FEAR FACTOR PT. 1

In my daily tour of the Internet Flu sites, I’m seeing an extraordinary level of panic being expressed, and with each day that passes, the tenor of the discussions are becoming more shrill. In one forum, I suggested that people consider volunteering to help out during a pandemic, and was immediately shouted down by a number of posters as being irresponsible for even suggesting it. THE ONLY SENSIBLE THING TO DO IS BARRICADE YOURSELF IN YOUR HOME FOR A YEAR! MAYBE TWO! LEAVING YOUR HOME PUTS EVERYONE AT RISK!

Why the visceral, almost violent response?

I’m no psychologist, but I can guess. These people have completely invested themselves in the idea of surviving in a post-pandemic world. Many have spent thousands, perhaps tens of thousands of dollars, preparing to barricade themselves in their homes for a year or more. For someone to suggest that it might be reasonable to leave their home, to help tend to the sick or provide some other community service, undermines their whole rationale for mortgaging the house to buy sacks of cracked wheat, automatic weapons, and full containment suits.

They believe that the air outside of their home will be filled with flu virus particles, and that even stepping into their backyard risks infection. They are buying expensive respirators, devising decontamination rooms, and are warning family members that if they leave the house once a pandemic alert is raised, they will not be allowed back in. At the very least, the returning family member will be forced into quarantine in the garage for a minimum of two weeks.

I’m sorry, but if things get that bad, we’re all screwed.

These folks have taken a potentially bad scenario and have made it much worse in their own minds. Avian Flu is a genuine threat, but right now, it’s only a threat. If it should become a pandemic, there is no scientific reason to believe that the flu virus will be so pervasive in the air that to walk outside is to risk contamination. These folks have morphed the flu virus into a Biohazard Level 4 threat, like ebola. Partially, I believe, because of the unusually high death rate associated with avian flu.

How then is the flu transmitted? What are the real risks?

The flu virus is shed by its carrier either through the respiratory system or through the digestive system. In other words, by coughing or sneezing, or by feces. The virus can remain alive on dry surfaces for as long as 48-72 hours, and has been detected in bird feces from between 6 and 35 days.

This is why hand washing is so important. We touch contaminated surfaces, like doorknobs or telephones, and we then touch our mouths, nose, or eyes, and become infected. Frequent hand washing has proven to be the most effective way to reduce the transmission of the flu virus. I strongly urge the use of hand sanitizers, even when we are not in a pandemic. We may laugh at Adrian Monk, but he would probably survive a pandemic.

The real bugaboo for most people is the idea that the flu virus is airborne. And here, there are a lot of misconceptions.

Yes, the flu virus may be expelled into the air when someone sneezes or coughs. If you are in close proximity, you could inhale these virus particles that are generally encapsulated in droplets of moisture. Droplets, however, are heavy. They do not remain airborne for very long. Minutes, maybe less. And the flu virus is vulnerable to UV rays from the sun, and desiccation. It will not float indefinitely in the air.

Ahh, people say. The virus can become aerosolized, and can `float’ without a droplet. There is some evidence that this is true. However, the virus cannot exist in this form for long. This is not anthrax, which can persist for decades. It’s a fragile organism. It has never even been shown that it can be distributed through ventilating systems in office buildings.

Simply put, if you stay away from infected people, and wash your hands frequently, the odds are you won’t get infected.

Obviously, the closer you come to an infected person, the higher the likelihood of transmission.

How close, is too close?

Indoors, sharing the same air, entering the same room with an infected person has some risk. Outdoors, my personal comfort level would be 30 feet. The use of masks, gloves, and gowns further reduces the chances of infection.

Medical personnel are exposed similar viruses every flu season. Some do catch the flu, but most don’t. They take routine precautions, and they are reasonably safe.

Yes, but couldn’t this virus mutate into some super contagious form we’ve never seen before?

The law of averages says: Anything that can happen, will. So yes, it is possible. And if that happens, the rules definitely change. But we have no evidence of avian flu becoming that sort of pathogen. To date, it’s been extraordinarily difficult to catch.

If a pandemic comes (still an `if’), we will probably be advised to stay home, avoid exposure, and only essential workers will be asked to report to their jobs. Restaurants, movie theatres, sporting events, and shopping malls will probably be closed. Public funerals may be outlawed. Indeed, entire cities may be quarantined, travel restrictions and martial law may be imposed. It will not be pretty.

But the odds are you can still step out into your back yard without undo fear. Is the risk absolutely zero? No. There is always some risk in everything we do.

Just remember, during the best model we have for a pandemic, the Spanish Flu of 1918, more than 70% of the country never contracted the flu, even though most of them were exposed.

The realities of a flu pandemic are bad enough. There’s no need to make it worse than it is.