# 690
While overseas reports on avian flu seem to be declining, the drum beat warnings in local newspapers seem to be picking up, as evidenced by this article in today's HeraldNet.
It's actually a pretty good overview of the problems the health care system, and people living in Washington State, will face in a pandemic. It stresses that most people must expect to be treated at home in a pandemic.
Published: Sunday, April 22, 2007
Influenza outbreak would tax resources
If a flu pandemic struck, county hospitals would be overwhelmed. Where would most of us find treatment?By Sharon Salyer
Herald Writer
The spark for a pandemic flu outbreak could strike the moment an airline passenger steps off a flight at Seattle-Tacoma International Airport. From there, it could spread throughout the Puget Sound region.
Schools, Seahawks games and movie theaters could be shut down indefinitely to try to slow the contagion.
Right now, state and county public health officials are making plans for responding to a worldwide outbreak of a deadly strain of flu similar to one that killed more than 500,000 Americans in 1918.
Health officials are carefully monitoring cases of bird flu, which has sickened 291 people in Asia and the Middle East and killed 171 people.
"We want people to know it's not going to be business as usual during a pandemic," said Meredith Li-Vollmer, a communication specialist for Public Health Seattle & King County.
Schools and day care centers could be closed. Absenteeism could hamper if not cripple businesses.
How severe could a flu pandemic be? Imagine the common flu bug on steroids.
On average, flu kills about 50 people in Snohomish County and 500 Washington residents each season. Many are elderly or have other health problems that weaken their immune system.
Under the worst-case scenario, a flu as severe as that which struck toward the end of World War I, an estimated 200,000 people in Snohomish County could become ill, about 2,000 people each day.
Even sending just one-tenth of that number - 200 people - to area hospitals could overwhelm the medical system, said Dr. Gary Goldbaum, health officer for the Snohomish Health District.
The public should be prepared to care for many of the sick at home, he said, with only the sickest of the sick, such as those who need mechanical ventilators to help them breathe, being treated at hospitals.
"Everyone else, if we believe they could manage, we're going to try to keep them at home," he said.
The article describes a healthcare system overloaded, businesses possibly crippled, schools and public venues closed, and up to 40,000 Washingtonians dying . . . and yet warns that people need to be prepared to stay home `at least a week'.
The `at least' portion of that statement, I suppose, leaves it open ended.
It is difficult, of course, for authorities to talk in terms of weeks, or even months of preparations. Many people simply don't have the financial ability to acquire that sort of stockpile, and asking people to do so, when they don't know when a pandemic may strike, opens them to criticism and liability.
Tim Serban, a director at Providence Everett Medical Center, was interviewed in this article, and makes it clear that medical care as we know it may be radically different in a pandemic.
During most disasters, emergency care is given to the sickest patients first, he said.
But a flu pandemic may be different, he said, when health care workers may have to shift to care for patients in a different manner - give care to "those who have the best opportunity of getting better."
He is, of course, talking about triage. And for many people, unused to the concept, this will be one of the toughest mental adjustments to make in a pandemic.
Medical heroics will be largely abandoned. There simply will not be the resources available; in terms of beds, ventilators, medicines, or medical staff to devote to patients with a poor chance of recovery.
This will apply not only to flu victims, but likely to all medical cases.
With 40% or more of healthcare workers out during a pandemic, and hospitals overrun with patients, we simply won't see the standard of care we've become accustomed to.
No, it's not a happy thought.
But it is realistic.
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