So here's an interesting way to look at things... rather than look to Chicken Little ('the sky is falling!') as the model of how the potential threat of pandemic flu should be approached, let's look at a more realistic model of how the world works.
Stephen Flynn, former Coast Guard commander and author of The Edge of Disaster, says that the United States medical system is unprepared to handle a catastrophic emergency such as a flu pandemic or a major terrorist attack.
The problem, Flynn says, is that hospitals have been trying to cut costs.
"The medical community has been moving in the direction of much of our economy," he says, "which is wringing out the extra capacity in order to essentially focus on the bottom line."
Given that baseline reality, and the likelihood that the current federal budget will not assist localities in coping better, any new or extraordinary stress on the system will not be simply absorbed.
Each year, more than 300,000 people are treated in U.S. hospitals for the flu. The common flu is dangerous; more than 30,000 Americans die from it every year. But Flynn is even more concerned by the prospect of pandemic flu, such as the outbreak that occurred in 1918.
Flynn estimates that a pandemic flu outbreak today would result in 80 million infected Americans. If the death rate were similar to that of the 1918 flu, then a current flu pandemic could result in 800,000 deaths in the United States.
But the 1918 flu is not worst case, and Flynn's estimate underplays the reality.
Why does it underestimate? Because 675,000 Americans died in 1918 when the US was a third of the population it is now. Other estimates of a 1918 style pandemic give upwards of 1.7 million deaths (it does no good to have modern medical care if you can't get in to the hospital). This former CDC head says 3 million. whatever the number, it's a reminder of the shape our health care system is currently in.
Oh, and by the way, the 1918 virus is not the worst case scenario. The current H5N1 virus going pandemic at its current case fatality rate of over 50% at attack rates of 35% is. A third of the world is ill and half of them die. This is a proposition written in serious peer-reviewed medical journals (see What Hospitals Should Do to Prepare for an Influenza Pandemic and The Prospect of Using Alternative Medical Care Facilities in an Influenza Pandemic, for examples). To utter such a thing is to be accused of 'fearmongering', of being a Chicken Little, but this is the reality... it's a threat that's being discussed all over the medical literature, and if it is upsetting to hear, nonetheless, it is merely a reflection of how professionals react to the knowledge of what's happening today in SE Asia (Indonesia) and Africa (Egypt).
Does that mean we'll have a pandemic this month or this year? I didn't say that; the reason I didn't is because no one knows when the next flu pandemic will be, or whether H5N1 will be the agent, or whether it'll have a high case fatality rate like 1918 or (worse) the current H5N1. That's simply unknowable at this point, despite the hard work done by flu experts all over the world in trying to figure out the answer to that one.
Given the uncertainty, what is the best thing to do? Prepare for it in advance, say the experts.
The former director of the U.S. Centers for Disease Control and Prevention predicts a pandemic flu that will cause a tsunami-like "disruption of goods and services" so intense it sweeps away the "staples of modern life."
Dr. Jeffrey Koplan, who headed the CDC during the SARS outbreak of 2002-03, on Thursday urged Connecticut's college administrators to draft their own plans for dealing with pandemics, rather than try to graft some other agency's ideas onto their institutions.
"It has to be your own," he said. It also must be dynamic and revised regularly.
Colleges and universities must consider factors such as whether they have on-campus infirmaries and whether students live on-campus, Koplan told the 300 academic administrators and health officials at the forum, "A Case Study for Campus Pandemic Flu Planning." It was organized by Yale University and held at Southern Connecticut State University.
And even if it's a different kind of emergency, like an ice storm or tornado, what happens if your neighbor prepares and you don't? In terms of pandemic:
Yale continues to wrestle with what incentives to put in place to have key personnel continue to work in the face of a life-threatening disease, she said. The ethical issues are who gets anti-viral medication and with whom do you share them?
Koplan called it the "little red hen syndrome," where one institution prepares, but another doesn’t and then wants resources. "What do you do? This is tough stuff," he said.
The Little Red Hen Syndrome. The Grasshopper and the Ants. Truly, everything you need to know you learned in first grade. So, consider what you can do that is sensible, affordable and acommodates your budget (and also fits in where you live). And while you consider yourselves and your families, others are considering infrastructure and the schools. in fact, reconsider what you do for any emergency. Chances are, you are not doing enough to help protect you and your family for when the unanticipated hits.
This public service message was brought to you by the Little Red Hen.