Question of the Week

February 26, 2007


No one knows exactly how or when a pandemic may effect us (and the rest of the world). This makes it not only difficult to plan for, but also difficult for many to rank as a planning priority.

"Contingency planning for an event sometime in the future is often difficult to justify, particularly in the face of limited resources and more urgent problems and priorities. However, there are two main reasons to invest in pandemic preparedness: 1. Preparation will mitigate the direct medical and economic effects of a pandemic, by ensuring that adequate measures will be taken and implemented before the pandemic occurs. 2. Preparing for the next influenza pandemic will provide benefits now, as improvements in infrastructure can have immediate and lasting benefits, and can also mitigate the effect of other epidemics or infectious disease threats. A major component of pandemic preparedness is to strengthen the capacity to respond to yearly epidemics of influenza."

These "yearly epidemics of influenza" affect millions of people worldwide, and tens of thousands die in the United States alone.

"Each year, influenza develops in up to 20% of all Americans, and >200,000 are hospitalized with the disease. Although influenza is commonplace and generally self-limited, an estimated 36,000 Americans die each year from complications of the disease. Worldwide, severe influenza infections develop in 3–5 million people annually, and 250,000–500,000 deaths occur."

Worldwide, hundreds of thousands of people die each year from influenza, but this is not considered a pandemic.

"An influenza pandemic occurs when a new influenza virus appears against which the human population has no immunity, resulting in several, simultaneous epidemics worldwide with enormous numbers of deaths and illness. With the increase in global transport and communications, as well as urbanization and overcrowded conditions, epidemics due the new influenza virus are likely to quickly take hold around the world. ... In the past, new strains have generated pandemics causing high death rates and great social disruption. In the 20th century, the greatest influenza pandemic occurred in 1918 -1919 and caused an estimated 40–50 million deaths world wide."

Throughout the country (and throughout the world), people are working to reduce the possible side effects if and when such a pandemic once again affects the world.

"Community strategies that delay or reduce the impact of a pandemic (also called non-pharmaceutical interventions) may help reduce the spread of disease until a vaccine is available. CDC has issued guidelines on actions, designed primarily to reduce contact between people, that community government and health officials can take to try to limit the spread of pandemic flu. Faith-based and community organizations will play an integral role in the event of a pandemic."

Prevention is key. Slowing the spread of any disease is preferable to trying to treat it. In reality, a combination of the two will likely be the most effective. While doctors and researchers are working to find possible medical methods of treatment and/ or prevention, non-medical strategies will need to be implemented, as well.

"The collaboration of Faith-Based and Community Organizations with public health agencies will be essential in protecting the public's health and safety if and when an influenza pandemic occurs. This checklist provides guidance for religious organizations (churches, synagogues, mosques, temples, etc.), social service agencies that are faithbased, and community organizations in developing and improving influenza pandemic response and preparedness plans. Many of the points suggested here can improve your organization's ability to protect your community during emergencies in general. You can find more information at"

Not everyone is part of a community or faith-based organization, but almost everyone has contact with other human beings on a daily basis.

"The most serious flu pandemic should prompt immediate isolation measures, including sending students home from school for up to three months and quarantining households with sick family members, according to federal guidelines issued Thursday [February 01, 2007]. Because it would take four to six months to prepare a vaccine to protect against a pandemic flu, the guidelines are critical to restricting the virus in the interim. The best alternative to a vaccine 'is to try to slow down the spread and buy some time,' said Dr. Julie Gerberding, the director of the Centers for Disease Control and Prevention." Detroit News

While staying home and staying away from others will help slow the spread of the disease, this will not be possible for all people. Doctors, nurses, emergency response personnel, and others will need to leave their homes to help fight the spread of the disease in other ways.

"The Department of Labor's Occupational Safety and Health Administration (OSHA) today [February 6, 2007] unveiled new workplace safety and health guidance that will help employers prepare for an influenza pandemic.... 'Employers and employees should use this guidance to help identify risk levels and implement appropriate control measures to prevent illness in the workplace.' ... Recommendations for employee protection are presented for each of the four levels of anticipated risk and include engineering controls, work practices and use of personal protective equipment such as respirators and surgical masks and their relative value in protecting employees. The Labor Department/HHS guidance also encourages employers to prepare a plan to deal with a depleted workforce during a pandemic. ... It is important to note that workplace safety and health guidance may evolve and change over time as new information becomes available. For instance, the characteristics of the specific strain of influenza virus ultimately responsible for the pandemic may affect the way in which the disease is spread and therefore additional guidance would be tailored to that information." U. S. Department of Labor

Part of the difficulty when preparing for a possible influenza pandemic, is not knowing what to expect, what will work, and what can be done to help protect those who are out fighting the disease.

"More than 2,000 students at the University of Michigan are helping to figure out whether wearing surgical masks and using hand sanitizer actually helps to prevent the spread of the flu. The university started handing out the hygienic tools this week to students in residence as part of an experiment to test if the low-tech measures offer protection from the influenza virus. The experiment comes as health experts watch for any signs that the H5N1 form of avian flu is mutating into a form that can spread easily between people, a change that could spark a pandemic. ... Students living in different dormitories will be assigned to use masks only, both masks and sanitizer, or neither. Use of hand sanitizer and masks will begin when a confirmed case of flu is found in a campus dorm, the researchers said. Study participants will be expected to wear the masks at all times in the dorm but it's optional elsewhere. ... They will also receive stickers and magnets that list flu symptoms and include a pager number for students to report suspected cases of the flu. A nurse will then go to the dorm to collect samples."

Community and faith-based organizations are being asked to prepare a plan and will be asked to help prevent the spread of the disease when that time comes. Department of Labor's Occupational Safety and Health Administration (OSHA) is asking businesses to prepare a plan and be ready to help when the time comes. Schools are notorious for having many people in a confined environment that often facilitates the spread of disease.

"Thursday, February 8, 2007 ... Bishop Blanchet High School in North Seattle announced that it won't reopen until Monday [February 12] because more than 300 of the Catholic school's 1,080 students have called in sick this week, mostly with flu symptoms. ... Principal Kent Hickey said he decided to close the school when the absentees went from 170 Monday to more than 300 Wednesday. 'We decided if we could keep the students away from each other for four days, maybe most would be healthy again,' he said. ... Instead, the school will hold online classes, or a 'virtual school,' as Hickey called it. Part of the reason for setting up such an online system was in preparation for an epidemic or other disaster in which students would need to stay home." Seattle Times

This school took the opportunity to test a plan that was already in place. Not all schools have a plan.

Questions of the Week: What personal planning have you and/ or your family done in order to prepare for a possible pandemic? What preparations should you make? What policies do your school, business, faith-based organization, and/ or other community organizations have established that will be put into practice in the event of a possible pandemic? What should you know about these policies and how they will affect you and/ or your family? What can/ should you do if there are currently no policies?

Please email me with any ideas or suggestions. Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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