Pandemic Flu Response & Emergency Preparedness

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Posted 6.28.2009

Pandemic Flu Response & Emergency Preparedness

by Margaret Trexler Hessen, M.D., Chair
Public Health Committee
Delaware County Medical Society

In recent weeks the term “pandemic flu” has left the conference rooms of medical schools and public health agencies and has entered everyday usage in media reports and in conversations among the worried public across the globe.

Thus far, although the disease continues to spread, it seems to be less virulent than originally thought. But the specter raised by the unusual timing and the apparent lethality in Mexico unleashed a series of public health emergency measures that gave officials a real-time exercise in procedures designed to deal with threats such as a bio-terrorist attack, a nuclear meltdown, a dirty bomb, or like the pandemic flu of 1918, a naturally occurring, rapidly spread infection of deadly severity. Over the next few months, lawmakers and public health experts will be analyzing the response.

As officials judge their performance in ensuring our health and safety, we should take the opportunity to consider our own preparedness for such catastrophic events. Every family and business should have an emergency plan.

Families should prepare for two possible scenarios: evacuation (e.g. fire, flood, some forms of attack) and shelter-in-place or “social distancing” (e.g. airborne contamination by chemical, nuclear or infectious material). Everyone in the household should know the plans.

Evacuation plans should include routes out of the house (in case of fire); a place to meet outside the house; a “go-bag” containing food, water, clothing, a battery powered or crank-operated radio, first aid kit and prescription medicines, personal hygiene items, important documents, and pet supplies if applicable. They should identify a likely safe place to go in advance if possible (e.g. a relative who lives out of the immediate area but within accessible distance), and a way to get there if ordinary transport systems fail. Be prepared to secure your property before leaving if time allows (e.g. know how to turn off utilities).

Families with school age children should be familiar with school emergency procedures. Shelter-in-place plans should include securing doors and windows; sealing off air vents and other air inlets; and having adequate food, water, personal hygiene supplies and medications for at least three days. It’s also advisable to have a battery powered or hand-crank radio. More information about personal planning for emergencies can be obtained at www.ready.gov or www.citizencorps.gov.

Businesses should also have emergency plans. These should include an established chain of command, regular back-up and safe off-site storage of computer files, cross-training of employees in case of large-scale absenteeism, a variety of alternate vendors in case of supply chain interruptions, etc.

More information about business planning for emergencies is available at www.ready.gov/business/index.html

Individuals can sign up to participate in Delco Alert, a community warning system that notifies residents of a major crisis or emergency. This service is provided through the Delaware County Emergency Services Department. Delco Alert can send you an email or send a text message to your cell phone or other wireless device. You let Delco Alert know how you’d like to be notified. To sign-up go to http://delco.alertpa.org

Getting back to flu…The current outbreak, while sufficiently widespread to be called “pandemic,” may or may not have great impact. So far, the degree of illness has been moderate and most people have recovered without treatment. . But it’s a reminder of what can happen. The 1918 pandemic killed 50 to 100 million people out of a total world population of about 1.8 billion. It caused enormous economic damage, especially as most of the dead were young adults in the prime of their working life. Even ordinary seasonal flu takes 30-50,000 lives each year in the U.S., usually among the very young and the frail elderly. It exacts a smaller but very real economic toll as well, in days of work missed in addition to direct medical costs. We should take influenza—any influenza—seriously.

Later this year, when the usual winter flu season rolls around, remember the lessons learned this spring: if you’re sick, stay home from school or work; wash hands frequently with soap and water or an alcohol based hand rub; avoid touching eyes, nose or mouth with your hands; cover your mouth and nose with a tissue when you cough or sneeze and discard the tissue.

Get vaccinated! Flu vaccine is not perfect. The flu virus mutates frequently, and it takes 6-8 months to produce enough vaccine for the United States population. So sometimes the circulating virus strains identified in January for the next season’s vaccine have already mutated by the time the vaccine is produced, diminishing vaccine efficacy. This year’s vaccine production is already underway and doesn’t contain the novel H1N1 strain of this spring’s outbreak. However, work on a vaccine against H1N1 has begun, and it’s possible that a separate vaccine may become available for use if necessary.

But although the vaccine in any given year may be imperfect, it is usually at least 70% effective, which is a lot better than nothing (which is what you get without vaccination). It’s inexpensive and safe. And if you DO get the vaccine and therefore DON’T get the flu, and therefore DON”T expose your elderly grandmother (or the old man who sat next to you on the bus while you were coughing and sneezing), who therefore DOESN’T become ill (perhaps fatally so), isn’t that worth it?