# 2039
It is not a new message, but it is one worth repeating.
In a pandemic, you will need to be prepared to care for yourself, or your loved ones, in your home.
Based on most US government estimates, 90% of pandemic flu victims are not expected to see the inside of a hospital. And as you will see, the idea that we could provide hospital care to 10% of those afflicted may be wildly optimistic.
If you think that is an exaggeration, and that health authorities will somehow magically squeeze all critically ill patients into a hospital, think again.
We have a finite number of hospital beds available, a nursing shortage during normal times, and precious little surge capacity. Every winter we see many of our hospitals pushed to the breaking point by seasonal flu.
A pandemic would be orders of magnitude more demanding of our health care resources.
This graphic is from the State of Florida Pandemic plan, but is representative of many state pandemic assumptions.
Admitting 640,000 patients into Florida hospitals would be a monumental task. The State has roughly 3 hospital beds for every 1000 residents. That's about 50,000 beds.
And most of the time, 90% are occupied.
The math, as you can see, doesn't look good. And it is no better in other states, or other nations.
The hope is that the impact of a pandemic can be reduced through the use of NPI's (Non Pharmaceutical Interventions) and spread across many months, thus reducing the impact on a daily or weekly basis.
Still, with only 50,000 beds in Florida, trying to get even 10% of flu victims treated in hospitals would be a major feat. Many would say that it is impossible.
As for the other 90%? They will have to stay home, and hope someone can care for them.
Complicating matters, nearly 1.7 million Floridians live alone.
This chart is from the 2000 Florida Census. The numbers vary from state to state, with the District of Columbia having the highest percentage of Live-alone's and Utah having the lowest, but Florida is fairly representative of the nation.
(click to enlarge)
Nationwide, 27 million Americans live alone. On the island of Manhattan, more than 350,000 people live alone. During a pandemic, these people will be particularly at risk.
Statistically speaking, if the attack rate of the virus is 35%, then nearly 10 million Americans will have no one living with them to care for them when they fall ill.
Of course, living with someone is no guarantee that you will have someone to care for you. Entire households could be stricken by the virus at the same time, and many people are living with someone who would be physically incapable of rendering assistance.
As bad as all of this sounds, it only grows worse when you add in the millions of single parents living with infants and small children. Not only are they at similar risk, their children are as well.
The point of this little mental exercise is that people need to be thinking about how they will cope during a pandemic, particularly those who live alone or with small children. Pandemic influenza isn't just a `bad flu', it can render a victim incapable of caring for themselves in a matter of hours, and they could remain that way for a week or longer.
Everyone should get a copy of Dr. Grattan Woodson's Good Home Treatment of Influenza, and have obtained the medical supplies they will need to treat themselves, or their loved ones during a pandemic. That includes making up packets of ORS (Oral Rehydration Solution) in advance.
While everyone needs to be preparing to care for flu victims at home in a pandemic, those who live alone, or know someone who lives alone, need to be thinking about how they will cope with this situation.
Having a pre-prepared `Flu Box' under the bed, filled with medicines and hydration supplies, is an important first step. Having a telephone next to the bed, is also an important consideration. Singles should make arrangements with neighbors or friends who can check in on them, tend to them, and who can call for assistance if needed.
A flu victim who might otherwise survive could die in a matter of hours without proper care, particularly if they are severely dehydrated. Having (and being) a `flu buddy' during the next pandemic could make all the difference.
I understand there will be resistance to the idea. People will ask, Why should I expose myself to the virus and risk illness or death to care for a friend or neighbor?
It is, admittedly, a calculated risk. And it is one that many will choose not to accept. But unless a substantial number of people do accept that risk, we risk losing millions of people due to simple neglect during the next pandemic.
A severe pandemic wave could last 12 weeks, and a pandemic could consist of multiple waves over a year or even two. While I'm sure some will try, the idea that most people will be able to completely isolate themselves from the virus is pretty remote.
After all, even in a pandemic people will need to go to work, get supplies, pay their bills, and yes, even care for each other.
Obviously children, young adults, parents of small children, and pregnant women should avoid exposure if at all possible. They are at the greatest risk of contracting and dying from a novel pandemic virus.
But there are millions of others who are not similarly constrained.
The government, and our health care infrastructure, won't be able to handle a severe pandemic without the help of ordinary citizens like you and I. There will be a great need for community volunteers and for neighbors to help one another during a crisis.
Yes, there will be risks involved. There always are.
But it will be how we respond to those risks that will determine how well our society, and our world, will fare during the next pandemic.
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