# 2460
The questions posed by today's ABC News special report are those that medical ethicists, bloggers, and journalists have been asking for quite some time.
In a pandemic, who gets access to precious resources? Who is truly essential? And how can we avoid a cascading collapse of society due to absenteeism and failed supply lines?
It is a bit heartening to see these issues being discussed openly by the mainstream media. I've only included the opening few paragraphs. Follow the links to read the story in its entirety.
In a Pandemic, Who Gets to Live?
Aftermath of a Pandemic Could Be More Disastrous Than the Pandemic Itself, Researchers Say
By LEE DYE
Nov. 12, 2008
As if wars and economic crises and natural disasters weren't enough, here's a challenge for some future president that few people even want to think about: Some day, perhaps soon, a president will have to decide whose lives are the most important to save, and whose lives are "nonessential."
Influenza victims crowd into an emergency hospital near Fort Riley, Kan., in this 1918 file photo....
Influenza victims crowd into an emergency hospital near Fort Riley, Kan., in this 1918 file photo. The 1918 Spanish flu pandemic killed at least 20 million people worldwide, and officials say that if the next pandemic resemblers the birdlike 1918 Spanish flu, up to 1.9 million Americans could die.
National Museum of Health/AP Photo)
This isn't going to be a doomsday story, because most people will survive the next influenza pandemic, which some public health experts believe is past due. It's not a question of "if," it's a question of "when," and one study from Harvard University estimates that the pandemic will kill somewhere between 51 million and 81 million people, mostly in developing countries.
Hundreds of organizations and institutions around the world are developing plans for dealing with the expected pandemic, and one challenging theme is begging for more public discussion. Some people will be more important than others in fighting the disease as it spreads quickly around the planet, and many more will be left to pretty much fend for themselves.
Who Is 'Essential'?
The top of the list is an easy one. Doctors and nurses will be vital, so they end up in the win column. Others essential to public health and safety will be next, but after that, the going gets tough. A provocative new study argues that the list needs to be broadened. Some truck drivers, for instance, may be just as important as doctors.
"The secondary consequences of severe pandemic influenza could be greater than deaths and illness from influenza itself," according to the study, authored by Nancy E. Kass, professor of bioethics and public health at Johns Hopkins University, and experts from several government agencies.
In a study published in the current journal Biosecurity and Bioterrorism, Kass and her colleagues argue that a pandemic could precipitate societal collapse on many levels, threatening the availability of resources "such as food, water, and gasoline."
What it boils down to is this: Medical professionals won't be very successful if the truck driver doesn't show up with the necessary medications because he couldn't get fuel for his vehicle.
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