"What do I do if a bird flu pandemic strikes?"
Welcome to my Web log (blog).
A brief bio: My background is in journalism and marketing communications. I have been directly employed by insurance, investment securities, and high technology companies. I have marketed products to emergency management agencies. I live in the United States. I'm older than 50. I have a family. My nickname on this blog is Chirp. I'm one small voice.
It's mid-November 2005 and I'm increasingly concerned that you and I haven't been taking the H5N1 strain of avian flu seriously enough. That may end up not being a problem, because the H5N1 avian flu may not develop into something significant for human health. From what I can tell, medical scientists and public health officials have no way of knowing with certainty what will happen regarding avian flu.
Probably the reason you and I haven't taken H5N1 more seriously is because we haven't heard about it. A good bit has been said - and by notable sources - but it gets lost against the background of wars, hurricanes, earthquakes, terrorism, politics, corporate news, and the din of popular culture.
That's changing. Those same experts who can't predict with certainty what H5N1 will do are clearly (in my opinion) "talking louder" about the potential for H5N1 to develop into something very major. Something very threatening to our lives, health, and economies. Authoritative sources from many directions are saying similar things and their messages are pretty consistent:
"...the [H5N1] virus may be evolving in ways that increasingly favour the start of a pandemic. ...H5N1 has become progressively more pathogenic in poultry ... and is now hardier than in the past... Evidence further suggests that H5N1 is expanding its mammalian host range."
- World Health Organization report. January 2005.
"H5N1 continues to evolve in the virtual genetic reassortment laboratory provided by the unprecedented number of people, pigs, and poultry in Asia."
- Dr. Michael T. Osterholm. Foreign Affairs, July/August 2005.
"...no virus of the H5 subtype has probably ever circulated among humans, and certainly not within the lifetime of today’s world population. Population vulnerability to an H5N1-like pandemic virus would be universal."
- World Health Organization report. January 2005.
"Once a fully contagious virus emerges, its global spread is considered inevitable."
- World Health Organization report. October 14, 2005.
"Businesses would be confronted with, say, 25% absenteeism, maybe more, as many workers take ill, stay home to take care of children or family members or refuse to go to work, especially in heavily populated office towers. Business continuity planning is essential..."
- Dr. Sherry Cooper, Chief Economist, BMO Nesbitt Burns. October 11, 2005. [890k .pdf]
"Few countries have the staff, facilities, equipment, and hospital beds needed to cope with large numbers of people who suddenly fall ill."
- World Health Organization report. October 14, 2005.
"Policy makers everywhere need to give the influenza threat top political attention and priority, to avert, delay or mitigate what could be a major global disaster."
- The World Bank. November 2005. [2.3Mb .pdf]
"In 1976, 37 U.S. companies manufactured vaccines. In 2002, there were only three."
- Trust for America's Health. June 2005. [212k .pdf]
A virus is unpredictable. So the comments above are cautiously punctuated with tentative words like "if" and "possibly" and "suggests" and "could."
These experts have been dancing delicately between (a) unduly alarming people based on the unknown and unknowable and (b) failing to give adequate warning in the face of an indescribable potential threat. But it appears that mounting evidence shows the threat's potential is growing. The experts seem to be getting more uncomfortable with the trend of developments - frankly, more alarmed, more worried. So they're getting more vocal. Future developments still remain unknown and unknowable. But these experts see disturbing incidents.
As a consequence, their message seems to be shifting more from "Think about how you would prepare" to "Get busy." Or even "Hustle! The world is way behind schedule in getting ready for this thing!"
One background issue seems to be the concern that in many cases public health systems reportedly haven't been funded and supported well enough. The public health system "safety net" needs strengthening in general, regardless of any specific health threat. But at the moment, H5N1 is what's driving the conversation.
It increasingly appears to be one of those times when it's better to err on the side of caution. Better to be prepared for something that doesn't come than to be unprepared for something that totally overwhelms you and everyone around you. (And in any case, such planning better equips us for any emergency or future pandemic, whether or not it's H5N1.)
And the experts' message is to everyone: individuals, businesses, schools, governments, health care providers - everyone. "Be working on your plan. Think about all the ramifications."
