What-if Scenario

Ambulance, Tamiflu, chemical compound, are courtesy of Wikimedia Commons. Mask picture taken by William

What would happen if the H5N1 is able to make the jump to human to human transmission, and becomes a pandemic?

Right now as it stands, only about 50% of people who have contracted bird flu have survived. In 1918 the Spanish flu epidemic killed about 50 million people worldwide. Despite the mortality rate, there was a 98% chance of surviving the Spanish Flu, meaning only 2% of the population died from this strain of bird flu.

So the question remains: If the Avian Flu is the next pandemic how will we control the outbreaks with minimal damage to human population? How will a pandemic affect our infrastructures and our ability to survive once this strain has burnt itself out? The question of “What if” looms on the horizon.

Thai government has raised war on avian flu. All trucks are stopped and inspected regarding the destination point, point of origin, and certificate of health. All owners are registered, inspected, and IDed.

Courtesy of Ministry of Agriculture, Thailand.

The first and foremost plan of action would be to make sure that reporting practices of outbreaks are in fact reported. As it stands now, reports in third world countries have faulty reporting systems (CNN 2006), meaning bird flu cases in humans may go unreported and unnoticed, which could allow the disease to get out of control in certain areas. This means we need to have in place reporting procedures, so all countries, regardless of economic status, have the means and ways to report these outbreaks swiftly and immediately. Along with reporting systems, there also must be a plan of action and a chain of command to implement the necessary procedures for diagnosis, isolation, quarantine, vaccines, in other words, a way to control the virus once it has passed to the general population. This translates into getting the necessary medical equipment and supplies, food for the affected areas should they be quarantined or isolated, compensation for loss of income, and a way to keep infrastructures intact.

The World Health Organization (WHO) has developed a global alert response system in conjunction with the plans of each country. The WHO has created the Global Outbreak Alert and Response Network (GOARN) to respond to a crisis situation. This network recommends certain reporting practices and procedures to control the virus in an outbreak situation. It is important in a crisis situation such as this that there are collaborations and mutual agreements between agencies and countries. So once a country has found itself on the door steps of a pandemic they would immediately report this to the WHO. A country would then determine the risk factor of transmission. One very important factor in this process would be to make sure everyone involved had clear roles and responsibilities.

A responsibility of local officials would be to trace the virus backwards to see who the person had come in contact with while in the contagious stages. Should there be simultaneous breakouts, whole areas would have to be quarantined and isolated to prevent any further spreading of the virus. Quarantine is usually in a hospital environment where isolation is considered home or community based. This means the hospitals would have to have enough rooms, equipment, supplies and trained physicians to deal with an outbreak. Communities would have to have enough food, water, and workers healthy enough to maintain their infrastructures. There would also have to be areas for mass immunizations and distribution of medication. We can see from situations where the Avian Flu has been found currently, that immediate action is very important in controlling the outcome and spread of this strain to date.

Once the policies of control have been implemented it is then up to the individuals themselves to become aware and educated on correct practices. This is something that must take place prior to this transmission stage. People must know what to do in this type of situation before it arises, and prepare for it, doing things like: stockpiling food, having chlorine on hand to purify water, having masks for breathing if they must go out in public, making sure safe food practices such as boiling or cooking food are observed, knowing how to get the necessary medicines and/or vaccines (this includes people who need medication for everyday health problems), keeping one's immune system healthy prior to an outbreak, and most importantly—not to panic. This means having confidence in city/state/country officials to be able to notify the general public with explicit instructions. There are some web sites that recommend having regular meeting with one's neighbors to facilitate a plan that coordinates with other agency plans in order to minimize the risk. The bottom line is this: people must become educated and aware of their community response plans in order to insure their health.

The one topic that has not been addressed thus far is the vaccines themselves. While countries are stockpiling Tamiflu and vaccine, and governments are pledging billions of dollars to research, we the people must wait for the outcome. As new strains mutate and appear there is no guarantee that any of what we have now will help once this hits the general population. This is why in a situation like this, knowledge is the best weapon. This is why we are building this web site.

Instructions for farmers, handlers, and cullers on how to disinfect chickens, including equipment, and transporting trucks daily. There's also instructions on how consumers should select, prepare, and discard the chicken. The government also offers loan on compensation for their chicken upon the early report on any outbreak

Courtesy of Ministry of Agriculture, Thailand.

The thought of “What if” becomes the reality of “What is”, because we know that a pandemic of some sort will most probably affect our generation. Fighting a pandemic will be difficult, but we can save vast populations by developing fast response systems.