Avian Flu Diary: Track Of The Cat

# 3302

It’s a scenario that Floridians, and many other coastal residents, face every year.

There is a threat out there; a category 1 – bordering on Category 2 storm.

It is still days away, and while it is moving in our general direction, it is possible (but unlikely) that is could dissipate or turn away.

Between it, and landfall, is a lot of very warm water, which can feed the storm and make it grow; perhaps to a Cat 3 or greater.

But there is also wind shear out there, that if great enough, it could tear the tops off the clouds and inhibit the storm’s growth.

You’ve got some lead time to prepare. What do you do?

Essentially, this is the same situation we now face with the novel H1N1 Swine flu virus.

It’s out there, and it is headed in our general direction. We are unlikely to escape the effects of it, although it remains to be seen how bad it will be.

There are many external factors that could affect the strength of the virus as it moves inexorably closer to us. Some of those factors could weaken it, while others could make it stronger.

Our ability to forecast these changes in intensity are extremely limited.

There is time to prepare – if we choose to – but the threat isn’t imminent. In fact, to many it seems quite distant.

By the time it is apparent when it will strike, and how bad it will be, it may be too late for many to do much about it.

So again, the question is. What do you do?

Pandemics (and we might as well get used to calling this virus a pandemic) are rated by the HHS like hurricanes. The mildest being a category 1 pandemic, and the worst being a category 5.

While the WHO is still trying to figure out how to implement a severity index, the HHS came up with one for the United States more than 2 years ago.

One that takes into account the possibility of a mild pandemic.

A Category 1 pandemic essentially has the same mortality rate as seasonal flu, but because it stems from a novel virus, it is assumed that 30% of the population (3 times normal) would be stricken.

Instead of the estimated 36,000 deaths we see in a normal year, with more people ill, we could see 90,000 deaths.

A Category 2 pandemic would be expected to produce between 90,000 and 450,000 fatalities in the United States.

With the high CFR (Case fatality Ratio) of bird flu, many people have been expecting a Cat 5 pandemic (which could still happen).

To some, in comparison, a Cat 1 or Cat 2 pandemic seems almost anti-climactic.

Of course, the residents of Galveston Beach, who are still cleaning up after Cat 2 Hurricane Ike, might take issue with that stance.

The point is, even if the H1N1 virus proves to be no worse than seasonal flu in virulence (and it is too soon to know if that will happen), it is likely to affect a greater percentage of the population, and that would amplify its impact.

As you can see, a strong Category 2 pandemic could be 12 times worse than our standard seasonal flu.

In a pandemic, young adults and children are often hit disproportionately harder than other age groups. To put it bluntly, even a mild pandemic could claim a lot of young lives.

Early (and likely incomplete) analysis (see More On The Ferguson Study) has put the CFR of the swine flu virus somewhere around 4 deaths per 1,000 infected.

What would normally be associated with a moderately strong Category 2 pandemic. Or roughly equivalent to the 1957 pandemic.

Whether this virus retains that virulence, or grows stronger or weaker, is something we can only wait to find out. Influenza viruses are unpredictable.

All we really know is that the threat is out there, beyond the horizon perhaps, but growing nearer. It has the ability to cause great damage, but it could weaken before it arrives.

It is impossible to forecast accurately. It could appear mild up until the very last minute, then flare up like a hurricane crossing the gulf stream just before it reaches the coast.

The question remains. What do you do?

Take it from a native of Hurricane country, the one thing you don’t do is ignore the threat.

There is no need to panic (I’ve yet to find any situation where that helps, quite frankly), but there is great need to prepare.

Your family, your neighborhood, your business, and your community.

Since we can’t know how bad this pandemic will be, the prudent thing is to prepare for a reasonable worst-case scenario based on what we know right now.

And we need to be prepared to alter our plans down the line if we learn that the threat has changed.

Right now, it appears that we may be looking at a Category 1 or perhaps even a Category 2 pandemic. That’s a reasonable assumption based on what we know right now.

Neither are to be trifled with.

Both could bring personal loss to you or your loved ones, and could cause significant societal, economic, and health-care delivery disruptions.

Those of us who live in the northern hemisphere have been given a gift.

The gift of time.

We have a few months before our next flu season begins. There is no guarantee that the virus will hold off until then (the 1918 pandemic arrived in late summer) but our major concern right now is what happens in the fall.

The focus of this blog has always been preparation, and so it will be as we watch this virus develop in the southern hemisphere.

Yes, we’ll follow the news, and the science behind this story. I’m as interested in that as you are.

But it is imperative that we not become so fascinated with the details of the story that we forget to prepare to meet whatever challenges this pandemic throws at us.

To get you started, if you haven’t already visited (and really examined) the HHS Family pandemic planning page, you should do so this weekend.