# 1048
Although the news has been relatively slow the past couple of months, the rhetoric regarding a future pandemic has picked up. Remarkably, we are seeing more realistic talk about the potential affects of a pandemic, and our limited ability to deal with one.
Consider that, a little more than a year ago, health officials mostly talked of the `possibility' of a pandemic, while assuring us that one was neither imminent nor inevitable.
Today, `when, not if' is the mantra, and we are told that a pandemic is `possibly imminent and `virtually inevitable'.
Sure, that's a definite `maybe', and honestly isn't very predictive, but it does signify a change in tone. Official admissions have gone from `a pandemic could happen' to `it will happen' in the course of a year.
The only questions being, 1) when and 2) by what virus?
Health departments and hospitals are holding more frequent, and more realistic drills this summer than we've seen before. Last year, many health departments around the country seemed intent to see how quickly they could setup and dispense a `vaccine' during a crisis. The fact that no vaccine exists to distribute didn't seem to deter them.
This year, the focus is on triage, and promoting home care for flu victims. Health departments are openly admitting what flu bloggers have been saying for two years, that hospitals would be overrun in a pandemic, and most people will have to be cared for at home.
With the release of the CDC's NPI (Nonpharmaceutical Interventions) recommendations, it has become acceptable to talk about there not being a vaccine for at least the first 6 months of a pandemic and the need to ration the limited stockpile of antivirals.
Last month I carried this story on the Alabama Department of Public Health's pandemic exercise. The opening paragraph of this news article is surprisingly blunt.
Drill will simulate flu pandemic
Saturday, July 21, 2007
The Alabama Department of Public Health has scheduled an exercise at Garrett Coliseum in Montgomery on Tuesday to simulate an outbreak of pandemic influenza. The one-day drill will simulate a situation in which large numbers of people become ill. Only the sickest patients will be sent to the hospital, and home care will be stressed. An alternative care site also will be set up to care for influenza patients who have no caregivers. Finally, the exercise will demonstrate the distribution of antiviral medications to priority groups.
The Montgomery City-County Emergency Management Agency, Alabama Hospital Association, Alabama Department of Public Safety, local hospitals, American Red Cross, volunteers and health department staff from the Anniston, Mobile, Montgomery and Selma regions are participating.
A far cry from the `a pandemic is possible, but unlikely, and besides, we're stockpiling Tamiflu and vaccines' message of a year ago.
Fairfax County Virginia, a suburb of Washington D.C., recently mailed out over 400,000 home pandemic flu care guides, one to every residence in the county. The 17-page pamphlet, called "Caring for Yourself and Others: Seasonal and Pandemic Influenza," (PDF File) was mailed with grant money the health department received from the Centers for Disease Control and Prevention.
The York, Pennsylvania Health Department last week urged all residents to prepare for a pandemic by stockpiling a 90-day supply of food, water, and medicine. The State of Alabama has, in the past, suggested 60 days. And a number of regional health departments have issued recommendations ranging anywhere from 2 weeks to 3 months worth of individual supplies.
Slowly the message is evolving. More emphasis is being placed on each individual citizen's responsibility during a pandemic; to provide for oneself, and to care for oneself.
It is basically the same message that flu bloggers and flu forums have been promoting for nearly 2 years. That a pandemic, by definition, would be an overwhelming event that no government could adequately prepare for. That individuals must take some responsibility for themselves and their loved ones during a pandemic.
Add to all of this the increased number of PSA's running on local television and radio stations around the nation this summer, and the Pandemic Leadership Blog, and there does appear to be a change to the winds of warning coming from our government.
Now, does all of this indicate that something is about to happen? Does this signify that a pandemic is about to start?
Frankly, I don't think so.
I don't give our government that much credit that they would know, in advance, when a pandemic would start. I believe they are watching the signs, just like the rest of us, and they are worried by them, but have no genuine idea when, or if, a pandemic will start.
A pandemic could erupt at anytime. Today, tomorrow, next month, next year . . . we simply don't know. And I don't think anyone can know.
All we can do is prepare as if it is imminent.
And be grateful for each day that passes where a pandemic doesn't start.
