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Sustainable Medicine + Sustainable Development = Duty to Die

Illegal Aliens & EMTALA









Dr. Madeleine Cosman, Ph.D., JD
October 6, 2005

Could an Illegal Alien trigger a national disaster of contagious Bird Flu? Now in October of 2005, only 67 people have died from Bird Flu although millions of wild birds and domestic birds such as chickens have perished. What exactly is Bird Flu? How can a person catch it? What is the danger to America? Why does President Bush consider using the military in case of an epidemic of Bird Flu? Why do the Centers for Disease Control estimate that 207,000 Americans will die if we have epidemic Bird Flu?


Flu is the short form for medical influence. The word for the disease goes back to the Middle Ages in Europe when a medical catastrophe was thought caused by the influence of the planets on the bodies of people because of their horoscopes. In the grand interrelated scheme of the universe the celestial spheres were thought to influence every earthly act of weather, of people�s health, and the integrity of each individual body.

You were healthy if your bodily fluids (the four humors: blood, phlegm, black bile, and choler, that made the sanguine, phlegmatic, melancholic, and choleric personalities) were in harmony with the rhythms of the planets. So powerful was the heavenly influence that if your personal planetary conjunctions were out of synch with a disease (for example, you were born under Pisces or Taurus, not Sagittarius), you dropped dead because of planetary influence or flu!

Why is Bird Flu or Avian Flu a threat to people? For hundreds of years viruses that have attacked animals have crossed the species barriers and attacked people. Birds often have been the vectors that first had the deadly diseases. Viruses either first jumped from flying critters to mammals such as pigs and horses and then leaped into men and women. Or the virus simply jumped the species barrier and went right from bird to man. That is the current threat.


Avian Flu has been deadly to Americans for at least a century. In 1918 the so-called Spanish Flu (code name H1N1) killed 500,000 Americans. As a world wide pandemic it killed 50 million people. In 1957-58 the Asian Flu (code name H2N2) caused 70,000 American deaths. In 1968-69 the Hong Kong Flu (code name H3N2) killed 34,000 Americans. These were major public health disasters.

The current Bird Flu has the code name H5N1 that refers indirectly to the source of the horror. Viruses are canny clever microscopic beasts that try to make new and novel forms that people cannot fight and kill. Customarily we develop immunity or we can get a vaccine to stimulate immunity so that if a virus attacks we can fight it off, win, and remain alive to tell the tale.

Influenza viruses come in three types: A, B, and C. Our current threat comes from Influenza A that has two sub types identified by their surface proteins. Small shifts in these surface proteins change the nature of the virus and its potency to injure and kill. In the code names there is usually an �H� and an �N.� �H� stands for hemagglutinin. �N� stands for neuraminidase. The numbers stand for the variants.


No vaccine can be created until scientists determine which variety of virus is attacking. As in any war, we cannot overcome our enemy until we can name him. Just as in our current national war that we are fighting in Iraq, Afghanistan, and here in America, we shall never conquer our enemy unless we identify it as Islamo-Fascism. If we persist in stating we are fighting a war on �terror� we shall perish since terror is an emotion not an enemy. Similarly a war on �terrorism� also is doomed to failure since terrorism is a technique of changing politics by attacking innocent civilians, not soldiers. If we persist in refusing to name the enemy, we cannot win against a technique or an emotion. There is nothing to bomb, nothing to use our American high technology against. There is no military goal against which our perseverance, excellence, and ingenuity can be applied.

If we know our enemy and because of political correctness refuse to name him, then we intentionally sabotage our opportunity to win the war. We preemptively surrender to the enemy.

Likewise, no effective vaccine can be created against Bird Flu unless we know precisely which strain of flu we must fight. If H5N1 is the enemy, we must name it and use that information that reveals which type of antibodies must be stimulated to fight the viral assault.

Naming the enemy also tells us how to prevent and treat the virus with medicines. Some novel strains of the Bird Flu virus are resistant to the four drugs already powerful against Bird Flu.


If you have access to the Roche medication called Tami-Flu, that may protect you. Only about 2 million doses per year are produced. The government is considering stockpiling them for use only for first responders and the military in case of an epidemic in America.

Influenza H5N1 is resistant to two of the major drugs used to fight Bird Flu, amantadine and rimantadine. The H5N1 virus will be killed by proper use of oseltamivir and zanamivir. Tami-Flu, as you can tell by the name, comes from drugs related to these.


In his October 4 Rose Garden news conference to discuss his Supreme Court nominee to replace Justice O�Connor, President Bush answered an unrelated question about how he would handle the potential disaster of a Bird Flu epidemic. He favored the military rather than local and state responders because, as he stated, there would be necessary quarantines.

A quarantine is an official legal restraint on people entering and people leaving a particular place. A house can be quarantined and everyone inside prohibited from leaving and no one permitted to get in. A block can be cordoned off and similarly quarantined. A section of a city or an entire city or region can be quarantined. The idea is to keep the disease raging where it is and not spreading to the rest of the population outside the site of quarantine.

