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Influenza Pandemics:
DEFENDING OURSELVES - PLANS. (Part 2)
A Pandemic means - everywhere all
at once.
The more we know about past flu pandemics the better we can defend ourselves
against the next pandemic.
If it breaks out in China today, the avian influenza will be everywhere in
the world in three weeks and in some cases within 72 hours. A pandemic usually has
two waves. In 1918 the pandemic went around the world 4 times and we didn't have
air travel! Today it will travel or have the potential to travel much faster.
What is important for the virus is the density of the people susceptible rather
than the number of people susceptible. In the first wave of a pandemic, 100% of
people are susceptible. That is because the virus has mutated and its exact
structure or androgyny is unknown.
Experts agree that it will take at the very best two months - more likely, six months, to produce a vaccine.
What Defenses Have We Against A Flu Pandemic?
Our best line of defense is early detection and early defense. Just as in the SARS epidemic, which was stopped very quickly thanks to the fast handling of health officials especially in Hong Kong, the next flu epidemic, if caught early enough, could be contained. Otherwise we have:
- social distancing (including hand washing, using face masks, closing schools, closing churches, telecommuting, figuring out how to do work from home)
- culling (which has a major economic and social problem for the poor)
- and of course we hope for vaccines and anti-virals (although both supply and resistance are issues still very much in question).
Other than that, we really do not have too much which can guarantee against a pandemic. The main strategy at the moment is the "Speed bump strategy” - try to slow down a pandemic to allow the technology to develop sufficiently to stop it in its tracks.
Pneumonia Vaccination
NOTE: About 40% of people with avian influenza will probably die from secondary pneumonia - and depending on the type of bird flu virus, it may well have the ability to lodge itself deep in the lungs. A good strategy to think about and explore with your public health expert and doctor is to get a immunization against pneumonia since some very good vaccines exist.
Other possible strategies:
- vaccinating poultry workers with H3N2 vaccine to reduce risk
- possible use of statins (a type of drug that inhibits cholesterol production in the liver) to mitigate symptoms and transmission
- chicken exchange programs (offer 1.25 healthy chickens for every sick chicken)
- business continuity -- protecting mail, food distribution, medical care, communications, networking
- finding faster methods to produce vaccines in multiple parts of the planet to avoid transportation bottle-necks. (In the middle of a pandemic when no planes are flying and no trains are going, how are you going to ship the vaccine which at the very best couldn't be produced until between 2 - 6 months after the initial androgyny has been determined?)
Sources:
Avian flu: update and review: Meeting on effective response and business
continuity for UN and humanitarian agencies, Tufts University, Boston,
Larry Brilliant, MD MPH, January 12, 2006
Next: » Outcomes and Social Reshaping following a 21st Century Pandemic
All Articles
in this series:
» The Influenza Pandemics of the 20th Century.
» Defending ourselves against the next influenza
pandemic.
» Outcomes and Social Reshaping following a 21st Century Pandemic.
» The six phases and three periods defined by WHO for Pandemics.
» The Ethics of Pandemics - who gets the medicine and who decides.
» Scenario - how the next influenza pandemic is likely to start.
Video Presentation:
(Requires free Google video software) (27 min.)
Description of smallpox eradication, polio, bird flu, SARS -- importance of
early detection and early response in fighting diseases and disasters. An idea
which won Dr. Larry Brilliant of Google.org the TED prize wish: a wish to create
a global early warning system. (Opens in a new window on the
Google Video site.)