Smallpox, Big Scare
Today President George W. Bush announced the government’s plan to implement a smallpox vaccination program within weeks, starting with half a million military personnel and another half million health care and emergency workers, then expanding the program by the end of next year to offer immunization to the entire American public. Officials estimate that at least 10 million doses will need to be created just to handle all public and private health, medical, police, fire, and emergency personnel. Tens of millions more doses would have to be generated if a majority of the public volunteers for the program.
Hold on just a moment. When was all of this decided? Was I abducted by aliens and missed the public debate? Smallpox was eradicated by 1980. What’s going on here? Terrorism, that’s what; or, more precisely, the fear of terrorism. That fear, in fact, has been in the driver’s seat since 9/11. A single shoe-bomb incident now means we all get to disrobe our feet in front of airport strangers.
Smallpox, it seems, would make a horrific weapon of mass destruction for terrorists. Between 1880 and 1980 it killed about half a billion people — more than all the deaths in the two world wars combined. So, yes, smallpox could be effectively employed as a deadly weapon by Iraqi or Al Qaeda operatives against Americans.
Then again, they could also use anthrax, or half a dozen other biological weapons. They could go with chemical weapons, even nuclear weapons. Heck, fertilizer in a cargo truck is pretty damn effective at razing a building to the ground. When did “we” the American public — presumably in charge of our own governance — decide which of the literally dozens of potential terrorist weapons should be targeted for protection? Given limited time and resources, are we really sure this is the most likely weapon to be used against us?
And we must bear in mind that the vaccination process is not without some risk. The smallpox vaccine is made from its weak biological cousin cowpox. When you are vaccinated with the weaker virus, your body develops an immunity to the stronger smallpox virus. So, in essence, you are purposefully making yourself slightly sick so that you do not later become deadly sick. Unfortunately, the system is not full proof. The Centers for Disease Control estimate that 74 people will suffer serious complications and one will die for every one million vaccinations given. Of the 130 million Americans never vaccinated about 2,000 would face life-threatening complications and somewhere between 125 and 250 would die. For the other 158 million Americans that may need revaccination, about 800 would be threatened with death, with about 40 succumbing.
These are not trivial casualty statistics. Although when compared to the roughly 30 percent death rate of an actual smallpox epidemic it may seem well worth the risk, what we do not know — or, at least, we have not been given the data from our government — is the likelihood that terrorists would or could use smallpox as a terrorist weapon. When told by experts and authorities that we are supposed to fear something, the natural human reaction is to believe them. But what worries me is what we are not being told to fear, or that we are being told to fear the wrong thing.
This is not a new problem. In the 5th century B.C. the citizens of the Sicilian city of Camarina were told by their leaders that they were being threatened by a disease pestilence festering in a nearby marsh. The city officials drew up plans to drain the marsh and rid the public of their newly discovered fear. The plague epidemic never hit and the citizens were grateful … until their enemies, the Syracusans who lived on the other side of the protective marsh, could now waltz across the drained land and conquer the Camarinas, which they promptly did.
Until we think through more carefully which threats are real and which are not, skepticism of the government’s program is a healthy response. Don’t drain the marsh until we know that is the best course of action.
This opinion editorial was originally published in the Los Angeles Times.