Timeline of UK media coverage of the mutated H5N1 bird flu

Avian H5N1 Controversy on Dipity.

In September last year a research group lead by Ron Fouchier from the Erasmus Medical Centre in Rotterdam, announced that they had succeeded in mutating the bird flu H5N1 into an easily transmitted avian form at a conference in Malta. It took only five mutations to make the bird flu easily transmissible amongst ferrets, the usual animal model used in virology studies. This would probably mean, that the virus could transmit easily between humans as well, through sneezing and coughing. Another research group led by Yoshihiro Kawaoka had done similar research at the University of Wisconsin Madison and had succeeded in making the avian bird flu too.  

In late December Fouchier sent his paper to Science and Kawaoka sent his to Nature to get published. The papers both included methodology sections, as science papers do, so that other scientists can replicate and do further research on their findings. At this point, on the twentieth of December to be exact, the NSABB released a statement voicing concern about full publication and proposed instead a redacted version in which only the main findings and conclusions were included. This lead to several news papers running articles about a dangerous 'killer' flu and dangers of bioterror. On January, Science and Nature co-released a statement from Fouchier, Kawaoka and the 36 co-authors announcing a 60 day suspension on all avian H5N1 research.

The recorded mortality rate of bird flu is 50%, a truly alarming number. The Spanish Flu that killed between 20 and 40 million people in 1918 had a mortality rate of 1-2%. Most news articles make this comparison. However, as the rate is based upon hospitalised and tested patients, it is probably a lot lower in reality. 

Because of this high mortality rate and that it takes only five mutations to make the wild form into the easily transmitted form caused fear that it could be used as a weapon of bioterror. Hence the proposed omission of methodology. This is a somewhat flawed argument, as a release of the mutated form would cause a pandemic that would be hard to contain and spread throughout the world, so the ones using the avian H5N1 as a weapon would be in as much danger as the rest of the world. Many virologists argued as well that a redaction will not constrain the knowledge of how to make the avian H5N1, as it was announced back in September at the conference mentioned above. 

One thing that speaks for publishing the papers in full is that it only takes five mutations to make it into the avian H5N1. This could happen in nature and poses a lot larger threat than bioterror. That researchers have succeeded in making these mutations occur before they have happened in nature puts them one step ahead of the virus. This means that we are now aware that it is possible through just a few mutations, and gives us the chance to prepare vaccines and improve infrastructure to cope with the virus. 

A conference with the lead scientists, representatives from the NSABB along with other expert virologists and bioethicists at WHO's headquarters in Geneva on February 17th and 18th concluded that publication should be postponed but published in full. Due to the high concern and amount of public fear they want to first sort out security questions concerning the research before publishing. But they will eventually publish both papers in full as they deemed it most beneficial for health. 

Clever Pills - right or wrong?

When someone mentions clever pills, the first image that pops into my mind is Bradley Cooper getting supernaturally smart in Limitless just by popping a pill now and then. However, that is far from possible pharmacologically (sorry, don't get your hopes up for getting a best-seller published, controlling the stock market, and become CEO of a major firm without any work but taking a drug).

But it is possible to enhance your mental capacity. Just think of how many cups of coffee a day you drink, and how hard it would be to wake up without it and it is easy to see that some of these substances are already very much in use and culturally accepted (apparently coffee is second only to oil as the world's largest commodity!). Caffeine is just a mild substance that slightly improve our wakefulness. Other drugs, like Ritalin, improve concentration skills in a much more significant way. It is given to people with ADHD, but it would improve anyone's concentration just as much. So we should start thinking about policy issues on these mental enhancing drugs. Should everybody have the right to take a drug like Ritalin?

I recently went to a talk at the Wellcome Collection in London about exactly this issue. The speakers were James Rowe, a neurologist from University of Cambridge, Bennett Foddy, researcher of bioethics at Oxford, University, and Simon Wessely, psychiatrist from Kings College London. They were all in agreement that we are a very far way from making people geniuses but that it is important to make clear policies already now. At best, they can give us a nudge. And it turns out, that people who are already smart are the least affected. Rowe explained the ethical problems very nicely. People are pretty clear on the rightness of using mental enhancing drugs when it comes to treating people with psychological disorders. In this case, the drugs would only give back what an illness has taken away. Most are just as clear on the wrongness of taking mental enhancing drugs for opportunistic effects, like using them for winning 'Who wants to be a millionaire'. Using drugs for opportunistic purposes can be equalled to using doping in the sporting world. The difficult part comes when addressing the middle grounds. Is it okay for a surgeon to use a concentration improving drug before going into surgery? How would the patient feel, or better yet, how would you feel as a patient, if you knew your surgeon was taking drugs, before conducting your surgery? How about university students? Couldn't you argue that by taking a concentration improving drugs that students would get the maximum out of their degrees, if it helps them learn more? On the other hand, as universities are a competitive place, where people with the best degrees will end up with much better possibilities on the job market, is it really fair that people willing/able to take drugs get an edge? Plus a million other situations in which you could argue equally for and against using clever pills. Those are the tough questions and the ones that need to be addressed. I think everybody should think about them as it could influence our society at some point. There is no clear answer. I have thought about it for the past week, and I'm still very conflicted. And I don't think I will ever come up with a clear answer.

So would do you think, clever pills, right or wrong? Would you take them? Would you be fine with your children, friends, colleagues, competitors taking them?