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This website contains the entire novel—linked and illustrated—along with information on influenza and bird flu, an art gallery & opportunities to buy personal protection gear and cultural merchandise (including books, movies, and music cited by American Fever's blogger).



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Day 8: Fearsome Fomites Everywhere

The cat and I watch the neighbors—silhouettes outlined by big flat screens.

I make up lives for these human dolls. Earlier a bald man across the street looked like he was playing video games while a younger woman changed her clothes again and again. (She wasn’t naked—just kept returning to the mirror in fresh outfits that were almost clownish.) I figured she was vying for her heartless lover’s attention with clothes I might want to ignore, too. I watched with morbid fascination. Nah, more like boredom.

Regarding last night’s experiment: Since my girlfriend is proud of her gleaming incisors—and would rightfully and righteously have erupted had she seen my suggestion that she isn’t tending them—I’m certain she isn’t monitoring my posts. Sob.

MICROBES AT OUR FINGERTIPSMy flu buddy wants me to come to meetings about fighting H5N1 in the neighborhood. The organizers sound pretty liberal: They’re planning a demonstration against the way companies have been laying off workers for the pandemic. I agree that cutting off peoples’ health insurance and cash flow exacerbates the economic plunge and probably spreads disease. I hadn’t realized layoffs were such a key item in corporate pandemic contingency plans. Still, companies have the right to fire people, just as the unemployed have the right to not buy their products. Nobody marched when they took my desk away.

I’d rather not strain my voice and lungs yelling at capitalists. My mask would muffle everything. My girlfriend would miss me. Ayn Rand would curse me from her grave. So thanks anyway, buddy. (In case he’s keeping up here.)

Now, please, listen up. This is serious! Today’s lecture concerns fomites—doorknobs, light switches, pens, ATMs, or anything else that accumulates germs and viruses. (Even prayer books: God may be on your side, but do you really want a sneezing worshipper at your side?)

The average person with a simple rhinovirus cold leaves contagious particles on 35% of the surfaces he or she touches. Healthy fingers pick them up 47% of the time. Don’t rub your eyes in shock at this study. It’s dangerous.

While bacteria can multiply on fomites (even dust particles), viruses such as H5N1 must lie dormant on surfaces, basking in a special coat of fat they nick from our cells when they replicate. The stolen fat protects them till we reach out, acquire them, and then touch the vulnerable mucous membranes of our mouths, noses, and eyes.

Washing your hands really vanquishes virus. Just don’t fall for noisy ads pitching high-tech cleansers and antibacterials with impressively unpronounceable names. Some kill bacteria that keep our cells healthy, especially in our digestive tracts. Some contain Triclosan, which sunlight turns into dioxin after we rinse it into the sewer. In treated water, Triclosan also produces chloroform, which can make you dizzy and tired, damage your liver and kidneys, and perhaps trigger cancer. Specialized skin sanitizers aren't always reliable, either: Mike Coston blogged about a company whose skin-care products were seized for bacterial contamination.

If Your Soap Passes the Drug Test, It’s Not Soap

Stick to the old-fashioned stuff, which closely resembles the soaps invented and manufactured in Palestine and in Iraq back in the Seventh Century. (They even developed a special soap for shaving!) Traditional hand soap is superior. But be warned that a drug testing kit commonly used by police officers falsely detects the so-called date rape drug (Gamma Hydroxy Butyrate) in soaps from Dr. Bronner’s, Tom’s of Maine, and Neutrogena; it passed on other so-called soaps, proving they consist of detergent.

As Dr. Michael Greger explains in his Bird Flu: A Virus Of Our Own Hatching (read it online for free) hand washing doesn’t so much kill a virus as dilute it until it’s no longer infectious. Cool water is healthier, doesn’t dry out our flesh as much as hot water does.

So fight fomites! That’s all the authorities tell us. Don’t touch anything, wash your hands constantly, lest these fancy-sounding surfaces dose you. That’s exactly what they preached in 1918. There wasn’t much else to say. Oh yeah, wear a good mask! And gloves….

