Thursday, August 11, 2005

Is Canada more clear-eyed?

Bird flu stories are now appearing with regularity in the newspapers. Here are two instructive examples:

Dexter, Missouri (11 doctors, 1 hospital, 6 clinics; population, about 7500). From The Daily-Statesman:
Officials gear up to educate public on bird flu
Stoddard County Health Department Assistant Director Tom Roy said state officials know there will be a pandemic sometime in the future; but they aren't sure when. In the meantime, all he said anyone can do is prepare.

It is with this mentality that Roy said the Stoddard County Health Department has been receiving information, and hopes to educate the public, concerning the Avian Flu.


A couple weeks ago the first reported death as a result of the Avian Flu came from Asia.

Until the possible arrival of the Avian Flu in America, Roy said public health officials will focus on educating the public as much as possible; much like they did a few years ago concerning the West Nile Virus.

"If the Avian Flu makes it to the U.S., we will do the same thing we did when educating and distributing information concerning the West Nile Virus," Roy said. "And people will hear more about (the Avian Flu) because it's a relatively new disease; not because it's here."

Roy said the primary concern at this point is whether or not the virus makes its way to the U.S. But, Roy noted, this practice I typical.

"A couple of years ago we were wondering if SARS would be the next pandemic, so we just waited," Roy said. "All we can really do is just wait and see what the state recommends we do. Right now, it's on our radar and we'll just have to sit and wait."
This starts off well, but it is clear the health department in Stoddard County doesn't know the facts and has no idea how to prepare or what to do. It is a remarkably fatalistic piece. This is rural Missouri and it is hard to fault them for this. There is a scandalous failure in leadership at the state and national level that is leaving this small town essentially defenseless and unprepared, despite the fact that they know there is a problem.

Now, Tacoma, Washington:
Influenza pandemic could overrun local hospital, Tacoma Daily Index, Tacoma, Washington

The odds are good that an influenza pandemic could occur within the next three to five years and health care officials are not ready to handle one.

Regional District of East Kootenay board of directors heard Aug. 5 that if an expected flu pandemic sweeps through the region, local hospitals will be overrun, not enough health care workers will be available to help out and social and economic costs will be vast.

Interior Health (IH) specific projects coordinator Margaret Creighton told directors that a Health Authority Pandemic Plan has been formulated but there is much more to be done and needed in order for the region to even be remotely prepared.


While vaccines could be developed to combat a new flu outbreak, not enough would be readily available to "immunize even the highest risk populations of infants, seniors, people with compromised immune systems or people in institutions, health care workers, people with cardiac/pulmonary conditions and family contacts of those already infected," she added.

According to Creighton's report, an unmitigated pandemic in B.C. would mean: up to 75% of the population being infected; about 33% would become seriously ill; about half a million people needing outpatient care; two to 17 thousand would require hospitalization; 800 to 6,000 people will die; the health care system will experience a 25 to 50% reduction in available staff; and the aggregate economic cost could range from $1 billion to $2.5 billion.


Outbreaks are expected to happen at the same time across Canada and the impact on individual communities could last weeks to months, Creighton said.

"There will be a devastating effect on the health and well- being of the public" and "effective prevention and therapeutic measures will likely be in short supply. Health care workers will be at an even higher risk of exposure and illness than the general population and widespread illness in the community will result in shortages of personnel in other sectors providing critical community services. Local governments have the primary responsibility for response and recovery from the consequences of pandemic influenza," she concluded.

Creighton also told the board that should such an outbreak occur, it is likely that the military will be required for manpower help.

"If we have a whole lot of extra people who are sick and health care workers are sick, we might need soldiers to help out. We are not prepared," she told the directors.
One of the reasons outbreaks race through the population so quickly is that there is a three to five day incubation period for influenza, Creighton said, noting, "it is likely you will have it before you know."
While this seems to be a Tacoma, Washington paper, the story is about British Columbia, a Canadian province just north of Washington state. Not many stories like this quoting US public health officials. Do you get the feeling the view is a bit more clear-eyed in Canada?

I'm sure I'll get comments from my many Canadian readers saying their country is also unprepared. But at least they know it. In the US, most papers are just sitting on their hands. Even big city papers aren't doing much better than little Dexter, Missouri.

It all comes down to the stunning lack of leadership at the national level. While our President makes speeches about keeping us safe and making war on unseen enemies, a Virus of Mass Destruction could kill hundreds of thousands or millions of citizens in the US.

But no speeches.