Pandemic Flu: Critical Infrastructure Management

From experts to laypersons, no one knows whether the Avian (bird) Flu will be will be the next disaster. New reports consistently state it will be the next major worldwide health concern for the following decade. In my opinion, fire and EMS personnel are a force in place for any type of calamity, and we need to prepare ourselves to answer the call. This article will help give you some basic talking points on what to prepare for in the event of a pandemic flu. It will also offer some guidance to discuss critical infrastructure concerns to stakeholders in your community.

Introduction

The next pandemic flu would impact the world population because it will be a strain of flu which humans have not been exposed to. It may be the "bird flu," or some other strain that mutates from bird to human. Here is a quick review on how the current avian flu would mutate.

The virus is currently in parts of the bird population. The current virus exists primarily in birds in Asia, Europe, and Africa. The virus has been reported to occur in some mammals throughout these areas as well. It has mutated to infect certain mammals, including cases involving humans. However, the virus has not yet mutated to be transmitted from human to human. Once this occurs, the potential for a widespread pandemic flu would be very likely.

Since the human population will have no natural immunity to this virus, the disease will be able to rapidly spread. Conservative estimations feel that 15-40% of the population will become either ill, or unable to work. Those in Fire/EMS will be faced with unprecedented numbers of ill patients, and will be required to staff crews while facing the same rates of illness within their own organization.

What the experts are saying

Dr. Michael T. Osterholm of the Center for Infectious Disease Research and Policy:

"Recent clinical, epidemiological, and laboratory evidence suggests that the impact of a pandemic caused by the current H5N1 strain would be similar to that of the 1918--19 pandemic. More than half of the people killed in that pandemic were 18 to 40 years old and largely healthy. If 1918--19 mortality data are extrapolated to the current U.S. population, 1.7 million people could die, half of them between the ages of 18 and 40. Globally, those same estimates yield 180--360 million deaths, more than five times the cumulative number of documented AIDS deaths." - Foreign Affairs, July/August 2005

He is also famous for his utterance after a press conference when he described our fate if a pandemic were to occur this year: "We're screwed."

Dr. Shigeru Omi, WHO's regional director for the Western Pacific:

"As the new cases of human infection with the H5N1 virus in Turkey show, the situation is worsening with each passing month and the threat of an influenza pandemic is continuing to grow every day." - MSNBC News, January 12, 2006

Dr. Julie Gerberding, Director of the American Center for Disease Control:

"We've probably never been closer to a pandemic than the year in 1917. And so when we see the ominous signs of this very bad virus continuing to propagate there, we do need to take it seriously and solve some of the problems that would be in our way from effective response in the United States." - CBS News, 1 January 2006

Dr. David Nabarro, U.N. system coordinator for avian and human influenza:

"We expect the next influenza pandemic to come at any time now, and it's likely to be caused by a mutant of the virus that is currently causing bird flu in Asia." - Newsday, 28 September 2005

"There are some subtle changes in the genetic makeup of H5N1 which suggest that it is making some of the mutations that would enable it to have a higher likelihood of being able to become a human-to-human transmitted virus" CIDRAP news, Dec 16 2005