And goggles. Your eyes are viral portals, too. Wearing this gear keeps you from touching your mucus membranes with unclean fingers. (Sure, it itches sometimes, and many public officials— such as this former New York City Health Commissioner—think flu can’t enter through the eyes; read on.)

Wash things, too. All you need for a cheap, potent disinfectant is a tablespoon of chlorine bleach and a gallon of water. (Don’t use it on plastic, though; for that you need a milder disinfectant.) Hard surfaces nurture microbes much longer than porous ones do—as long as 24 hours—however counterintuitive that might seem. In other words, surfaces that take good fingerprints are the most dangerous. Scrub them fomites!

I miss shopping carts and subways. But I must be safe here at home … doh! The keyboard. My girlfriend uses it all day. It’s hers. What a fool I am.

Then again, we've got better ways to trade germs.


Day 9: A Trail of iPods to Hell

Closing the schools was a great idea on paper. (Even though, as a Brookings Institution report concluded in 2009, it could cost up to $47 billion in parent-worker absenteeism—particularly that of health-care workers.)

Everyone knows children are prime flu vectors. Once infected, they can take six days to show symptoms as they traipse from the playground to your kitchen and back to school before anyone notices a problem. Look at the 1918 mortality rates in St. Louis, where they quickly closed the schools, vs. those in Philadelphia, whose authorities ignored the plague. Philly’s peak was more than four times higher and ran far longer. Nonpharmaceutical measures made a difference.

SCHOOL BUSES: SHOULD THEY STAY OR SHOULD THEY GO?Highs and lows in the pandemics of 1957 and ’68 corresponded to the academic schedule, presumably because crowds of kids with fledgling immune systems help flu reach critical mass. Not to mention Wave II of the Great Influenza of 1918, when barracks of young soldiers exploded with disease, camp-by-camp, state-by-state. (Then they gave it to the German Army, which collapsed and lost the war.)

Today a ragtag army of bored students roams New York’s streets, trading germs and viruses like ringtones. They can’t shop in empty stores. There’s no work. No one’s organizing volunteers. (Everyone’s too busy waiting on the government.) Teens hang.

Kids and cops are the only people I spot from my window. I’m like a retired shut-in, thrilled when some delinquent wanders past with a cranked-up boom box. Most whippersnappers wear earbuds.

So some spirited college students decided to put on a campus show, an outdoor hip hop concert that would deliver pandemic education in the form of handouts and a speech or two. Typically, the police cut the power before this permit-less event could begin. Some mischievous performers started rapping peace lyrics, without amplification. The cops stood by.

Suddenly one of the singers quietly collapsed in the sunlight. The silence that followed turned into a long whooping roar.

Before the authorities could figure out that the rapper suffers from asthma, the audience had scattered for miles. At least 26 kids were injured in the panic. (Two passersby on the street freaked out and got run over.) A sophomore tumbled over a wall, broke her neck, and died before anyone spotted her crumpled like a doll on a pile of cinder blocks. Count her as the city’s (forever unofficial and uncounted) 37th bird flu fatality.

Lost iPods, tablets, and cell phones lay scattered across campus and down the streets, marking that sad stampede. Lots of shoes, too.

I fear it would be easier for New Yorkers to adapt if more of us were dying. All that’s happened so far is that a lot of people are laid-off, schools shut. The viral pace is too slow for a city that likes to get down and move on, to confront problems fast. I feel it myself, and I’ve always predicted a slow climb to catastrophe. This was a sad warm-up.


Day 10: An Outbreak of History, Mine & Ours

There’s lots of dangerous talk about mandating mass quarantines, which no credible experts think can fend off pandemic flu. Beware the kind of governmental exercise that makes uninformed people feel a crisis is coming under control.

Look at how quickly Florida’s National Guard occupied poor neighborhoods when H5N1 broke out in Miami. Was that a health measure? A bid to intimidate the locals? A kind of coded reassurance to the (distant) general public—a message that order will be maintained by any means necessary?

You may find this hard to believe, but the U.S. government and press ignored H1N1 in 1918. Although influenza wound up taking far many more lives than World War I did, the state had already mobilized to fight Germany. One enemy was enough.

