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Home Front: WoT

U.S. Issues Guidelines in Case of Flu Pandemic

2007-02-02

CDC issues sensible guidelines, NYT notes that poor, minorities, women, gays most affected. No plan is perfect, but this one is a good start.

ATLANTA, Feb. 1 Cities should close schools for up to three months in the event of a severe flu outbreak, ball games and movies should be canceled and working hours staggered so subways and buses are less crowded, the federal government advised today in issuing new pandemic flu guidelines to states and cities.

Health officials acknowledged that such measures would hugely disrupt public life, but they argued that these measure would buy the time needed to produce vaccines and would save lives because flu viruses attack in waves lasting about two months.

We have to be prepared for a Category 5 pandemic, said Dr. Martin Cetron, director of global migration and quarantine for the Centers for Disease Control and Prevention, in releasing the guidelines. Its not easy. The only thing thats harder is facing the consequences. That will be intolerable.

In an innovation, the new guidelines are modeled on the five levels of hurricanes, but ranked by lethality instead of wind speed. Category 1, which assumes 90,000 Americans would die, is equivalent to a bad year for seasonal flu, Glen Nowak, a C.D.C. spokesman, said. (About 36,000 Americans die of flu in an average year.) Category 5, which assumes 1.8 million dead, is the equivalent of the 1918 Spanish flu pandemic. (That flu killed about 2 percent of those infected; the H5N1 flu now circulating in Asia has killed more than 50 percent but is not easily transmitted.)

Posted by:Steve White

#8 While most of this sounds good and sensible, I would think that the transportation centers ( rail, bus, planes) should not be left open, but rather restricted; transportation of supplies only, and essential personnel, and any leisure or business travel shut down. to do otherwise is, IMHO, just asking to exacerbate the spread.

Posted by: USN, Ret. 2007-02-02 15:16

#7 Bright Pebbles in Blairistan: If you are in closed quarters, you want an air cleaner with UV light to sterilize pathogens. However, the vast majority of infections will come from surface contamination, especially the hands, taking the contamination to the mouth, nose and eyes.

An almost ridiculously inexpensive, easy and safe air cleaning system that also sterilizes surfaces is simplicity itself: a water vaporizer with a pint of ethyl alcohol (like 'Everclear'), added to it. The alcohol will be carried in the water droplets everywhere.

Alternatively, if you add Citrical, which is metallic calcium ions in a gel, to vaporizer water, it is remarkably antiseptic--but may damage your motor, though I'm not sure of it.

Posted by: Anonymoose 2007-02-02 13:50

#6 http://www.pandemicflu.gov/

It's wild seeing how seriously the US govt is taking this threat. We've had briefings and reports on what our protocols will be in the event of an outbreak. They're touting about a 40% "workforce diminishing" at any one time. Of that, they expect rougly half of the cases to be fatal.

I realize usually we plan on worst case scenarios, but this is really out there.

We've taken to maintaining our hurricane season supplies year-round now.

Posted by: Anon4021 2007-02-02 12:50

#5 I find these useful.

Even just to keep the dust down in offices with PCs.

http://www.optimair.co.uk/acatalog/Optimair_Online_Shop_Portable_Air_Cleaners_4.html

You could ask offices to switch off Aircon, or install a UV + HEPA filter system.

Posted by: Bright Pebbles in Blairistan 2007-02-02 12:21

#4 trailing wife: I've long been an advocate of creating an entire multimedia curriculum online for this and other reasons.

In many ways it is far better than a real classroom because it can be edited to just the best parts, and it doesn't waste as much time as a real class.

The students computer can download classroom videos days ahead of time, then they watch the video at the same time as the rest of the class, with their live teacher in the background to answer questions, query students, and otherwise monitor the online class.

Posted by: Anonymoose 2007-02-02 12:16

#3 In re: closing schools. Many schools have websites nowadays, and many teachers have web pages. Much schoolwork can be done on-line, at least for the more prosperous districts. And the kids will be just as happy for the most part IM-ing each other while doing other things on-line... at least for a while. And if there really are a lot of people getting sick, they'll be content with that.

