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Pandemic

Sun, 04/26/2009 - 08:08 — Rottenchester

Eric Massa's call for closure of the Mexican border got some attention in the local media. It's too early to tell whether Massa's call is panic or prescience, but some of what I've read about the Mexican outbreak is not a confidence booster:

I'm a specialist doctor in respiratory diseases and intensive care at the Mexican National Institute of Health. There is a severe emergency over the swine flu here. More and more patients are being admitted to the intensive care unit. Despite the heroic efforts of all staff (doctors, nurses, specialists, etc) patients continue to inevitably die. The truth is that anti-viral treatments and vaccines are not expected to have any effect, even at high doses.
[...]
The truth is that mortality is even higher than what is being reported by the authorities, at least in the hospital where I work it. It is killing three to four patients daily, and it has been going on for more than three weeks. It is a shame and there is great fear here. Increasingly younger patients aged 20 to 30 years are dying before our helpless eyes and there is great sadness among health professionals here.

One of the most interesting, and scariest, works of history I've ever read is The Great Influenza, which documents the 1918 "Spanish Flu" pandemic. A few take-home lessons from that book:

  • Like this outbreak, the 1918 pandemic killed the young and healthy, not the old and weak.
  • The 1918 pandemic began with outbreaks in crowded areas (Army bases) and it seemed to "flare up", kill large numbers, and then go away for short times. Overall, it was short (18 months) and deadly (50 million killed worldwide).
  • The care in 1918 was mainly supportive. Hospitals quickly became overwhelmed by the large numbers of victims.
  • One of the major contributors to the spread of the 1918 pandemic was minimization by authorities. This included wartime censorship which filled the newspapers with happy talk instead of news which could have led to school closings and quarantines. Authorities also did things like holding massive draft call-ups in cities where flu was reported.

Comments

Sun, 04/26/2009 - 18:41 — Anonymous (not verified)

closing the boarders would cost millions of dollars in trade and commerce. Great idea Massa, your own party has already come out against such a dumb idea.

Sun, 04/26/2009 - 18:43 — Anonymous (not verified)

PS ... this must be bush and randy kuhl's fault

Sun, 04/26/2009 - 21:01 — Rottenchester

I don't think this issue is partisan. It's true that closing the border has huge practical problems, and I'm not sure that it's the right thing to do, but I'm also not sure its the wrong thing.

Remember that the 1918 flu outbreak killed 2.5-5% of the world's population. Read that sentence again. Between 2.5 and 5% of the world's population was killed in 18 months.

Also, while there is some hope that anti-virals like Tamiflu might lessen the impact of a pandemic, and there's also hope that the availability of mechanical ventilation and antibiotics might provide better supportive care, the fact remains that we just don't have the resources to hospitalize millions of people. The SARS outbreak in Toronto, which affected a far fewer than 2.5-5% of the population of that city, brought the medical establishment there almost to the breaking point.