Trying To Imagine What Could Happen
The ramifications could be mind-numbing. Potentially very large numbers of people sick or dead all around the globe. (The estimates vary, but they all involve BIG numbers.) No natural immunity. Probably no vaccine for months. The health care systems could be overloaded. The global economic impact could be unknowingly large and may domino very swiftly. Closed borders. Crippled supply chains. Any activity or site involving groups of people or person-to-person contact could be affected to some degree - perhaps restricted or cancelled. Think about workplaces, schools and universities (including dormitories), stores, day care centers, airports, public transit, religious assemblies, sporting events, places of entertainment, tourist sites, fitness centers, nursing homes, doctors' offices - even hospitals (e.g., no "Visiting Hours").
These impacts on daily life might last for weeks ... and might occur all over again in a second or third wave of sickness.
The disease itself is something to be avoided. This is not just "the flu" (although annual garden-variety flu viruses are under-appreciated killers themselves). If we can compare H5N1's potential to the last major pandemic flu in 1918-19 (and it may or may not be like that, but the scenario has similarities), young, healthy adults were prime victims. (Just the opposite of what you'd think.) Often the virus killed very quickly, kicking immune systems into a frenzied overdrive so the body basically killed itself instead of curing itself. Survivors, meanwhile, suffered an ordeal unlike any they had ever experienced.
Taking Action: Medical and Non-medical
So the threat is very real (although, at this writing, it remains only a threat). We all need to "think about how you would respond" in order to (1) avoid contracting H5N1 bird flu, should it emerge as a human pandemic, and (2) cope with the changes in daily activities which a pandemic likely would force upon us for a while. Unfortunately, the focus of most coverage in the news and on blogs, thusfar, is on the science or the politics of an H5N1 avian flu pandemic. Few deal with the practical ramifications (and, therefore, the practical preparations) for either individuals or organizations.
And too many comments from politicians, policy makers, and medical experts suggest that vaccines and antiviral medicines (e.g., Tamiflu) will save the day when, in fact, those remedies either don't exist yet or won't exist in sufficient quantity in the foreseeable future. Such overly-reassuring comments, regardless of how well-intended, simply lull us into a false sense of security. And they distract our attention from valuable non-medical steps we can be taking in our homes and businesses.
In this blog, I intend to focus on taking action - responsible individual and organizational preparation in the face of a possible worldwide avian flu pandemic. I'll also report news developments, mainly to make us aware of the potential risks we face.
Adjusting to the Idea (It's OK to be Scared)
Some of our preparation is mental, some is physical.
The first thing we need to do is understand what we might be up against - what a flu pandemic might entail (e.g., the scenario a few paragraphs back.) That can be shocking.
The scale of a truly major pandemic and the personal threat it poses would be unlike anything experienced by most people alive today. When you also realize that an influenza pandemic may not be a remote possibility but a looming possibility ... well, it's scary. (It scares me, and I consider myself a pretty rational person who doesn't try to borrow trouble or assume the worst.)
Actually, it should scare us. It's even good that it scares us. Because (1) a pandemic flu is a frightening prospect, something it's normal to fear, and (2) when we're scared, we pay attention and we take protective action.
By the way, to say we're scared doesn't mean we're running through the streets in a panic. It just means we see this threat for what it is and we're very concerned, even worried, about what it could turn in to. And we act accordingly. (You may be scared of that big, vicious dog next door - and with good reason. So you keep your distance and watch him out of the corner of your eye. Scared, but level-headed action.)
It may take a bit of mental adjustment to get used to the idea. That's OK. That's normal. Just keep studying the matter. Give it time to digest. Then build your game plan.
Countless Ways to Prepare ... Today
Unlike nearly a century ago when the 1918-19 "Spanish Flu" happened, we can see this potential threat coming. So we can get ready for it. There's plenty we can do. You need to make plans - at home, work, school, wherever - and begin pulling together the reasonable resources needed to weather the storm that may be on the horizon. You don't have to do it all overnight; but you don't need to put it off, either.
