Thursday, November 8, 2007

Jericho: Pandemic Influenza

Many thanks to Shootfire1 for this valuable information.

You may ask, how will Pandemic Influenza effect me? I'm young and healthy. Influenza kills the very young, the very old, and the infirm. That's true with "seasonal influenza." Pandemic Influenza is different. Spanish Influenza killed children and adults in the prime of their lives in 1918. The exact death toll of that pandemic is unknowable, but estimates place the worldwide death toll at anywhere from 20 to 100 million. That was in 1918, when there were far less people in the world. It had about a 2% CFR (Case Fatality Ratio), which means that 2% of those infected died. The best guess of scientists is that Avian Influenza currently circulating in Asia, Africa, and the Middle East with human cases, and in Europe with sick birds, is a likely candidate to go pandemic. Indeed, it is considered by WHO (World Health Organization) to be the single greatest threat to public health today. At present, its CFR is 75% among 10-19 year olds. The CFR decreases gradually with age, with the elderly being at least risk of death. The numbers are still very high for all age groups, much higher than Spanish Influenza.

Next you may think, "but medical science has changed a lot since 1918." That's true. Yet there still is no cure for influenza. We have vaccines, but even they are not foolproof. They are based on the best guesses of scientists as to which influenza strain already circulating will be the biggest problem in a given year. The vaccine has to match the virus. If the virus changes, the vaccine may be useless. Even under the best of conditions, there will not be enough vaccine to protect everyone once a strain achieves the ability to go pandemic. Relatively speaking, very few people get influenza vaccinations every year. Therefore, the infrastructure does not exist to manufacture the mass quantities of vaccine necessary to vaccinate everyone, once the virus has become a pandemic strain. It would take 6 months to develop a traditional vaccine, and even then vaccine would not be available for everyone. Vaccinations would be reserved for those in critical positions, whose skills are needed to maintain infrastructure. We have a lot more advanced ways to treat the symptoms of influenza now, like ventilators. Unfortunately, there aren't enough ventilators to go around. Our local hospital has a total of 75 beds. Ten of those are ICU beds with ventilators available. Our town has 33,000 people. If only 1500 were to become sick in a wave, the current CFR would seem to indicate at least a third of them would need mechanical ventilation. They would also probably need it for more than a day. We do not own 500 ventilators. Difficult choices would need to be made about who gets a ventilator and who doesn't.

What does this have to do with preparedness? How can I possibly prepare for a pandemic? Well, there has been a lot of research on the likely consequences of a pandemic. Because of expected high rates of absenteeism, you can expect supply chain disruptions. These supply chain disruptions may be extremely pervasive, even effecting local utilities. Where I live, 50% of our electricity relies on coal. If coal miners, transportation workers, and utility district employees are absent due to personal illness or sick family members, there could be serious interruptions of service. A failure at any or all of these supply chain points would be devastating. Then think about all the people it takes to produce the groceries at your market, to transport them to the market, to put them on the shelves for you to buy... Now, imagine if only half the normal number of people reported to work for an extended period of time.

HHS Secretary Michael O. Leavitt is on the record, repeatedly stating, "pandemics happen." He says there is no reason to believe that one will not happen again. What has changed the most since 1918 in our society is not the ability of healthcare to deal with a pandemic, but with our economy's ability to cope. Since 1918, we have developed a "just in time" economy. We go to the grocery store once a week, or more. Stores rely on shipments nearly every day to keep their shelves full. Hospitals operate at near peak census every day. The supplies on hand are what they need, not what they would like to have in case of a large and extended surge of patients. Indeed, when PPE (Personal Protection Equipment) like N95 respirators, gloves, and isolation gowns run out at the hospital level, the majority of nurses asked at say they would stop coming to work. We have to be prepared to provide care for sick loved ones at home.

On average, a pandemic strikes three times per century. The last influenza pandemic was in the sixties, and it was unusually mild. We are overdue. What's more, we don't store food the way our parents and grandparents did. We are more dependant on municipal water sources, which also rely on just in time deliveries of the chemicals required to make them safe to drink. Storing food and water should be on everyone's minds. The Federal Government has spoken on this issue. Any local government that depends on the them to be a lifeline if they don't prepare is "tragically wrong." The government will not be able to meet your basic needs in the event of a severe pandemic.

Everyone should consider storing food, water, medical supplies, alternate sanitation, means to prepare food, and maybe even a personal supply of PPE. (WHO guidelines recommend at the minimum N95 respirators.) If you haven't done so yet, you should look at your preps to see if you should expand them to cover the specific threat of Pandemic Influenza. Many scientists who are experts in pandemic influenza are making personal preparations. Perhaps you should, too!

There is an important piece of legislation coming up for discussion at HHS.

These discussions are critical to how funding is spent. It is my opinion that informing the public of the facts needs to be adequately funded. Preparing for a pandemic has to begin at the individual level, and people will not do that if they don't have the facts. Many agencies are hesitant to get the message out there because they think the public will panic. Risk communicators everywhere are struggling with how to inform the public in a way that will get them to take action without causing a panic. On another front, there is a certain political stance that is quick to point to disaster planning as fear-mongering. Unless the informed make their voices heard, a great many people will never see this coming.

DIGG chat in Jeritopia

Friday - November 9th - 10 PM est

Everything you always wanted to know about Digg,
but were afraid to ask.

Yes, this is a Jericho chat room but everyone is welcome. You will have to register. Come see why Digg is so important to every fan of every show.

We will also be discussing having a Digg Day with the theme broadened to include topics of importance to and provided by multiple fandoms.

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