SARS SHOCKED THE WORLD, HO HUMOn entering World War I in 1917, Washington suppressed free speech and seized thousands of newspapers. A Federally sanctioned private gang called the American Protective League worked with the Attorney General to spy on people and stifle dissent. Lest the pandemic distract the masses from the War Effort, American health officials insisted there was nothing unusual about that flu. No one mentioned or reported that U.S. troop ships embarking with healthy draftees were unloading their corpses in Europe—if they hadn’t already dumped them at sea.

Ah, but Spain was neutral. When H1N1 raged in Madrid—whose papers were allowed to report widespread death—the warring powers’ press discovered that a special flu had erupted there! ‘Spain’ became code for things that couldn’t be discussed. A global disease that may well have started in the fields and parade grounds of Kansas thus became known as the Spanish Flu.

From SARS to H5N1

A pathologist in Pittsburgh has asked what made me a flu bug.

It began with SARS. When the first case of Severe Acute Respiratory Syndrome was reported in New York, where all diseases turn up, I ordered paper N95 masks. The box didn’t reach me till the scare was nearly over.

 I started reading about viruses, beginning with Frank Ryan’s Virus X, a striking exploration of microbes and how the destruction of rain forests may be uncorking nature’s antipersonnel devices—viral bombs that defend species we’ve never even heard of. Plagues and Peoples by William H. McNeill taught me how disease has shaped and changed human society from the start. Jared Diamond covered some of this in Guns, Germs, and Steel, too. (These books and others I mention are now available for sale on my new Cultural Merchandise Page!)

I discovered that the doctors who first encountered SARS were terrified that it was something called H5N1, which I recalled had killed chickens in Hong Kong. (The story of SARS is vibrantly told in Karl Taro Greenfeld’s China Syndrome.) After reading John Barry’s excellent The Great Influenza, I realized that SARS had proved relatively easy to contain because victims showed symptoms before they went contagious. In the case of influenza, infectees spread it for days before falling ill—if they become ill at all. As many as half the people who carry seasonal flu may never show symptoms. They can pass it along with each breath and handshake.

Obscure Alarmist Makes Good—Finally

After my first year of investigating H5N1, friends stopped humoring me. People emailed articles disparaging my pandemic. Lefties said it was a conspiracy by the Bush Gang to profit from Tamiflu. (Successor Barack Obama’s portfolio prospered by holding shares in the same company—Gilead—though this didn’t bother anyone.) The right-wing John Birch Society called bird flu a scam “to justify expansions of government power and integration of nations.” Still, my favorite political comment was that the moral failings of liberals would cause H5N1 to kill more of them. Are party pollsters tallying fatalities yet?

After a few H5N1 alarms, pandemic fatigue set in. Americans don’t like to prepare for the worst; optimism sells. If you predict a catastrophe, it had better show up.

Then came the unexpected: swine flu. I stockpiled supplies, began filling orders, and got a Pneumococcus vaccination. (Half of all American seasonal flu victims die from pneumonia.) I took it very seriously.

Gradually scientists came up with lots of reasons why H5N1 would never turn contagious in the ways Pandemic H1N1 was thought to have done in 1918. Nothing fails like failure! Now that humans are finally receptive to H5N1, I look forward to the rush of studies that will explain why it happened.

 Now click on Graham Parker’s ferocious song about Protection.


Day 11: Be Afraid—Pneumonia Follows Flu

I’m sorry this comes so late. My roommate interrupted me with a mandate: We had to dress up as a couple on a blind date. She ordained no less than 150 minutes of uninterrupted improvisation while we drank. Excessively, I fear.

The first person to break character would have to spend a painful sum on anything the other wished to order online. No question she’d cash in. So, then, would I, even if it never arrives….

I wish I could remember the BS I came up with. She can fling it in her sleep. I fear I was predictable, an East Village guitarist trying to assemble a band. I wore sort of gothic clothes, black boots and cool hat. She began as a fetching, innocent out-of-towner, turned out to be a lass with a past. She loves to lure me to the dark side.

