Health Experts Discuss Flu Pandemic Strategies Washington authorities preparing for the next flu pandemic acknowledge that the best tools for protecting Americans are the same ones used in the pandemic of 1918, including home quarantines, school closures and cancellation of public events.
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Health Experts Discuss Flu Pandemic Strategies

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Health Experts Discuss Flu Pandemic Strategies

Health Experts Discuss Flu Pandemic Strategies

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A year the Bush administration unveiled its plan to fight a possible future flu pandemic, one on the scale of 1918, when more than a half million Americans died. The government is still refining that plan. This week experts held a workshop in Washington to examine how much protection the nation can get from the very same public health measures used in 1918.

Here's NPR's Richard Knox.

RICHARD KNOX: When the pandemic struck 88 years ago, about the only advice officials could give was hunker down. Don't go out in public. Keep your children home from school. Keep travel to a minimum.

This week's workshop is examining those very strategies because there won't be an effective flu vaccine for months after the next pandemic strikes and there won't be enough antiviral drugs. Dr. Howard Markel is a medical historian at the University of Michigan.

HOWARD MARKEL: If pandemic flu were to happen and we did not have enough vaccine or antivirals, we're in a way jerked back into the 1918 era because all we have are the time tested tools that were applied 100 years or more ago.

KNOX: Markel and his colleagues have been looking back at how American communities coped during 1918 using those classic strategies. They're arriving at surprising conclusions.

Take Gunnison County, Colorado. In the fall of 1918, officials there barricaded roads, quarantined anybody getting off the train, closed schools and banned public gathers. Nearby communities had flu cases and deaths in the hundreds. Gunnison County counted only two cases and one death.

Markel is also looking at cities where things didn't go well in 1918.

MARKEL: Denver, for example, and Newark had good strategies in place but there was so much infighting between the mayor and the health commissioner and the state board of health and so on and so forth that all these interventions were probably for naught.

KNOX: This week's workshop, organized by the Institute of Medicine, also considered whether today's Americans would go along with recommendations that would disrupt their lives for weeks and months. A new survey shows that nine out of ten Americans say they would, at least in the short term.

Robert Blendon of Harvard says the survey also uncovered some big problems.

ROBERT BLENDON: We had one in four people say, if they couldn't go to work for seven or ten days, they would either lose their job or their business.

KNOX: And many Americans say they wouldn't have anybody to take care of them if they fell ill with the flu.

BLENDON: The one in four who could be sick at home with no one to care for them calls out for some sort of emergency home care services and it would be very hard to get that going if you didn't plan for it ahead of time.

KNOX: Blendon says 75 million people could need home care and they'll be disproportionately elderly, disabled and poor. Bruce Gellen acknowledges the problem. He's one of the federal government's chief pandemic planners.

BRUCE GELLEN: There are sectors of the community that we know will have more trouble than others and we're going to need to think through how they can be assisted to protect themselves and their families.

KNOX: Local communities are rehearsing some of the decisions they'll have to make during a pandemic. Dr. Jeff Duchin of the Seattle-King County, Washington Health Department says there's one such exercise there tomorrow.

JEFF DUCHIN: Good. With that happening in 1918, we saw a mishmash of haphazard and reactive measures to try and respond to a severe pandemic that had variable and minimal effects.

KNOX: By planning ahead this time, Duchin says the idea is to do better the next time using many of the old time-tested tools.

Richard Knox, NPR News.

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