Quarantine is the medieval method for preventing the spread of contagious disease and through the centuries has led to murders of those who impose and maintain the quarantines. Naturally everyone inside the quarantine wants to escape, and those who are cordoned out of the place of contagion do not want to get near it, or accept products from it, unless their family or their valuables are inside.

Thought he did not state it directly, in essence the President implied that after the Hurricane Katrina debacle in New Orleans he learned that the military is superior to the local authorities in getting help to the needy. Therefore in case of a Bird Flu epidemic he would preempt the state and local officials, assure a declaration of martial law, and force people to be imprisoned in their quarantines with the force of the American military.


Details on our woefully inadequate national preparedness for a biological disaster such as a new Bird Flu epidemic are enumerated in the August 2004 document prepared by the Department of Health and Human Services called National Pandemic Influenza Preparedness Plan. It has four salient points. We must create excellent surveillance and detection. We must stimulate quick vaccine development and production. We must start anti-viral stockpiling. We must have vigorous research. Looks good!

But a year later and a year closer to disaster, we have nothing but theory. We are not prepared for Bird Flu or for most of the other known potential bioterrorist attacks on our beloved nation.

Epidemiologists speak about the phases of a worldwide illness such as Bird Flu. In the Interpandemic Phase, there is Phase 1, and Phase 2 where no subtypes of the Flu move from animals to people. Then there is the Pandemic Alert Phase that includes Phases 3, 4, and 5 in which some Bird Flu moves from the winged creatures to the human earthwalkers and then from person to person. In Phase 4, small clusters of person to person transmission of Bird Flu progress to Phase 5, in which larger clusters of person to person contact yields infections and deaths.

Next is the Pandemic, the world wide contagion and world wide devastation. We are at the end of Phase 4 on the cusp of Phase 5.

Centers for Disease Control experts estimate a MEDIUM Pandemic. What does that mean? Note these stunningly precise estimated numbers. Between 89,000 and 207,000 will die of Bird Flu. Between 314,000 and 734,000 will require hospitalization. Between 18 million and 42 million Americans will require medical visits. Between 20 million and 47 million Americans will be sick and affected by Bird Flu.

Customarily Flu outbreaks come in �waves,� with waves being 3 months to 12 months apart. Bird Flu outbreaks are usually �over� in about 2 years.

Extrapolate figures from this MEDIUM to a LARGE or HORRIFIC epidemic. The prognosis is grim.

My information from HHS and CDC is available to any who care to study HHS and CDC documents or consult their websites. A clever Islamo-Fascist terrorist does not even have to create his own weapon of mass destruction if he can simply steal a person with contagious Bird Flu and help him cross our open border with Mexico. Person to person contagion will do the rest.


We know that Illegal Aliens are bringing to America diseases we already had vanquished thanks to our excellent medicine and sanitation, and diseases of Third World poverty that rarely if ever were seen in America. I have reviewed many of these diseases in �Illegal Aliens and American Medicine,� published in Journal of American Physicians and Surgeons (Spring, 2005), and in essays on line on

Multiple Drug Resistant Tuberculosis (MDR-TB is resistant to at least 2 of the major anti-TB drugs) now has infiltrated 38 of California�s 61 health jurisdictions. Illegal Aliens have caused increases in Chagas Disease that now affects our blood supply. Dengue Fever, leprosy, malaria, polio, e-coli, and Kawasaki Disease all are resurging. When we do not know who crosses our borders, we cannot tell who is carrying what in his backpack, and we certainly cannot know what microorganisms he is carrying in his body.

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The threat from Bird Flu is extreme. We must guard ourselves against it. One excellent preliminary medical precaution is to close our borders against Illegal Aliens.

� 2005 Madeleine Cosman - All Rights Reserved

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Dr. Cosman is a medical lawyer located in California. Her forthcoming book in 2005 is Who Owns Your Body?: Doctors and Patients Behind Bars. She lectures worldwide on medical law and medical policy, has testified before Congress on medical law issues, and has spoken in Washington for Cato Institute and Galen Institute. She wrote the ABCs of the Clinton Medical World for Congress in 1993. A Director of California Rifle and Pistol Association, she writes "Guns and Medicine" for Firing Line. One of her 15 published books was nominated for the Pulitzer Prize, National Book Award, and was a Book of the Month Club Dividend Selection.

Madeleine promotes free-market, patient-centered medicine, and Health Savings Accounts.

Her J.D. is from New York's Cardozo School of Law, Ph.D. from Columbia University, M.A. from Hunter College, and B.A. from Barnard College. She is a member of the New York State Bar, New Jersey Bar, American Bar Association's Health Law Section, and American Inns of Court. Madeleine is Professor Emerita of City College of City University of New York and a Life Fellow of the New York Academy of Medicine.










The threat from Bird Flu is extreme. We must guard ourselves against it. One excellent preliminary medical precaution is to close our borders against Illegal Aliens.