It was hard not to crack up, so she took the prize. Which she instantly spent downloading music. So I feel we both won. Pandemic Playhouse: A worthy game for quarantined adults!

I even found out why she doesn’t read my blog: She prefers to get her flu information “from the source’s mouth.”

Now for what I wrote so soberly before she refreshed my mind.

The Puzzle of Pneumovax 23

Readers ask about the pneumonia vaccine I mentioned. I don’t normally get flu shots because I prefer to rely on my natural immune response. The eggs in which they grow influenza vaccine haven’t been so receptive to avian flu, so I’m not optimistic about a timely H5N1 vaccine.

TIME-HONORED PRACTICE: FLU VACCINE IN MOTIONMan is already striving to dispense with the chickens. Companies are making flu vaccine via something called cell culture. The tobacco industry wants to grow vaccine in a certain leafy crop that’s losing its allure. And the corn industry wants to raise flu vaccine for humans and swine in stalks.

Maybe my youth makes me complacent. I share some of Bill Maher's suspicion that too many vaccines might weaken our immune systems. And I’m repelled by arguments such as this one, which compares people who decline vaccination to drunk drivers!

Still, I find Pneumovax compelling. Virtually every H5N1 case includes pneumonia, which is an inflammatory condition with many causes, not a disease. A third of all swine flu pneumonia deaths might have been prevented had the victims been vaccinated against bacterial sources of pneumonia. (The other deaths were caused by viral pneumonia, for which no vaccine exists.)

Since 2001, newborn Americans have been vaccinated against bacterial pneumonia, which globally kills two million kids a year. Merck’s Pneumovax 23 shot for adults is stronger, fights 23 different strains with few side effects. Then it can be boosted, reactivated after at least five years. What’s an adult not to like?

There’s a mystery. The government’s advisory committee recommends P 23 shots only for adults who are HIV carriers, are otherwise immuno-suppressed, or are over 65. Merck’s P 23 Web page recommends shots for immunocompetent (healthy) people 50 and older, says the shot should last up to nine years, and then fuzzes over the question of revaccination.

Part of the problem is that the shots have been around only since the 1980s and the data on the usefulness of boosters is limited. The policy solution seems to be have been to hoard the shots for old folks.

That might be a waste. As this blog entry by Mike Coston explains, a study in Edmonton showed no benefit to people over 65, compared with those who had not received it. This dovetails with evidence that older folks don’t show that much response to seasonal flu shots either. Maybe it’s all academic. Few people among the recommended groups bother to get Pneumovax 23.

Since none of this makes much sense, I insisted on getting injected in April 2009, when the news broke about swine flu in Mexico. The doctor wasn’t happy because I’m so young, but I’m pleased to have done it. P 23 is your call. Don’t sue me....


Day 12-13: A Good Turn Goes Sour in Brooklyn

I’m sorry I didn’t post last night. I won’t lapse again, as long as I’m healthy enough to type and the Internet is up to carrying it. Even in a blackout, I could post by candlelight with a charged laptop; my DSL would function like a telephone landline, albeit without a router.

I went on a mercy mission to someone I’ve known all my life. He’s a bit older than me. Without dwelling on the past, I’ll explain that he used to have a lot of problems, which he solved by stumbling into New York’s post-9/11 land rush. He found better highs peddling overpriced apartments than he’d ever nailed on the street. For a while, he was so manic his family suspected he’d gone back to dealing drugs after graduating rehab with multiple ‘degrees.’

He turned out to be much better at legitimate commerce than he was at mooching and scamming. You can’t snort real estate. Within a year he was dressing up to feed underweight models. He endorsed the kind of ‘conservatism’ that opposes state power except when you can use the government to confiscate people’s property. He thought Goldwater was a health drink with bling.

IMAGINE MEETING ME AT NIGHT....My old friend took to lecturing me about the slimmer salary I was making in my own profession. He shrugged off my warnings about a real estate bubble and for a long time he was right. Not even a vertical interest rate chart could dampen demand for his services. When subprime collapsed, he laughed. He wouldn’t have sold to those people anyway. He could move any high-end property. When foreigners stopped bidding, he caught a bounce doubling down on foreclosed homes in selected neighborhoods.

