce to you who just walked in no stranger to Arkansas founding dean of the Clinton School of Public Service, Senator David Pryor.

  • Stand up on behalf of the students, faculty and staff.

  • Welcome you to this community conversation.

  • It is amazing what a great speaker and a great topic will do for a crowd.

  • So we're honored to have you here.

  • Our students are not here tonight.

  • They are on their international internships.

  • And before you leave, take a look at the map on the back of the room.

  • You see where they are?

  • Certainly of interest to us is the this virus and its impact on the countries where our students are now working.

  • So this topic is both timely and personal, and we're glad to have you here.

  • We will be announcing our new class in early August, and we'll also be announcing our distinguished Mr Public Print programming schedule, which I think you all will like.

  • Enjoy, I hope, like our e mail system where people can respond and come to these events get used to bore because we've got a lot coming this fall.

  • And coordinating that activity is a young man who was a graduate of the University of Nebraska in a pretty fair tennis player in his own right.

  • No, and joined us about a year, year and 1/2 ago at the school and is now the director.

  • A public programming.

  • It is done a fabulous job recruiting an attractive quality.

  • Speakers like the one we have tonight.

  • So the introduce our guest speaker, I want you to be a young man that you're gonna hear a lot about the future.

  • One of the talented young people that we're glad to have on the staff of the Clinton School.

  • Would you welcome a native of South Carolina, a graduate of the University of Nebraska, Patrick Kennedy.

  • Thank you.

  • I, too, would like to thank everyone for coming out tonight and want to welcome you to the Clinton School.

  • Public Service.

  • This is a treat to see all of you here.

  • And I'm excited to have you all here and more in the future.

  • I'd also like to give a special thanks to Dr Thomas Bruce, our associate dean, who has been a strong advocate of holding conversations that global health here at the Clinton School and under his leadership, we will continue to have more of these calm discussing the intersections between global health and public service.

  • I can sure thank you for all your help and guidance in this process.

  • But tonight we're here to discuss an issue that is pretty important issue and is received much publicity lately.

  • And that is the threat of a global pandemic.

  • Uh, much of the conversations that you have seen as of recently has been about the avian influenza virus, also known as the H five n one virus that could potentially trigger a global pandemic and cause massive chaos and disrupt all aspects of life with the United States and around the world.

  • Um, our speaker tonight continually emphasize, is that whether it's the avian influenza or it is an emerging disease that we have yet found and it doesn't even exist yet a global pandemic will, in fact, come the he equates it frequently to the hurricanes.

  • That hurricane will come.

  • We don't know what shape will take, but it will come.

  • In fact, our speaker recently said that if it is, if it is going to happen, it is not.

  • It is not when it is going happen.

  • It is when it is where and it is, how bad.

  • So there really is no better person to talk about this issue tonight about the threat of the global pandemic than our speaker, Dr Michael Foster home.

  • How to tell you a little bit.

  • Just a little bit of doubt about Dr Michael Foster home.

  • Hey is the director of the Center for Infectious Disease Research and Policy.

  • He is the associate director of the Department of Homeland Security's National Center for Food Protection and Defense.

  • He is a professor at the School of Public Health at the University of Minnesota.

  • And in June of 2006 Secretary Michael Leavitt, department Healthy Human Service is appointed Dr Auster, home to the newly established National Science Advisory Board on bio security and in the past month, talking to global health experts throughout the state.

  • Throughout the nation, it said, Doctor Osterholm possesses two qualities, and that is courage and conviction, and that has been evident in the work he's done around the world s so as you can very well tell, we're very privileged.

  • Tohave Dr Rosa home address.

  • Right.

  • And please join me.

  • Michael was Thank you, Patrick, for that very kind introduction.

  • Senator, it's great to be here.

  • Dr.

  • Bruce, I wanna give my acknowledgment of someone who's been a long term fan of work you've done for many years.

  • Dean Rutherford.

  • Thank you.

  • Also, it's a real honor to be here in the throes of Clinton.

  • Here, give it all the president why he was there and I had the fortune to spend some of that time working in some of those programs.

  • And I think it's great and I don't want to diminish that.

  • But I have to tell you the person that I have the fondest in greatest love for of all public policy people probably is Senator Dale Bumpers and Betty Bumpers, who have had a chance to work with in the area of the immunizations for 20 years.

  • And I have to tell you that it is an experience to spend time with Dalen, Betty and work they've done and they truly are real public health hero.

  • So while they're not here tonight, they're here in spirit clearly, uh, and it's great.

  • Well, I'm here tonight to talk about something that no one wants to talk about it everybody wants to talk about.

  • And that's the issue of the concept of an influenza pandemic and what it might do.

  • Let me, at the very beginning, set the record straight as a public health professional and how I will view this issue tonight and go from there.

  • A 9 11 of 2001 year for the 9 11 event, I published a book called Living Terrors.

  • What America Needs to Know To Survive Coming Bio Terrorist Catastrophe.

  • In that book, it was primarily about bioterrorism, including the use of anthrax.

  • Kind of like it waas.