At the same time, we have to temper our preparedness decisions with the fact that a flu pandemic from the H5N1 virus might not occur. So we (and our governments) are caught between two considerations. If a pandemic comes, no preparation will have been enough. But if the risk subsides and there's no pandemic, we will have wasted at least part of our investment. Deciding which way to go is a daily challenge in risk management and emergency preparedness. As Dr. Peter Sandman, a noted risk communications consultant, observes, "Preparedness isn't about things that are already happening. And preparedness is only rarely about things that are sure to happen. Preparedness is mostly about things that might - or might not - happen."
However extensive your planning turns out to be, what might you do? Some starter ideas:
- Learn about H5N1 bird flu and monitor its developments. ("Forewarned is forearmed.")
- Should the H5N1 bird flu gain the ability to spread readily among humans, alter your activities to reduce chances of exposure. Think about how you would do this. For example, avoid crowded, enclosed places whenever possible.
- Become more conscious of improving your personal hygiene to reduce chances of exposure. Handwashing is mundane; but, hey, it works.
- Obtain items which might help you reduce your public exposure while meeting your household needs. (By the way, "stockpile" is not a dirty word. Governments are stockpiling antivirals and probably other medical supplies ... and I'm glad they are.)
- Think about how you might collaborate with your extended family, neighbors, and community. Emergency preparedness begins at the local level. Don't rely on federal, state, or provincial governments. They're limited in what they can do in a case like this. Meanwhile, you have a lot of flexible control over what you can do.
- For businesspeople, think about your employees' health. How can you fight the spread of flu in your work environment? Also, collaborate with your customers, suppliers, industry, and government. Plan how to mitigate any "shock to the system" which a pandemic might deliver to your supply chain. (This is simply an addition to your business continuity plan.)
My Limitations & Your Responsibilities
I'll do what I can to help you (1) track major developments with H5N1 avian flu and (2) think about your own pandemic plan (both personal and organizational). But I must warn you of my limitations. (Pardon me if I sound like a lawyer here. But I think it's best for us both.)
I'm just an average citizen. I'm providing some information, not an advisory service. In particular, I do not provide medical advice or financial advice.
I can't emphasize enough - I'm not a medical professional. I have no training or expertise in infectious disease, public health, or any other field directly related to health care or influenza and pandemics.
I don't work for any government. I don't work for any public or private health organization. I'm not a policy maker. I do not hold an elected office.
I do not guarantee that the information I provide will necessarily be accurate. I'm reasonably intelligent, have reasonable judgment, and am pretty good at sifting information. But I'm out of my field (if I haven't made that point clearly enough already).
I do not guarantee that the information I provide will necessarily be timely. I'm one person. I can only read and write so fast. And I might get sick or otherwise detained from publishing information on this Web site.
In sum, I make no claim to be authoritative or that the information I present is reliable.
You are responsible for you. You are individually and solely responsible for (1) researching influenza Type A H5N1 ("avian flu" or "bird flu") and its potential risks from all available sources and (2) deciding how, if at all, avian flu affects your life and the lives of those about you and (3) taking any action (or no action) in response to the existence of avian flu (or any other potential pandemic agent, for that matter).
What I Offer
Here's what I offer - and all I offer: I'll be a citizen journalist. As a journalist and communications professional, I've spent a career researching and synthesizing information, then presenting it in clear, effective ways. I hope to accomplish that here.
In that sense, I'll be doing a lot of the work for you. But ultimately what you learn, where you learn it, and what, if anything, you do in response is singly and entirely your responsibility. Don't take my word for anything. Do your own research through sources I reference and elsewhere. (By the way, I intend to regularly cite and link to my sources of information. Please look at them yourself and draw your own conclusions. As your knowledge grows, perhaps you can become a helpful resource for those around you.)
In case you're wondering, I'm doing this on my own. No one has hired me to write a blog to benefit their company or industry. (But I do have a Tip Jar, if you want to compensate me for my efforts; see the "Contribute" link in the margin. And I'll probably regularly have advertising, hoping to make some income that way.) I'm investing a ton of time plus some out-of-pocket expenses to publish this blog. If you think it's useful, please tell your friends to visit the site. And subscribe to this blog's RSS feed. [What's an RSS feed?]
Unfortunately, I only speak and read English. So I expect I'll be fairly limited to referencing resources which are in English.
H5N1 may "fizzle out" and never reach the point of readily passing from person to person. I hope so. But whatever the future holds, I wish for you good health.