Thursday, April 30, 2009

PANDEMIC: Why you should take this seriously

“It is all of humanity that is under threat during a pandemic,” Margaret Chan, WHO director-general, said at a news conference in Geneva

Sounds serious doesn't it? That's why I am taking time away from my normal blogposts on historic preservation and restoration to speak directly to the readers of my blog, many of whom I have become friends with.

Many, MANY, years ago I worked for a State Department of Health, I worked in their Epidemiology Resource Center and my job was to do statistical calculation of "attack rates' and to determine those rates of transmission based on "clusters". Clusters are an group of individuals infected with a particular virus. Once you have cluster you can determine just how many people are likely to get a particular illness and based on that mortality rate' you can determine a 'guesstimate' as to the number of people who might die from that illness.

A NORMAL flu strain, one that we have medicine for, kills 36,000 people in the United States in a typical year.

So what ius a pandemic? Wella pandemic would be a category 5 flu. Now you may be asking what does that "mean"? Well there were guidelines created a few years back by the CDC a Five level system. The media is explaining this simply as a "guideline' for local governments as to how to "prepare" during a flu outbreak. What they are NOT saying is what this actually means. Here is from the guideline established a few years ago:

Category 1, which assumes 90,000 Americans would die, is equivalent to a bad year for seasonal flu . (About 36,000 Americans die of flu in an average year.) Category 5, which assumes 1.8 million dead, is the equivalent of the 1918 Spanish flu pandemic. (That flu killed about 2 percent of those infected; the H5N1 flu now circulating in Asia has killed more than 50 percent but is not easily transmitted.)

That's right, a category 5 means that we could expect 1.8 MILLION DEAD .

That is why you are seeing so many school closings, It is one of the first thing governments do. Unfortunately the Obama administration has chosen to downplay all this, not explain what this really means. In my opinion a serious mistake. Bear in mind that we normally see 36000 dead as a result of a NORMAL flu outbreak.

These numbers are based on projections from the 1918 Spanish Flue Pandemic that hit the United States and the world back then. That Pandemic killed 675,000 in the United States and 40 million worldwide, more than died in the first world war. The pandemic ran over 18 months and in basically 3 waves. The first was more mild wave. Interesting to note that Cincinnati fared better than most in the 1918 outbreak because many caught the milder form and that may have strengthened their immunity to the more virulent stains.

Today we have other factors that could affect the outcome in "worst case" scenarios. Americans are older, we have a significant elderly population now and we have a large population of people with HIV , many of whom not tested and unaware that have a compromised immune system.

We can "hope' this new flue strain mutates into a milder less contagious form. However it could do that and then re-emerge as a much stronger form. Nobody knows and the next few days and weeks will determine which direction this may be headed.

What we "may see':

Cities close schools for up to three months in the event of a severe flu outbreak, ball games and movies and all events canceled and working hours staggered so subways and buses are less crowded. Anyone sick sent immediately home and those in contact sent home for a week to 10 days.

Such measures would hugely disrupt public life, but the argument is that these measure would buy the time needed to produce vaccines and would save lives because flu viruses attack in waves lasting about two months.

The World Bank, in a worst-case scenario published in October 2008, said a flu pandemic that’s similar in scope to the 1918 outbreak known as the Spanish flu could kill 71 million people worldwide and push the economy into a “major global recession” costing more than $3 trillion.

So if you now may understand how serious this really is, and I hope you do. The next question is what do you do?

Common sense.

Avoid large events in the short term until we know where this is headed. Avoid your exposure to "public places" Fast food places, grocery stores things like that. Buy soda in cans not from fountain drinks at the gas station. If you are going to the grocery bring antibacterial wipes with you to wipe down the handles of the carts. You should have a supply of these on hand also hand sanitizer. If you have children or elderly in your house Hand Washing is critical!

Food: There could be short term food shortages. Make sure your pantry is well stocked with canned goods, especially "one can" meals. You should be treating this like being prepared for a natural disaster like an earthquake or hurricane. Think about the things you would need for that and apply them to this situation.

Gasoline: Fill your car and try to keep it reasonably full for the next few weeks at all times. If this goes bad, fuel could be in short supply not to demand because people will stay home but because production could be cut dramatically due to people sick or people staying home to avoid getting sick.

Medications: If you currently take medications make sure you have supplies on hand. Now would be a good time to make sure you have a good first aid kit. Hospitals 'could' be overburdened and could turn away non life threatening injuries.

It is better to prepare for the worst case than to not prepare at all thinking this will just "go away". If you become sick, go immediately to the hospital or your doctor. It will be critical that government knows where cases are so they can keep exposures to a minimum.

If this sound like I am overreacting, I am not. I understand the epidemiology of this kind of outbreak and I understand what can happen. I am more amazed that our Federal government is not coming clean with the American public about what to expect and is downplaying this. At least those that read my blog will know and I feel better for telling everyone the truth. Lets hope this moves to a mild strain or doesn't mutate, but you need to be prepared if it doesn't.

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