# 278
Should the H5N1 avian flu virus erupt into a pandemic in the next year or so, our defenses against it will be inadequate by nearly every measure.
The Federal Government’s numbers on a potential pandemic, which are considered very optimistic by some, indicate we could expect a 35% attack rate, with a 10% hospitalization rate, and a 2% fatality rate. That works out to 105 million stricken with the virus, 10 million hospitalized, and 2 million dead.
We face an acute hospital bed shortage. There are roughly 1 million hospital beds in this country, 90% of which are occupied at any given time, leaving at best, 100,000 open beds to handle 10 million patients.
Aside from the beds themselves, we will face an acute shortage of nursing and healthcare workers, along with ventilators, antibiotics, IV’s, and protective equipment.
There is no pandemic-strain specific vaccine. Here in the U.S. we have about 8 million doses of a pre-pandemic vaccine that might confer some protection, but as it’s based on an older strain of the virus, how effective it would be is unknown. Eight Million doses will cover just 2.66% of the population.
The most optimistic estimate is that it would take 6 to 8 months before the first limited supplies of pandemic specific vaccine would be available, after the pandemic begins.
Tamiflu, the much-lauded treatment for avian flu, is in very short supply. The Federal government currently has roughly 20 million courses of Tamiflu stockpiled. Each course assumes 10 pills over 5 days, which has been questioned as being inadequate by some doctors and researchers. The best-case scenario is we have enough Tamiflu to treat 6.66 % of the nation. It is far more likely we have enough to treat half that number.
Absenteeism is expected to run 40% (again, an optimistic number), and will likely result in severe interruptions in the supply chain. This means that deliveries of food, fuel, and medicines may be disrupted. The average American family is currently unprepared for any prolonged interruption in their ability to acquire food or other essential items, and many may find that community quarantines, or the closure of stores will place them in an untenable situation.
The Federal Government’s pandemic plan leaves most of the actual burden of dealing with a pandemic up to the individual states, and the response from the states has been uneven at best. While many states have prepared elaborate pandemic plans, most are long on charts and graphs, and are short on substance. A few states are still working on their plans, but are `confident, if a pandemic comes, they will handle it’.
I’m not encouraged by those statements.
Even among states that claim to have a well-designed pandemic plan in hand, I see more smoke and mirrors than anything else. Vague assurances that they are `looking at ways to reduce the effects of a pandemic’. They’ve formed committees, and are holding meetings. Reports will be issued, I’m confident, at some point in the future.
Nearly every state has held, and points proudly to their rapid vaccination drills. Never mind that a vaccine for the general public probably won’t be available until a year into a pandemic. Drive thru vaccination drills inspire public confidence, and that’s all that really matters.
As inadequate as the plans are on the State level, they are almost non-existent on the local level in most communities. For the most part, city and county health departments (with a few notable exceptions) are waiting for guidance from their states on how to proceed. And in most cases, there is no guidance, other than to say nothing.
City and county governments are relying on their health departments to `handle’ a pandemic, and conveniently ignore the problem.
Given the statistics I laid out at the beginning of this essay, I understand the reluctance of authorities to talk about the problem. It is easier to pretend everything is fine, and pray the problem goes away. No one wants to go public and tell the people just how poorly prepared we really are, should a pandemic begin.
And yet, that is exactly what needs to be done.
The only cure for a pandemic is a local response. The Federal government can do only so much, and has admitted as much. States can oversee the larger picture, but can’t micromanage what happens in local communities. It will be up to each county, city, and town to deal with a pandemic, should it come. Mayors, city councils, and county commissions need to be working on this problem, and taking it seriously.
And so far, for the most part, they aren’t even included in the planning.
Cities and counties, of course, have limited resources. The only way they can cope with a pandemic is if they can coordinate civilian volunteers. That means civic organizations like the Rotarians, Kiwanis, Elks or the Chamber of Commerce. It means church groups, the Salvation Army, and the local chapters of the Red Cross. And it means citizen volunteers of every stripe.
But it's more than a year into the planning stage for a pandemic and that message has yet to filter down to the local level.
We’ve excluded the very people that will have to deal with the problem, in the interest of not alarming the populace. A very good plan, as long as a pandemic never comes.
The time has come to admit, publicly, that the State and Federal government needs the help of its citizens to combat a pandemic. It’s time to come clean, and admit our vulnerabilities, and ask for help. There are a thousand things that ordinary citizens could do to help mitigate the effects of a pandemic, and many would step up and volunteer, if asked.
If we had volunteers, what could we do?
We need to be holding classes in every town on home care of flu victims, proper infection control, and ways to reduce the transmission of the virus. Too alarming? I don’t think so. During the 1960’s, schools routinely handed out civil defense brochures to kids on how to build fall out shelters and on radiation poisoning. It didn’t destroy our psyche then, I doubt that pertinent flu information would today.
Volunteers could be working on setting up neighborhood watches, so that everyone could be checked in on during a pandemic. Distribution centers could be assigned, so that when needed supplies are available, volunteers would know where to go to help distribute them. Training sessions should be held, and those with special skills identified, so that each community would know in advance, what their assets are.
Nursing homes and hospitals will need relief workers. Not everyone’s cup of tea, I know. But there will be some willing to volunteer to do that sort of work. They need to be identified, and trained.
The advantages to raising the alert on the local level far outweigh any disadvantages. Sure, some people will worry. They should. A potential pandemic is a worrisome thing. Ignoring it doesn’t make it go away. But most will grow used to the idea, and actually prepare, mentally and physically. They will take the recommendation to stockpile essential food and medicines seriously, and by doing so will remove a tremendous burden from the relief workers during a pandemic.
Even if a pandemic doesn’t come, every community would be better prepared to withstand a crisis, whether it be a hurricane, earthquake, tornado, or flood. The big upside to all of this is we have a real opportunity to begin to act like a community again, to have real regard for the health and welfare of our neighbors.
Our government, at all levels, bemoans the fact that Americans don’t trust them.
The first step in establishing that missing trust is for the government to show a little faith in the American people, and level with them. Treat them like adults, not children.
A radical idea, I know.
But it’s one we'd be better off embracing sooner than later. While there's still time to make a difference.