  • But I also talked about the fact that the World Trade Center tower in the Al Qaeda one year before it happened.

  • If you'd asked me in that intervening year between 9 11 2000 and 2001 what the likelihood that that attack would occur?

  • I probably have told you given, you know, my science background of risk, I don't know one and 5001 in 10,000 or something like, Really, I am here to tell you tonight and hopefully provide the support of information.

  • Why the risk of an influenza pandemic is one it is going to happen unless you can somehow eliminate hurricanes blessed Minnesota.

  • You suddenly put a big baggy around our state, eliminate winters you will not ever, ever escape and the next influenza pandemic.

  • So at the outset, let me just just miss any idea.

  • Is this real or is this another Y two k?

  • Whatever this is going to happen, the question, as Patrick framed it, is we just don't know when we don't know what which which virus will cause it, and we don't know how bad it will be.

  • But tonight I'll give you a sense of why we today are as vulnerable to an influenza pandemic as a society is a world, as we may have been in our entire history of humankind.

  • A very strong statement again.

  • But let me share with you why I think that to be the case now.

  • I have about 9000 slides in my repertoire slides.

  • Last count.

  • I had to get rid of all of them to keep one that I think really tells the story where we're at today in the world.

  • This is the slide, and I realize it may be hard for some of you to see, but what you have on the right vertical bar.

  • Here's population in billions in the left, one is days to circumnavigate the globe.

  • And this is the last 150 years in the last 150 years.

  • We haven't really changed a lot for the last 50 years.

  • What it took to get around the world that the 1st 100 years of that time period really made a big change from one year toe, literally.

  • With the advent of the Boeing jet, we're talking now about 42 hours.

  • What has not reflected in this bottom line is what goes around the world today.

  • The global just in time economy is our Achilles heel.

  • While it's our strength, it's our major major vulnerability, and we'll talk about that tonight in the context of inch wins it.

  • Much of what we count on every day originated offshore somewhere, and anything that interrupts international trade and travel will interrupt quickly the global economy.

  • On the other bar, you see the world population.

  • Today, there are 6.5 billion people on the face of the earth, and the number grows quickly back in 1918 upend a time.

  • I'll talk about tonight relative to the previous pandemics, the world population was 1.8 billion today, one out of every nine people's ever lived since the caves is on the earth today.

  • That's a remarkable concept.

  • The point is, that also has real implications for what a pandemic will do Now there's a lot of people who put yeah, wins and avian influenza, Modern world view of pandemic.

  • You can't quite see this business chicken little over in the left bar.

  • This is We're all going to die a bunch of tombstones, and we find ourselves a society typically wanting to fit in either.

  • One couple months ago, I was on Oprah and, needless to say, my email was overrun.

  • After that, I was on there literally thousands of emails and they really divided into two camps.

  • One camp is you know, why in the hell are you scaring us so badly?

  • This is just, you know, you are irresponsible.

  • And the other side of it was saying we're all gonna die and you're not telling us the truth.

  • You know really?

  • You know, why aren't you leveling with us how bad this is gonna be?

  • And I guess this is a natural kind of of relational reaction to any kind of news like this.

  • In fact, ladies and gentlemen, the truth is in the middle, we're not all going to die.

  • We'll get through the next pandemic.

  • Justus.

  • Any civilization has before us, but it's gonna be tough if you believe that it's not gonna happen or you believe we're all gonna die.

  • You can go home, get your bottle right now, go to bed and just write it off because there's nothing you could do.

  • And that's not the case.

  • There's much we can do.

  • What we need to understand is now is the time.

  • And every day we waste to do more and I'll talk about that.

  • Do more later as we go through this.

  • Now, here's an example of why you might very well be quite confused.

  • This is You know, what some would say is one of the prominent papers in United States, The New York Times.

  • This is the same science writer, the same editor for the science writer, the same newspaper on May 14th Sunday publishes a story above the fold that says avian flu wanes and Asian nations that first hit hard.

  • If you read that story, you would come away thinking, you know, this was another Y two k.

  • You know, people kind of really blew this.

  • It wasn't really all that important.

  • Inner same author, Same journalist writes a story.

  • Bird flu deaths Indonesia Raise Concerns Talking about this cluster of cases were just unfolding.

  • An Indonesian said The baby, This is it.

  • Maybe it's coming.

  • Then another's for human flu transfers may exceed reports suggesting a lot more is going on out there.

  • We ever knew about same journalist, same newspaper.

  • What does this mean?

  • Today?

  • We're being with back and forth constantly about what do we really know or not, including our New York.

  • It's not in depth.

  • It doesn't really understand what's happening.

  • And so tonight, what I want to do is I can tell you right now at the outset, and this may be a reason for a number of you to get up and leave.

  • I know less about flew today than I did 10 years ago when I was teaching my graduate students 10 years ago, I thought I knew a lot more about this topic in the more we've learned more, we realized very humbly how little we really know, and I'll try to share that with you tonight.

  • What we really know don't know.