Posted by: trailing wife 2007-02-02 11:40

#2 The most effective measures are inexpensive, easy to implement, and produce the greatest results.

One I strongly suggest be recommended to local government of any size is to set up automated phone banks. A dozen such machines could blanket a town with recorded messages to get critical information out quickly, and to get critical feedback from the public ASAP. Literally calling every single residence in a town, it would maximize the efficiency of emergency services far better than "911". This would do much to reduce public fear.

But towns and cities need for someone to suggest it to them. Most of them probably already have or can cheaply get such equipment, and it could be set up and operational in a few days.

Another cheap, easy and highly effective idea is for towns and cities to buy great amounts of hand sanitizer and ear loop masks. If every business in a city was issued one or more quart-sized bottles of sanitizer to keep at their front door for free public use, and complimentary ear loop masks, it would provide a massive "fire break" against the spread of the disease. Not just from direct human to human spread, but also by reducing contamination to objects.

The ongoing University of Michigan study is right on. That is, giving students in a dorm a large bottle of hand sanitizer for their room, and issuing them small bottles to carry around with them, and giving them masks to wear. This is EXACTLY what should be done nationwide for people who live or work in close quarters, like students.

Relatively speaking these are incredibly inexpensive ways to reduce a killer epidemic to just a rare few outbreak of people who are "unlucky".

The most effective federal response will be in monitoring interstate commerce. Also relatively inexpensive as these things go, it is very common sense:

1) Put agents in airports, bus terminals, etc., just to look for people who are obviously sick, and get them quickly quarantined. Setting up "plastic sheet" quarantine stations at these places, to hold people who might be ill until they either need transport to medical facilities or have passed the incubation period without symptoms.

2) Set up health stations at the major transport corporations. Truck drivers, flight and railroad crews should be so familiar with the flu that they recognize and react to it immediately. The same with any place such people congregate, like truck stops.

It is absolutely vital that everybody learn the critical information about the disease, which would include:

1) The incubation period. How long you have the disease before you start to show symptoms.

2) The symptoms themselves.

3) The infectious cycle. After a person is infected, how long they can infect others.

4) What to decontaminate and how to decontaminate. Contamination avoidance.

Posted by: Anonymoose 2007-02-02 09:25

#1 It's good the researchers are studying historical data to get an idea of what measures would help the most. The response to their proposals is riddled with politics, as usual, they got a swipe in at the war in Iraq. "We'd be facing the same problem" -- schools are still the place where the largest numbers of children gather, keeping group sizes down will help a great deal. "many employed people cannot afford to stay at home" -- but they can afford to die, this objection is brainless.
The part about buying the "time need to produce vaccines" didn't mention the minimum four-month lead time necessary to produce a vaccine matched to the culprit virus, by which time the pandemic will have done much of its damage.
Keeping sick people at home is a good idea, unfortunately people in early and infectious stages of influenza usually have no symptoms at all. By the time they feel sick, they have probably contributed to the infection of dozens of others in the usual course of everyday life. Keeping as many people as possible, sick or not, home for 7-10 days, all at the same time, in an area just at the start of an epidemic, would definitely break the cycle of transmission. The timing is critical. The cost of such a holiday is immense. Some workers in key areas, public safety, public utilities, transportation, health care, food delivery, etc. are absolutely essential and can't be spared. Having households lay in a 7-10 day supply of essential commodities well ahead of a possible epidemic would help a great deal, but nothing has been done about this aspect of preparation.
A key gap in these proposals is a refusal to consider restricting air travel, which is far and away the most rapid means of moving influenza epidemics around the world. I imagine very few air travelers are engaged in activities critical to public safety and the world economy, the vast bulk are engaged in recreational or optional business travel. No great damage (besides that to airline revenues) would be done if these travelers stayed home for three months, but modern individuals prefer to think their wants and cravings are more important than the public safety. The discussion also implies a black and white approach to closing state borders -- as opposed to restricting traffic to the necessary deliveries of food & supplies and restricting travel for personal pleasure which would seem to account for the greatest proportion of interstate highway traffic. Unfortunately keeping people out of certain areas also means restricting others from leaving certain areas.

Posted by: Anguper Hupomosing9418 2007-02-02 04:31

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