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An image of the virus that causes yellow fever

An image of the virus that causes yellow fever, a disease found primarily in sub-Saharan Africa and tropical South America.

Planning and politics of epidemics

Conferences take aim at epidemics as they affect businesses and the social fabric

By Deane Morrison

February 14, 2006; updated February 15

With its concentration of experts in such areas as epidemiology, humanities and public policy, the University has taken a lead role in efforts to plan for a possible influenza pandemic, and two conferences this week will transfer the benefits of that expertise to the business community and the public. University and business leaders will wrestle with tough questions, such as how one keeps a business running with 20-50 percent of employees out sick, during "Business planning for a pandemic influenza: a national summit," a one-of-a-kind conference yesterday and today at the Minneapolis Convention Center. At a second conference, "Epidemics in the making: politics and the production of infectious disease," to be held tomorrow and Friday, conferees will gather in Nolte Center on the Minneapolis campus to examine the history of epidemics with the aim of preventing race-, class-, and gender-based discrimination in responses to future outbreaks of infectious disease.

The first conference grew from a realization by its sponsors, the University's Center for Infectious Disease Research & Policy (CIDRAP) and the U.S. and Minnesota Chambers of Commerce, that "private sector preparedness will be a pillar of any response to a pandemic," says CIDRAP director Michael Osterholm. "CIDRAP and the chambers of commerce have recognized that this is an international, national, and regional issue. We serve as a neutral location for government and business to come together and share experiences, concerns, and plans for the future."

The companies attending represent nearly $3 trillion in annual revenue, so keeping them functioning during a crisis has obvious advantages. A major goal of the summit is to identify areas of weakness in business preparedness plans, which will then become priority areas in future planning efforts.

Highlighting the summit will be a keynote dinner address Tuesday evening by Ted Koppel, who has maintained a longstanding interest in global issues through more than three decades of reporting. The former anchor of Nightline is now a managing editor for the Discovery Channel, a contributing columnist for the New York Times, and a regular commentator on National Public Radio.

CIDRAP will continue disseminating information about the looming flu pandemic through its Web site--www.cidrap.umn.edu--DVDs, and other means, Osterholm says.

The second conference opens Thursday evening with a keynote address on "The politics of infectious diseases: global surveillance and early warning systems" by Stephen Morse, a professor in the Columbia University School of Public Health and Department of Epidemiology. On Friday, Susan Craddock, a University professor of women's studies and global studies, will moderate both morning and afternoon panel discussions featuring experts in a variety of fields from the University (including Osterholm), pharmaceutical giant GlaxoSmithKline, the Minnesota Department of Health, the American Public Health Association, and elsewhere.

"People are concerned about avian flu, and the conference is designed to answer those concerns," says Craddock. Topics include progress to date in vaccine production, how a possible quarantine would be handled and whether it would take away civil liberties, and how hospitals can handle emergency care.

"Also, epidemics aren't just the spread of pathogens, but social and political phenomena as well," says Craddock. "In my work on epidemics in San Francisco, I found that Chinatown was targeted during a plague epidemic. The reigning department of public health people drew a line around Chinatown and quarantined that area. A judge said they couldn't do that, it was racializing the epidemic.

"We need to examine cases where discrimination was blatant. Are we adequately training and scrutinizing public health people not to quarantine some and not others? Those with the least means of escaping tend to get left behind and bear the brunt of epidemics." During a 19th century yellow fever epidemic in Memphis, people able to escape by train spread the disease, Craddock says. She says that with authority for enforcing rules to contain an epidemic invested widely, not all public health professionals and police will be equally well trained, and some will find the rules confusing. Therefore, planners must be alert for this situation and work to prevent mistakes because they can still happen, even in this day and age.

Other questions to be raised concern vital matters such as who will have access to limited supplies of vaccines or the drug Tamiflu.

"Even with the best criteria, you would be saying some people are more valuable than others," says Craddock.

Panelists at the conference, which is sponsored by the University's Institute for Advanced Study, are coming with no prepared remarks, she says. Discussion and debate with the audience will be welcomed. The idea, says Craddock, is to study epidemics from a broad range of perspectives and keep the discussion going on campus after the conference is over.

Read more on the first conference at http://www.cidrap.umn.edu. More on the second conference is at http://www.ias.umn.edu/symposiumcal.php.