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Smallpox Apocalypse
by Tom Holsinger
July 22, 2002 A major smallpox attack on America would spiral overseas into the greatest catastrophe in history unless we resume preventive vaccinations. The epidemic would probably kill a tenth of the human race.
This is, fortunately, unlikely as the perpetrators would gain nothing. America would suffer among the least, while Muslim countries would suffer among the most. Terrorist states and extremist Islam will be annihilated, and not merely at American hands.
Smallpox is violently contagious with an unvaccinated 30% fatality rate. Survivors are disfigured. We have just enough vaccine for all Americans, Mexicans and Canadians. Perhaps one in a million will die from vaccination, while more will be disabled. Newer vaccines are safer. Rapid production of less effective vaccine using raw cowpox might be possible, but distribution in undeveloped countries during a world epidemic is problematic.
Last ditch protection is "variolation" - deliberately infecting people with smallpox pus - to create a less dangerous form of smallpox. This kills 1-2 per hundred. Speedy variolation of whole populations requires many existing victims plus great social discipline, and is least likely to work in undeveloped countries most in need of it.
The immune-impaired are far more vulnerable to infection but cannot be safely vaccinated. All infected will die.
Terrorists could start a smallpox epidemic here, without suicide volunteers, if Iraq helps or they obtain xSoviet smallpox. Weaponized smallpox powder reportedly drifted from an abandoned xSoviet biowar facility to infect the crew of a fishing vessel passing downwind. The unvaccinated crew died while all the vaccinated contracted smallpox, but survived. Smallpox powder is the nightmare scenario.
The best defense is mass pre-attack vaccination because the attack wouldn't happen due to being obviously futile. Voluntary pre-attack vaccination of just 10-15% of adults would vastly facilitate post-attack inoculation of everyone else. The vaccinated could maintain order and essential services while the unvaccinated hide in their homes pending inoculation.
The federal health establishment opposes even voluntary vaccination, contending it would kill too many people. Some other agenda is clearly involved given that the whooping cough vaccine mandatory for infants is as dangerous as existing smallpox vaccine.
That agenda is denial. They've spent their whole lives trying to eradicate smallpox, and can't adjust to 9/11. Obstructing vaccination lets them continue to deny that their life's work was wasted. Their institutional cultures and individual agendas mean they'll come up with other reasons against voluntary inoculation with emerging safer vaccines, and obstruct orders to permit it.
President Bush will have to spend too much of his time making a balky bureaucracy obey. Voluntary vaccination can only work if implementation responsibility is taken from federal health authorities, possibly by delegation to the states with funding. That would require Presidential involvement only once.
But the nightmare could start before then. Federal planners, excepting FEMA's Office of Emergency Preparedness, are clueless about public behavior in emergencies. They assume, as in Cold War plans, that people will act normally during the apocalypse instead of fleeing to the hills in panic, all without needing food, fuel, etc. Comical examples exist.
Post-attack inoculation will be additionally disrupted by 50+ million Mexicans surging here seeking vaccine not available in Mexico. That would magnify America's own panic, violence and collapsing civil infrastructure. All this is ignored so the federal health establishment can pretend their plan will work.
Worse, knowledge that they made the epidemic possible by obstructing pre-attack vaccination, repeated displays of politically correct federal stupidity concerning terrorism, and the arrival of millions of perceived infected Mexicans, will shatter public confidence. Americans will feel they must save themselves in defiance of a government whose incompetence caused the disaster. This is a prescription for chaos.
Fortunately the federal government is not our only government. State and local governments have always been our bulwark against disasters, and smallpox will be no exception. Additionally the American people will spontaneously organize themselves - consider Flight 93. We'll muddle through somehow, at higher cost, because we have enough vaccine, even for Mexico.
The rest of the world won't be so lucky. A significant outbreak here would unavoidably spread, including to countries where it would be unstoppable for lack of vaccine and social cohesion.
The leading disaster area will be sub-Saharan Africa due to AIDS. At least half its 500 million people will die. 10-15% fatalities of the 1.7 billion in India, Pakistan and the Arab world is not unreasonable. These areas' probable fatalities total 400-500 million, so 100-200 million more fatalities among the world's other 3.9 billion, mostly in Southeast Asia and South America, make 10% total smallpox fatalities worldwide quite possible. Most American dead - several million is reasonable if it starts here - will be immune-impaired, assuming most of the latter avoid infection. They might not.
There'd be hundreds million more dead from secondary causes - social collapse, genocidal nuclear attack on terrorist states, etc. The economic consequences would be ghastly. Most of the world participates in the money economy, unlike the 1930's, so the worst and longest depression in history would start.
Social effects would be awful too, notably here. Watching millions of us die horribly, with more millions disfigured, will scar America's psyche and self-image. Civil liberties and immigration would be savagely affected. Almost all Muslim immigrants would be deported - some would be lynched.
The American people will have a reckoning with Washington for wrecking the country by giving its games priority over our survival. Few in Congress will be re-elected, and President Bush would likely be removed earlier for "failure to perform his office".
Worse, public rage at all things federal would make significant Constitutional changes quite possible. Even an all-new Congress might not be trusted to propose suitable amendments. This could result in the states calling a second Constitutional Convention.
We might not be Americans afterwards, which would be terrorism's ultimate victory. The Bush Administration risks America's future by not letting us volunteer for smallpox vaccinations.
But that has its own risks. Next: DOING IT TO OURSELVES - Vaccination and the Immune-Impaired.
Tom Holsinger is a California attorney and wargaming grognard. He began writing for Strategy Page in April 2002 when Jim Dunnigan asked him to rewrite an email for publication. |
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