America’s Pandemic Plan
Last month President Bush was briefed on the 240 page federal pandemic plan and is expected to sign off on it within the next week. It is a surprisingly comprehensive, and sobering analysis of what would be needed if a 1918 style pandemic were to occur. While I’ve not seen the entire document, the overview of it indicates the government is looking to take care of the broad issues, and as it has warned, expects individual communities to solve local problems.
Not everything I’ve read makes sense. But that is to be expected. After all, this is a Federal Plan.
There is debate as to how to utilize our nations meager stockpile of antiviral medications, Tamiflu and Relenza. Right now, we have 5.1 million courses of Tamiflu on hand. The goal is to secure 21 million doses of Tamiflu and an additional 4 million doses of Relenza by the end of this year. By the end of 2008, they hope to have a total of 51 million doses.
What is not mentioned is their definition of a `dose’. For a regular influenza, a dose is anticipated to be 10 pills of Tamiflu (2x day for 5 days), but recent studies have indicated that a much higher dose will be needed, as much as 4 pills a day for 10 days, to combat the Avian flu. If the lower dose is being used for these calculations, then we really can treat 1/4th as many victims as the planners indicate.
But of more concern is the discussion of withholding Tamiflu from front line personnel and reserving it for people who have contracted the disease. Many doctors and nurses, firefighters and EMT’s have been told, up till now, that they would receive prophylactic doses of Tamiflu while they were being exposed to the disease. This reversal will probably not set well with them.
It’s not an easy decision, of course, and the science behind it may be valid. But telling front line personnel that they won’t receive the protective drug until they fall ill may induce many of them to walk away from their jobs. Getting health care workers to go into the breach will be tough enough without this bit of back peddling.
Other major points of the document include increasing the capacity of the Internet so that more people can work from home, and children can receive their school lessons. The overview doesn’t say how they intend to do that, but if they can, it is probably a good idea.
The Veterans Administration is preparing to provide `drive-by’ clinics where flu patients can be evaluated in their cars, given meds, and sent home. I expect that may become a trend in other hospitals as well.
The Pentagon, fearful of supply chain disruptions, is stockpiling latex gloves and other supplies.
Even the Treasury Department is looking to contract out the printing of our currency to other nations if our own mint is unable to function due to absenteeism. This one, I have to admit, worries me a little. If our printing presses are offline, the likelihood is that the same will be true in other countries. And I’m hoping the government is not looking to hyper-inflate our economy out of debt, using the flu crisis as justification.
Paper money, which is passed from person to person, is likely to be a vector for the virus. Having more paper money on hand may not be the wisest move, but I’m sure they expect major runs on the banks, and since there is less than 10% hard currency to cover the `wealth’ of our nation, more will probably be needed.
There are plans to open toll free flu lines, with nurses on hand to answer questions, so that flu victims can be treated at home. Another admission that the hospitals will be unable to cope. And the VA system of 153 hospitals is bringing in extra supplies; medications, equipment, food and water. According to chief public health officer Lawrence Deyton, "It's a few days' worth, not enough to last months."
The reality is, no hospital will be equipped to handle a pandemic.
There are plans to impose travel restrictions, dispatch the National Guard to major cities to handle `insurrection’, and contingency plans to bring in retired workers to fill the gaps when the absenteeism from the flu threatens an agencies ability to function. No word on how they will induce citizens to take the place of fallen employees.
Nowhere in this overview did I find any mention of providing food, water, or medical supplies to individuals or communities. Not that I expected that. It is clearly impossible. But for those who expect a FEMA truck to arrive in your neighborhood with MRE’s and bottled water during a pandemic, this should be a wakeup call.
Individuals and communities will clearly be on their own. The Federal Government will have their hands full keeping the Internet running, phone and electricity service intact, and maintaining some semblance of law and order in the big cities.
They obviously take this threat seriously, and admit going in, that they will be limited in what they can do to mitigate the effects of a pandemic. They talk of 1.9 million deaths in the United States, but obviously they fear it could be worse.
Citizens must accept the idea that, if a pandemic comes, they will be on their own. They will be responsible for feeding their families, caring for them if they become ill, and protecting their homes. The time to prepare for such eventualities is now, before the general populace wakes up.
Once that idea becomes firmly entrenched into the national conciousness, things could get ugly in a hurry.