Having survived swine flu, the guy now sees the avian variety as a buy opportunity. He aims to grab some pricey apartments whose owners leave in a bag.

Even the carnage in the stock market fails to quell his bullishness. Bottom feeders, he says, will soon bid prices back up, as they did after 9/11. “Demand is demand,” he grunts, “and I am da man.” You get dizzy rolling your eyes around him. He doesn’t even notice.

My old friend has always been the biggest H5N1 skeptic I know. To start with, anything he doesn’t want to believe is plain wrong, and he couldn’t see how a plague would facilitate his flight to respectability. When the first New Yorkers caught bird flu, he ignored it. When it spread through the city, he blamed me.

Then he stopped calling or emailing. Though my girlfriend savored the hiatus (she despises him), I’ve been trying to reach him for a week.

Yesterday he phoned to ask if I’d bring him some masks, gloves, and goggles. He was more frightened to leave his apartment on the Brooklyn waterfront than I was to leave mine. He wanted a lot of gear for his girlfriend and their closest friends. As a courtesy, of course. He’s like family to me, as I guess they are to him.

I donned my protective gear and set out for the condo he acquired four months ago, a small space in a refurbished factory with a world-class view of downtown Manhattan.

Putting on Airs, Underground

On the subway, masked riders were trying to keep distant from those whose faces and hands were naked. Some can’t afford to take precautions. Do they resent their shrouded neighbors? Class divisions grow painfully awkward when they become matters of life and death.

I saw parents and children wearing masks like the ones I sell, others with paper masks, and some with nothing. On one platform stood a young couple with a toddler; each wore paper towels fastened with rubber bands around their heads. They knew and they cared. I wish their attitude could protect them.

I had to look away, clutching my big opaque bag of masks and gloves and goggles. I had even packed children’s masks for my friend’s girlfriend’s sister’s kids.

Adults avoided one another’s glances in those swaying cars. Only the children looked around. It was sad to behold their eyes; kids are rarely fooled. The defenseless ones knew the others had something they can’t have, something more important than a branded shoe. They looked about curiously, politely, helplessly. I wondered if the masked tykes had drippy noses, too. I wanted to make a speech.

There was nothing to say that hasn’t been said before. Nothing I believe could have made much difference to them now, on that train.

I wish I had quietly taken the rubber-band family aside and given them some gear. When the heart calls, it’s best to answer quickly. Or risk hating yourself all night. (In the morning, Ayn Rand will tell you it’s all right.)

I reached the condo late. Hard to imagine, but subway service has degenerated.

A House Infested I Couldn’t Stand

My friend’s girlfriend had been replaced. The one I knew worked for AmEx in human relations or resources or whatever they called personnel last month. She was pretty in a non-descript way (blonde-descript?), wore khakis, and left all controversy to my friend. I don’t think I’d have recognized her next to me on the subway.

The woman who greeted me at the door was memorable. She was younger, dark-haired, clad in a minimal lace bra. She sustained a pair of his boxers with willpower and cheek. A huge ink angel adorned her naked back, tattooed wing tips dipping to a place I tried not to stare at.

She had never heard of me or my charitable mission, though I’m sure she’s heard of American Express. My friend had gone out. She hoped he’d return soon. After about an hour, I realized she didn’t know him very well.

I regretted having taken off my gear. I couldn’t find soap in the bathroom. The kitchen was full of moldy cardboard takeout cartons and bugs you can see without a microscope.

My friend’s cell phone wouldn’t answer, but I couldn’t leave. Worried, I watched TV from a hard designer stool while she sprawled and slept fitfully on the giant leather sofa. She sniffled a lot. He never returned. At sunrise, I left the bag and went home.

As I scoured my flesh of microbes, scrubbing myself raw, I heard an eerie wailing. It wasn’t my cat. He was crouched on his sill in the bedroom, listening warily to what must have been a woman down the block, moaning in musical scales.

My girlfriend explained she’s heard it several times, always around 8 a.m.—unless I’m snoring. (A lie!) She’s lacked sympathy of late. This morning she was icy. Still is.