  • And what's a Maybe now the World Health Organization put out a document last October about 10 things you must know about pandemic influenza and let me just say at the outset, at least from the perspective I come from and some of the room may have some additional comments.

  • But the W.

  • H O is really often considered to be one of the most conservative organizations we ever deal with.

  • I mean, they typically are, if you want to have a nice conservative base, where by the conservative meaning, you know, they never shy too far away into the future, etcetera.

  • So take these comments on this light pandemic influences different from avian influenza.

  • 0.1, I'll explain the difference tonight.

  • There's a lot of confusion about avian influenza in what's human pandemic influenza.

  • Second, while influenza pandemics are recurring events like earthquakes, hurricanes and tsunamis, pandemics happen and they will happen again, and that's an important concept in the sense of understanding what we have to prepare for.

  • The world may be on the brink of another pandemic.

  • I gotta tell you, that's pretty strong language for the W H O to say we're on the brink.

  • Another painting as last October.

  • All countries will be effective.

  • Nobody's gonna escape this one.

  • This will be a worldwide event.

  • Unlike a lot of catastrophic events.

  • Wars, natural disasters typically are very regional in their nature and temporary.

  • They tend to be rather short lived at least natural disasters.

  • Widespread illness will occur all comment what widespread illness means.

  • Medical supplies will be inadequate.

  • I will lay out for you right now that our medical care system in this country will be no better during a pandemic in 1918.

  • Now that seems very strong, and a lot of people are negatively react to that.

  • But I will point out why that's the case.

  • Modern medicine as we know it will not take place.

  • A large number of deaths will occur.

  • You'll see what those numbers mean.

  • You know what?

  • How are they related?

  • Economic disruption will be great.

  • W.

  • Joe saying this now every country must be I don't know what that quite means yet, but I will tell you that it's at least in spirit, correct.

  • And finally the w h o alert the world in the pandemic threat increases.

  • I'm not sure I have complete conference a W H O That way.

  • In this recent cluster in Indonesia, only two W H O investigators actually made it to the rural villages Sumatra.

  • In Indonesia, they were, in essence, escorted out pretty quickly for reasons that have to do with some communication skills.

  • It was only because a very persistent Bloomberg News reporter from Hong Kong found at third generation of cases where we would never have known about that.

  • So also don't think we have this elaborate surveillance is melter that's gonna quickly respond to these things because that's not the case.

  • Now I've had it.

  • A couple of additional things you must know about pandemic influenza vaccine and antiviral drugs love minimal impact on the pandemic.

  • It occurs the next several years.

  • Why?

  • Because we won't have vaccines and drugs.

  • I'll explain why that's the case.

  • No quick fixes right now, one of the things that I have the hardest time about doing in Washington with is Everything's about a quick fix just before it happens or after it happens.

  • There aren't any quick second ball.

  • It's going to turn waves.

  • Pandemic influenza is a situation that occurs where once it emerges in world, it has historically swept through the world in waves, meaning that it will go through a community in the spring on a no tire area of the world and then somewhere else throughout the world at the same time in the early summer.

  • And then it comes back.

  • And what's interesting about in 18 90 the pandemic, then the third wave 16 months into the pandemic was by far the worst one that killed the most people in 1918.

  • It was the second wave that occurred in the fall of 1918 even though the first wave it occurred in the spring in 1957 and 60 eight's two pandemics were quite mild.

  • By all of our estimates, there was the first way that was the most severe.

  • We don't have a clue when to blow our wad.

  • When do we take what limited resource is We have and put him out there because we don't know which way is gonna be the worst one.

  • That's a lot of indecision at a time when we need really good decisions.

  • Non pharmaceutical interventions Florentine Infection control Justin Scene will have limited impact.

  • That's in part true, because of the fact with quarantine with influenza.

  • While there has often been stated your infection up to a day before, it's some of that occurs.

  • But the point of it is by the time we realize you have influence, that you'll have likely transmitted to a number of people.

  • That's very different than with SARS, whereby the you're likely transmitting wasn't really that high until about the fourth or fifth day of your illness.

  • You were in the hospital often by then, and then on top of it we were manipulating you terms.

  • Your air source and self worth had made it worse.

  • It's not easy to quarantine.

  • We won't be able to do that Infection control.

  • Come back to today.

  • We will not.

  • We will run out of mask and respirators overnight, and I'll give you the reason why Social Distance e.

  • I don't know what this means.

  • I mean, how do you keep people at arm's length away so that I don't breathe on you.

  • Well, today we worry about that because social distancing works.

  • If it's only the first couple of feet in a story, Senator.

  • But I've nailed you pretty largely already tonight.

  • Here.

  • If I If I realized I have flew on the way home tomorrow morning, I'll give you a call.

  • But in addition, we now know that influence also could be transmitted via the aerosol route.

  • The idea that it can also move distances to the back of the room.

  • And so it's not just only up quotes, and so I'll come back to this.

  • But the idea of what can we do about it is, and we have to be honest with our public about what we know and what we don't know, because as soon as we tell him, do this or do this and it doesn't work.

  • And then we realized we kind of was wishful thinking, not based on