Next pandemic may be closer than you think

If it strikes, as much as 40 percent of work force might have to stay home

By Mary Wade Burnside
Times West Virginian

FAIRMONT — If a pandemic flu epidemic strikes, as much as 40 percent of the work force might have to stay home because of illness or the need to take care of family members.

That would include hospital and emergency workers, thereby depleting the segment that would be needed the most during a time of crisis.

Not only would some people with the flu go without professional medical treatment, but even such incidents as car accidents might have to go untreated by police or an emergency squad.

“There is a strong possibility that if we just have half of our staff, that we would have to have some people take care of themselves,” said Chris McIntire, director of emergency services in Marion County. “Believe me, we would do the best we possibly can of getting help to everybody.”

McIntire also serves as the chairman of Marion County’s Local Emergency Planning Committee, which meets monthly. The group plans for potential events including natural disasters and terrorist attacks, but recently, pandemic flu has been a primary focus. An emergency plan is available for public viewing at the Marion County Commission’s office, and, McIntire said, eventually the document should be available via the Internet.

Part of the plan would be for as many people as possible to stay at home, or “shelter in place,” in an effort to prevent the spread of the pandemic.

“That’s the major focus right now,” McIntire said. “If you think about it, there’s no place with 58,000 beds in Marion County. At home, there’s someone to take care of the sick. There’s food at the house and shelter. It’s only logical to keep people out of harm’s way.”

It’s been nearly 100 years since the 1918 flu pandemic killed an estimated 50 million to 100 million people worldwide, and some health officials say it’s not a matter of if but when another one will strike. The World Health Organization warns that a substantial risk exists for a pandemic flu to emerge in the next few years.

So far, the bird flu, which has jumped from animals to humans but has yet to be easily transmitted from human to human, is considered a likely candidate to be the virus that causes a pandemic, but no one knows for sure.

“Pandemic flu is going to be a very challenging event,” said Jamie Moore, the regional all hazards coordinator.

Moore works out of the Monongalia County Health Department in Morgantown, but his scope includes not only that county, but also Marion, Harrison, Taylor, Preston and Doddridge counties.

“The problem with a pandemic is being that it’s a new strain of virus, we won’t have immunity,” Moore said. “So it has a pretty devastating effect on the body when you get it. Being that no one has immunity, it goes through the population pretty quickly.”

According to www.birdflufacts.com, a vaccine against the deadly H5N1 virus of bird flu is under development, but has not been tested and would not be available until after a pandemic begins because the new virus has to emerge before it can be included.

Even though there are a lot of unknowns about a pandemic, based on the 1918 flu episode, health officials can come up with potential scenarios. They are bleak, with death expected on a scale that might be difficult to comprehend.

“Nobody is real certain,” McIntire said. “In England, where they are having cases of it, they are estimating that it could affect 7 percent of the population, and 2 percent of that could be fatalities. That’s a large number when you are talking a county of 58,000, to have something of that magnitude. It would send shockwaves across the entire county.”

In the case of a pandemic, Moore of Monongalia County envisions a scenario in which the first wave of the disease would last for about eight weeks.

“It could vary,” he said. “And then it kind of dies down. Then it comes back within another month or so.”

And while the nation watched the devastation of Hurricane Katrina, at least the residents of Louisiana were able to get outside help from the rest of the country. That will not be the case with a pandemic.

“The ability of folks to send help is going to be limited,” Moore said.

Eventually, vaccine would be manufactured and administered, and the population would begin to build up immunity.

In 2007, pandemic flu has been the topic of discussion at two Fairmont events, including an informational summit at Fairmont State University in January and a regional meeting of area county health departments earlier this month.

In the case of an outbreak, the Marion County Health Department, acting with guidance from the state and the Centers for Disease Control and Prevention (www.cdc.gov), would be the entity that tracks the illness and provides leadership to the community.

But before an outbreak might occur, health officials encourage families to be prepared to stay at home with supplies for food, water and other items.

A Web site, http://pandemicflu.gov/plan/individual/familyguide.html, provides a comprehensive list of items that people should have on hand, including two weeks of nonperishable food and two weeks of water, which would be one gallon of water per person per day for consumption, food preparation and sanitation.

“We’re basing this on the assumption that up to 40 percent of the work force might not be working, maybe greater,” said Lloyd White, the administrator of the Marion County Health Department.

That number could include power and water plant employees, which could endanger utilities.

“We don’t know if we’ll have water or electricity or other utilities because of these unknown factors, so it’s good to plan for that,” White said.

The county has a grant from the CDC that includes $22,000 for pandemic flu, said Tammy Hare, an epidemiologist with the Marion County Health Department. Of the grant, $4,000 has gone to the Local Emergency Planning Committee, which is stockpiling supplies, including 20,000 specialized N95 masks for responders.

Also, the Marion County Board of Education has gotten $1,000 to buy supplies, including thermometers, “so they can take kids’ temperatures and see whether or not they should be sent home,” Hare said.

Health surveillance is an important part of dealing with a pandemic, health officials agree, and even though the disease will be different than seasonal influenza, if people get their annual flu vaccines, it helps in the long run.

“If you do get sick and you know it’s not regular flu, then you eliminate that as a possibility,” said Janet Crigler, the infection control coordinator at Fairmont General Hospital. “Plus, we don’t want people coming in with seasonal flu where there is avian flu.”

In the case of a pandemic, the expectation is that the hospital would become too crowded to deal with everyone who is sick, whether with the flu or with the everyday sicknesses that will not just go away because of the crisis. People with the flu would remain at home and be cared for by their relatives, who would try to keep them hydrated and deal with the illness as best as possible.

“The most important thing people can do is to learn what they need to have at home as far as supplies and learn good home care,” Crigler said. “Sometimes, the hospital is not the best place to be.”

E-mail Mary Wade Burnside at mwburnside@timeswv.com.