Preparing for the Next Pandemic

Foreign Affairs ^ | July/August 2005 | Michael T. Osterholm

[Judith Anne]

Summary: If an influenza pandemic struck today, borders would close, the global economy would shut down, international vaccine supplies and health-care systems would be overwhelmed, and panic would reign. To limit the fallout, the industrialized world must create a detailed response strategy involving the public and private sectors.

Michael T. Osterholm is Director of the Center for Infectious Disease Research and Policy, Associate Director of the Department of Homeland Security's National Center for Food Protection and Defense, and Professor at the University of Minnesota's School of Public Health.

[Judith Anne]

I really recommend this article.

[Judith Anne]

Pinging the list to an important article.

[Jet Jaguar]

BTTT

[TXBSAFH]

It is a question of when not if.

[AntiGuv]

Can disaster be avoided? The answer is a qualified yes.

I'd say the practical answer is a resounding no. The measures required to minimize the impact of an influenza pandemic simply have no reasonable prospect of being undertaken in a systematic way. Any limited ad hoc measures will not produce any great difference toward the ultimate outcome, although they are better than nothing. From a long-term perspective, the most advisable measure would be to expand medical supply production capacity, which is sorely needed anyhow.

As for shutting down trade and borders, that will do little to help the United States. The illegals will bring it across the Rio Grande as sure as chit. Moreover, the illegals will wait until the last moment before they go to emergency room, spreading the pandemic far and wide during the interim. Most of them won't get vaccinated either due to a variety of reasons. This isn't 1918, or even 1968..

[Judith Anne]

The article addresses three "whens."

First--now.

Second--a year from now.

Third--a decade from now.

[Judith Anne]

I agree with your practical answer.

Quarantines will do nothing but give a false sense of security.

Which is why I propose PERSONAL preparation, before, above and beyond any commercial or political preparation.

[conservativewasp]

I was thinking of talking to my doctor and getting and filling several prescriptions for an anti-viral drug. Additionally, surgical masks and latex gloves along with a good food supply in the basement(already have a fair amount just because of Costco). Any other thoughts?

[Judith Anne]

Don't wait too long on those antivirals, and don't get amantadine, Tamiflu is probably better...

[dljordan]

"Don't wait too long on those antivirals, and don't get amantadine, Tamiflu is probably better..."

I read an article the other day about how the Chinese farmers had been feeding Amantadine to their livestock and now the bird flu virus is resistant. I bookmarked the Tamiflu website two months ago.

[Judith Anne]

Yes.

[null and void]

Ooops.

[null and void]

In 1918-19, most deaths were caused by a virus-induced response of the victim's immune system -- a cytokine storm -- which led to acute respiratory distress syndrome (ARDS). In other words, in the process of fighting the disease, a person's immune system severely damaged the lungs, resulting in death. Victims of H5N1 have also suffered from cytokine storms, and the world is not much better prepared to treat millions of cases of ARDS today than it was 85 years ago.

Are there no drugs for treating or preventing a cytokine storm?

Anyone???

[Judith Anne]

For patients on mechanical ventilators, Haldol has been found to be useful in lowering mortality rates.

Haloperidol has been used for many years to manage agitation in mechanically ventilated intensive care unit (ICU) patients, and it is the recommended drug for treatment of delirium in the ICU," Eric B. Milbrandt, MD, MPH, assistant professor of critical care medicine at the University of Pittsburgh School of Medicine in Pennsylvania, told Medscape in a phone interview. "In addition to reducing agitation and delirium, haloperidol inhibits secretion of pro-inflammatory cytokines and improves survival in an experimental model of sepsis in rats."

..."Haloperidol has anti-inflammatory effects on cytokines," Dr. Milbrandt noted. "Given these effects, treatment with haloperidol may have reduced the cytokine storm associated with critical illness, thereby reducing multi-organ dysfunction and improving survival."

Found at: http://www.csrt.com/e_news.php?display&51&item

[Dog Gone]

That is one scary article. Yikes.

[Judith Anne]

That is one scary article. Yikes.

No kidding...

[blam]

Keeping track of things. (bump)

[Siobhan]

An article to note. BUMP

[Myrddin]

ARDS is what killed my dad in December 2003. It was triggered by ash from the fires in San Diego. Essentially a chemically induced pneumonia. No treatment worked. I knew the party was over when the docs hung a Vancomycin IV. That is the last resort against bacterial infections. The phlegm in his chest finally jammed the respirator tube. The ICU staff didn't notice until he went into cardiac arrest. They spent 20 minutes getting his heart running again, but he was never responsive again in any fashion.

[null and void]

Damm. Sorry to hear that.