Wednesday, March 08, 2006

Worst-Case Scenario for H5N1 Avian Pandemic Flu

During Hurricane Katrina we witnessed how vulnerable the US is to disasters. New Orleans was a scenes of mass hysteria. The health system was also grossly ill-prepared. Hundreds of patients in skilled nursing facilities were left behind to die. Charity Hospital was a nightmare. Short-staffed, no power, no food, no medicine. Staff hand-ventilated critically ill patients hour-after-hour, day-after-day; with the hope, "they are coming to save us." But noone came.
After 5 days without rescue, hospital staff became exhausted, hopeless, and disheartened. Such severe physical duress and emotional torment can only be paralleled to that which was experienced by the Donner party. And in the moment of dark desperation a few could not squeeze the Ambu bag any more and resorted to euthanasia. I do not condemn but mourn.

During a severe H5N1 avain flu pandemic there will be massive disruptions of transportation, economy, and utilities. The first pandemic wave will last 6 weeks. At its peak, a hundred thousand US citizens could die in one day. The supermarket shelves will be stripped bare in a few hours of the first day. As the pandemic rages on and the food runs out, I can't imagine the acts of desperation that will transpire. The hospital can run up to a week without resupply and less without power. There will not be any vaccine, there will not be any Tamiflu (not that it helps anyways), there will be no ventilators, there is no treatment. The nightmare of New Orleans and Charity Hospital will flood over every city and hospital across the country and across the world.

Beware of the belief that because we are so technologically advanced that we won't fair as poorly as they did in 1918. The US may be the only world superpower, but we as Americans are weak. We are so much less self-sufficient and less independent than 1918. With NAFTA and World Trade, we import our food from Brazil and Mexico and our N95 masks from Taiwan. In 1918 food was locally grown and harvested. Americans knew how to cultivate a garden, how to save, how to rashion, and how to make due. We are emotionally weak. In 1918, women died in childbirth, and babies died in infancy. All Americans in 1918 knew how to deal with loss. Today, we cannot emotionally manage the loss of a few who volunteer their lives for their country and to pay the price of freedom for their brothers. Even if the eventual H5N1 avian pandemic flu virus isn't as virulent as in 1918, we will fare much worse.

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