Wednesday, December 19, 2007

Pandemic Flu Virus

The evolution of flu viruses cannot be predicted. This makes it difficult to know if or when a virus might mutate to become easily transmittable among humans. Therefore, it is impossible to say when another pandemic will arise, or whether it will be mild or severe. One thing is known; it is not a question of if, but a question of when.

However, the World Health Organization (WHO) asserts that once a virus allows for efficient human-to-human transmission, a pandemic can occur. Because of high global mobility and interconnection, illness could spread quickly and, if the virus has a high fatality rate, threaten millions of lives around the world.

A flu pandemic may strike in waves, each of which could last for 6 to 8 weeks. An especially severe pandemic could lead to widespread illness, a large number of deaths, and economic loss.

Everyday life would be disrupted because so many people in so many places would become seriously ill at the same time. Impact could range from school and business closings to the interruption of such basic services as public transportation and food delivery.

A substantial portion of the world's population would require some form of medical care. Healthcare facilities would be overwhelmed, creating a strain on hospital staff, and a shortage of beds, ventilators, and other supplies.

Central to preparedness planning is estimating the mortality rates of the next pandemic. Experts' answers to this fundamental question have ranged from 2 million to more than 50 million. All of these predictions are scientifically grounded. The reasons for the wide range of estimates are numerous.

Even in the best case scenarios of the next pandemic, 2 to 7 million people could die and tens of millions would require medical attention worldwide.

Interventions: Distributing antiviral treatments to inffected individuals and others near them to reduce symptoms and susceptibility; vaccinating people, possibly children first, with either 1 or 2 shots of a vaccine not well matched to the strain that may emerge; social distancing, such as restricting travel and quarantining households; and closing schools.

The results also showed that vaccinating school children first is more effective than random vaccination when the vaccine supply is limited. Regardless of contagiousness, social distancing measures, alone, had little effect.

But when the virus was highly contagious, all single-intervention strategies left nearly half the population infected. In this instance, the only measures that reduced the number of cases to below the annual flu rate involved a combination of at least three different interventions, including a minimum of 182 million courses of antiviral treatment.

No Interventions: The results showed that, with no intervention, a pandemic flu with low contagiousness could peak after 117 days and infect about 33% of the US population. A highly contagious virus could peak after 64 days and infect about 54% of the population.

Rhode Island is one of only seven states, including Massachusetts, that have yet to make any purchases toward its share of the stockpile of anti-virals for pandemic influenza, which is something public health policy officials say puts the entire nation at risk.

The state has until June to comply. Also, Rhode Island doesn't have a liability shield law in place to protect health care volunteers in the case of a public health emergency.

A pandemic could deliver a "shock" to the economy, with immediate demand- and supply-side effects, as well as longer-term supply-side effects.

As a pandemic spreads, international travel would dramatically decline as people avoided flu "hotspots" and governments restricted travel. In all likelihood, people would quarantine themselves and their families by staying at home more. Nonessential activities requiring social contact would be sharply curtailed, leading to significant declines in retail trade. People would avoid public places, such as shopping malls, community centers, places of worship, and public transit. Attendance at theaters, sporting events, museums, and restaurants would decline.

Schools and business would suffer. It seems likely that many schools would close, and even if they did not, attendance would fall dramatically as parents kept their children at home. In either event, large-scale school closings would lead to a spike in workplace absences because parents would stay home to care for their children even if they were not sick. The impact on businesses of all kinds due to employee absenteeism would be dramatic.

The general slowdown in economic activity would reduce gross domestic product (GDP).

Business confidence would be dented, the supply of labor would be restricted, supply chains would be strained as transportation systems were disrupted, and arrears and default rates on consumer and business debt would probably rise. It seems likely that the stock market would initially fall and rebound later.

Estimates of the economic impact vary widely. A pandemic could cause a serious recession in the US economy, with immediate costs ranging from $500 billion to $675 billion.

The following is a sampling of predictions from financial leaders:

WBB Securities LLC predicted a pandemic could cause a one-year economic loss of $488 billion and a permanent economic loss of $1.4 trillion to the US economy

The Congressional Budget Office said a pandemic could deal a $675 billion hit to the US economy
The World Bank has predicted a pandemic could cost the global economy $800 billion a year.

Despite the advance warning, the world is ill prepared to defend itself against a flu pandemic. WHO has urged all countries to develop preparedness plans, but only around 40 have done so.

The WHO has further urged countries with adequate resources to stockpile antiviral drugs nationally for use at the start of a pandemic. Under the current situation, most developing countries may have limited access to vaccines and antiviral drugs throughout the duration of a pandemic.

Coming soon: How you can prepare.

No comments: