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View Diary: Medical Crisis: The Shape Of Things To Come (245 comments)

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  •  A culling of the herd (1+ / 0-)
    Recommended by:
    ladybug53

    "If pandemic flu suddenly requrires the hospitalization of hundreds of thousands, we are screwed."

    I disagree.  A wave of flu, wiping out immunodeficient elderly and HIV patients might bail us out for awhile.  I am not hoping for this at all so I am not trying to offend but that would be the silver lining.  And since we don't have enough hospital beds and vents how do you think they will make the call. Antivirals and vaccines for health care providers first and no vent over age X or if you have a comorbidity such as A, B or C.  

    •  more sterotyping (0+ / 0-)

      no vent over age X

      Why impose an artificial age limit? (80 is ok to "vent", 81 not ok) Why not look at the complete patient? Why are a certain age are other health consideration not relevant?   Are you saying that all you need to know is age?

      •  Read my post (0+ / 0-)

        And look up co morbid factors.  Since we would be VASTLY under supplied with vents and providers, the CDC would issue triage rules like but maybe not exactly like what I said.  Individual docs would choose to follow the guidelines or not.  But use your freedom of information act and see what your communities emergency plans are for various disasters and events.  Now think about what the plan for Katrina was before and after.  Now think about the fact there has not been a flu pandemic in the time of jet travel and according to most posters here ED's are already overwhelmed.  So someone or some people are going to decide who lives and who dies if we have a pandemic as described above.  Is it right or wrong? I think it is amoral not immoral but you probably disagree.  I leave it to the CDC and the people on the ground to act on there best intentions. Hopefully their upbringing and education have prepared them for the situation.

    •  Only time will reveal the exact nature of the flu (1+ / 0-)
      Recommended by:
      ladybug53

      Ah, but you're assuming that the long awaited pandemic flu will hit the elderly and those infected with HIV the hardest. By the way, the immunodeficient usually also includes children. This assumption may not necessarily hold true. You may be interested in revisiting the so-called Spanish Flu of 1918, so-called because it most probably started in the United States, which hit young, healthy adults between the ages of 18-40 the hardest due to their over exuberant immune response.

      •  here's an excellent web site (1+ / 0-)
        Recommended by:
        ladybug53

        illustrating that point.

        http://www.historylink.org/...

        and here's another illustration...

        http://www.fluwikie.com/...

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Tue Jan 08, 2008 at 11:38:31 AM PST

        [ Parent ]

      •  Its all Assumptions (0+ / 0-)

        Until it happens, and I lose little sleep over birdflu or terrorism or any other calamity.  Heart disease, and motor vehicle accidents and cancer.  Thats the real threat for my age group.  Nobody worries about that stuff.

        •  nobody worries about the stuff in this post (1+ / 0-)
          Recommended by:
          ladybug53

          either. Not enough, anyway.

          "Until it happens" is the dumbest argument ever.

          Just saying.

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Tue Jan 08, 2008 at 11:44:03 AM PST

          [ Parent ]

          •  Dumbest argument ever (0+ / 0-)

            No I am not saying we should worry. I thought "Because I said so" was the dumbest.

            I was saying any thing you prepare for or buy insurance you are assuming it will or might happen.  I have not been in a car accident in 8 years I drive the speed limit yet I still have insurance.  I am very healthy yet I keep by paying extra from my check insurance.  Years ago the decision was made to quit vaccinating for smallpox.  If there is ever a new outbreak this decision will be criticized. In the mean time it is a item line on a budget.  So whoever controls our communicable diseases prevention has to look at what is possible, probable, and plausible.  The rub is hindsight is 20/20.  And most success is never appreciated.  Example no terrorist attacks since 9/11.  Are we safer or are we snapping our fingers to keep the elephant away.  See no elephant its working.  In the mean time if flu wipes out 2.5 percent of the US and shuts our economy down every talking head will be saying the peoples name responsible for the policies surrounding the pandemics management.

            I suggest living healthy and enjoying life whatever it is that kills you, your dead anyway right>?

            •  "Because I said so" (0+ / 0-)

              that is a close second ;-)

              "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

              by Greg Dworkin on Tue Jan 08, 2008 at 11:58:42 AM PST

              [ Parent ]

            •  in fact (1+ / 0-)
              Recommended by:
              ladybug53

              a more grown-up way to approach life is to repair the levees before the storm.

              Considering how to regionalize care in a crisis (including learning how to get hospitals, schools and nursing homes to cooperate), identifying alternative care facilities (we have one hospital, and a major highway runs through my town. An accident involving transported toxic chemicals or nuclear waste could cut the town in half for some days), drilling the mas casulaty events, etc. is a great way to prepare for pandemic flu AND whatveer else comes. That's also true for making plans about using the internet to teach people how to care for themselves at home.

              Drilling, educating, identifying and using your local resources... it's all best done in advance. And, in fact, a great deal of work is being done right now to prepare.

              The only argument not to is a childish "until it happens..." and we saw the results of that attitude in NOLA, in a big way.

              I'd rather be a grown-up.

              "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

              by Greg Dworkin on Tue Jan 08, 2008 at 12:40:40 PM PST

              [ Parent ]

    •  actually (0+ / 0-)

      pandemic scenarios (not a 'bad seasonal flu', a pandemic) have 25% attack rates and often hit the young and healthy, with 35% or so of the work force out ill for 4- 6 weeks in 3 or so waves.

      a really bad pandemic will have 2.5% case fatality rate. H5n1, of ocurse, has higher right now, but skip that for the moment.

      here's the system burden:

      http://www.newfluwiki2.com/...

      The numbers were put together by Eric Toner at UPMC and are very credible.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Tue Jan 08, 2008 at 11:35:02 AM PST

      [ Parent ]

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