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Getting Ready for the Pandemic |
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Written On: July/August 2006 |
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Written By: by Paul Schlienz |
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No one knows when the next flu pandemic will hit the planet. Government, business and medical researchers are, nevertheless, busily preparing for its eventual appearance.
Pandemic flu is not to be confused with the influenza outbreaks that annually hit the United States during the fall and winter, killing approximately 30,000 people per year.
"A pandemic is an outbreak that spreads very rapidly around the world and is caused by a new or novel virus," Washington’s Secretary of Health Mary Selecky said. "It can happen anytime of year—not just the typical flu season."
In contrast to the usual annual flu, there is typically no vaccine for pandemic influenza, thus making it all the more deadly.
Although it has yet to appear in North America, H5N1, a lethal influenza virus that has its roots in Southeast Asian avian populations, has spread as far as Europe and Africa through wild bird migration. Although H5NI has so far only infected 225 humans—all of whom worked and lived in close contact with domestic poultry—128 (57 percent) of these people died. H5N1 is of great concern because it is rapidly mutating. Indeed, the World Health Organization fears that this virus could transform from a malady that is strictly transmitted by birds to one that is easily transmitted from person to person. If this mutation occurs, the avian bird flu will become a human pandemic.
Drastic Measures
Flu pandemics are nothing new. Over the last hundred years, the United States survived three pandemic flu outbreaks. The cost of these pandemics in lives and disruption to society was, however, very great.
Worldwide, up to 50 million people died—more than the entire death toll of AIDS over the course of its first 25 years—during the infamous 1918 Spanish flu pandemic. Of the 1918 pandemic’s deaths, at least 650,000 were in the United States. Later pandemics—the 1957 Asian flu (1 million to 2 million dead worldwide; at least 70,000 in the United States) and the 1968 Hong Kong flu (About 700,000 dead worldwide; approximately 34,000 in the United States)—were progressively less severe, but still devastating in their impact.
The 1918 pandemic profoundly altered the day-to-day lives of Americans from coast to coast. First appearing on the east coast after ravaging Europe, the pandemic rapidly spread westward until the entire United States was affected. Drastic responses were taken by communities from coast to coast.
In Spokane, all schools, theaters, places of amusement, dance halls, bowling alleys, and churches were closed. Conventions and other public meetings were banned. In order to avoid attracting large crowds, department stores were forbidden to hold special sales. Streetcars were prohibited from carrying more passengers than could be seated. Strict enforcement of regulations regarding ventilation, sanitation and spitting became the norm. Spokane’s stock exchange was also closed, and jury trials were suspended.
Although these measures may appear draconian, Spokane’s actions did save lives. Indeed, Spokane was able to keep its Spanish influenza death toll down to a low 1,045 out of 16,985 patients. Compared to other cities, including Philadelphia, where the mayor unintentionally allowed the virus to spread exponentially by refusing to cancel a popular parade, Spokane was relatively unscathed by the disaster.
If H5N1 or another avian virus becomes easily transmittable from human to human, U.S. public health officials may respond in ways that are similar to Spokane’s reaction to the 1918 flu.
"In a worst case scenario, as in 1918, business as usual would have to cease," Selecky observed. "Public health officials would have to take some dramatic measures, which we would not do lightly."
According to Selecky, such actions may include closing schools, urging elected officials to ban large public gatherings, encouraging shopping malls to cut down on their hours of operation, and urging members of the clergy to cancel their religious services.
Vaccinating the population would also be a major concern. While the federal government has developed a vaccine against H5N1, it is only mildly effective, stimulating an immune response only half the time in healthy adults. Unfortunately, the vaccine is difficult to make and probably not effective against emerging strains of the virus.
Then, if there was a vaccine, public health officials would be forced to choose who would receive it. Ironically, this might mean that the elderly, who are usually the most at risk from the annual flu outbreaks, would be last in line for a vaccine since some studies have suggested that younger populations would be more vulnerable in a potential H5N1 pandemic.
In the meantime, many countries and the WHO are preparing for a potential pandemic by stockpiling anti-viral drugs, including Tamiflu and Relenza, both of which are in short supply. It is dangerous, however, to view treatment with anti-viral drugs as a magic bullet. Production capabilities for these drugs are limited in the medium term, and some H5N1-infected individuals have developed resistant strains of the virus after being treated with Tamiflu.
Getting Prepared
Clearly, the potential for a pandemic flu virus is now on the government’s radar screen. The preparations of Washington’s Department of Health are only one facet of the pandemic flu planning that is now in motion in the United States.
In November 2005, the U.S. Department of Health and Human Services issued a plan for readiness and quick response in the event of an influenza pandemic. The plan includes:
• Intensified surveillance of bird flu and its spread.
• Collaborating on international and domestic
containment measures.
• Stockpiling anti-viral drugs and vaccines while working with industry to increase production capacity.
• Improving federal, state and local preparedness and increasing health care surge capacity.
• Developing public education programs and improving communications efforts.
On April 14, 2006, Gov. Christine Gregoire signed an agreement with HHS, committing Washington to coordinating its efforts with the federal plan.
"It’s impossible to predict when the next pandemic will occur or how hard it will hit, so it’s wise to prepare for the worst," Selecky commented. "We must all work together to achieve that goal—communities; businesses; schools; public health; and local, state and federal government[s]."
Business, indeed, does have a role to play in pandemic flu preparation. In recent months, AWB has taken a leading role in communicating the latest information on pandemic flu preparedness to Washington’s business community and the general public. A new Web page—www.awb.org/biz/pandemicflu.asp—with links to important Web-based pandemic flu resources was created.
For this Web page, AWB, along with Associated Florida Industries and Wisconsin Manufacturers and Commerce, which created similar pandemic flu Web pages, were recently honored by the National Association of Manufacturers for their use of the Internet to help raise public awareness of pandemic flu.
"AWB strives to be a portal between government and the business community," AWB’s Vice President of Operations Dick Walter said. "We’re trying to be an intermediary and bell ringer. Regarding pandemic flu, we’re saying, 'Pay attention to this. This is real.'"
Walter urges businesses to prepare for pandemic flu by:
• Stressing the need for employees to wash their hands, since the flu is carried by fluids that typically spread by the touch of a hand.
• Having supplies of non-prescription drugs at work sites.
• Sending home employees who exhibit flu symptoms.
• Considering how the business can operate if a significant portion of its workforce is staying at home.
• Considering working at home as an option.
• Having backup systems in place.
For more information on how your business can prepare for pandemic flu, Walter recommends that businesses consult www.pandemicflu.gov/plan/businesschecklist.html, a Web site operated by HHS.
Walter also stresses that individuals need to prepare for pandemic flu. Steps they should take include discussing with family members what will be done if they get sick, staying away from work if they’re sick, and keeping their children away from school if they are sick.
"Ultimately, we need to ask, 'What can I do?' rather than 'What can government do?'" Walter concluded.
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