November 22, 2017

How a True Pandemic May Look

A pandemic is one of the “big” scenarios that concerns me the most. The reasons for my concern are: 1) We have had multiple pandemics throughout world history, 2) Modern ease of travel can quickly spread a pandemic and, 3) The super bugs that modern antibiotics are ineffective against. Because of the last two concerns, if we have a true pandemic, things could get ugly very quickly.

I’m sure you remember the Swine Flu or H1N1 pandemic. In the 07/21/09 issue of the German Weekly, Der Spiegel, there was an Interview with Epidemiologist Tom Jefferson

“SPIEGEL: Do you think the WHO declared a pandemic prematurely?

Jefferson: Don’t you think there’s something noteworthy about the fact that the WHO has changed its definition of pandemic? The old definition was a new virus, which went around quickly, for which you didn’t have immunity, and which created a high morbidity and mortality rate. Now the last two have been dropped, and that’s how swine flu has been categorized as a pandemic. “
The morbidity rate is the amount of the population that has an illness or disease. The mortality rate is the amount of people killed by an illness or disease.”

From LiveScience.com
“There are currently 28,774 cases in 74 countries, according to the latest WHO statistics. (There are 13,217 cases in the United States, with 27 deaths.)

Declaring a pandemic is a big official deal, so big that this is the first global flu epidemic in 41 years (the last one was the “Hong Kong flu” which killed 1 million people). A pandemic is something like a global version of an epidemic, which is a disease outbreak in a specific community or region or population. “

So if H1N1 wasn’t a pandemic, what does one look like? As mentioned, the “Hong Kong flu” killed 1 million people:

The 1968-1969 pandemic The Hong Kong Flu
“In comparison to other pandemics, the Hong Kong flu yielded a low death rate, with a case-fatality ratio below 0.5% making it a category 2 disease on the Pandemic Severity Index. The pandemic infected an estimated 500,000 Hong Kong residents, 15% of the population.[4] In the United States, approximately 33,800 people died.”

While there was a tragic loss of life, this was only a class 2 pandemic, and the loss of life was mostly seen in Hong Kong.

Pandemic of 1918-1919
“The 1918 pandemic killed an estimated 20-50 million people worldwide, including 675,000 in the United States. The pandemic’s most striking feature was its unusually high death rate among otherwise healthy people aged 15-34. During normal seasonal flu outbreaks, severe complications and death are most common among the elderly and young children.“
 
 
Superbugs

I like About.com ‘s definition of superbug:

“Definition: A strain of bacteria that is resistant to one or more antibiotic(s) that would normally treat the bacteria”

It goes on to explain how superbugs are caused and why they are a problem:

“The increasing emergence of superbugs is a direct consequence of antibiotic misuse. Misuse of an antibiotic results in incomplete elimination of bacterial infections, which, in turn, leads to survival of strains of bacteria that have evolved to resist that antibiotic. Superbugs can be dangerous because of the limited number of treatment options available. Among some of the more common superbugs are methicillin-resistant Staph aureus (MRSA) and multiple-drug or extensively drug resistant tuberculosis (MDR-TB and XDR-TB).”

More on antibiotic misuse from the Mayo Clinic:“If antibiotics are used too often for things they can’t treat — like colds, flu or other viral infections — they become less effective against the bacteria they’re intended to treat. Not taking antibiotics exactly as prescribed also leads to problems. For example, if you take an antibiotic for only a few days — instead of the full course — the antibiotic may wipe out some but not all of the bacteria. The surviving bacteria become more resistant and can be spread to other people.”
 
 
What Can We Expect in a True Pandemic?

If there was an illness that had both high morbidity and mortality rate, say morbidity of H1N1 and the mortality rate of SARS (which had a mortality rate of 9.6%), I believe we would quickly see a domino effect. Schools would close as soon as there was one infected student reported (this happened in multiple schools with H1N1). It is also possible that truckers would not want to risk catching the new bug and decide to stay at home, instead of delivering food and other supplies to infected areas.

Think about your company and every company you interact with having 30% of the workforce sick and not at work. That doesn’t take into consideration people that must take off work to help a sick family member or those that would call in sick out of fear. Now maybe you can see the blow this would have on the economy.

It is possible that quarantines would be installed to try and keep the morbidity rate as low as possible. Which could make it interesting as this study cited by the Los Angeles Times states that First-responders are needed in a pandemic, but not all may want to work, a study finds.

“When asked about willingness to work various shifts, 35% said they wouldn’t be willing to work any shift. And 12% of participants said they’d rather quit or retire early than report for duty.”
 
 
What Can We Do?

We can be ready to take care of ourselves and not be a drain on a system that could very well be taxed to the limits. By taking care of ourselves I mean things like having a minimum of 90 days food stored, having over-the-counter medication stored to give some comfort and aid to any family member that might become sick.

We can also be ready to self-quarantine our families if we see the morbidity and mortality numbers begin to climb. If you cannot self-quarantine, then wash your hands often, use the anti-germ gel as well and touch your face as little as possible. Try to avoid contact with others.

If there is a true pandemic there will be a lot of fear in the populace. People are dangerous when they’re afraid, so even if there is a quarantine there very well could be those willing to break curfew to look for food or other supplies. We should also be ready to protect our family from the grasshoppers.

Here is a little light reading, it is some of the articles I have read in research of pandemic and superbugs.

PandemicFlu.gov

Hong Kong Keeps Ban on Some Chinese Poultry Imports After Flu Link Found

Drug-Resistant ‘Super Bug’ Hits LA County Hospitals, Nursing Homes

U.N. agency warns of possible bird flu resurgence

Yahoo News: Disfiguring tropical disease surges.

Scientists Find New Superbug Spreading From India, there are almost no drugs to treat it.

Also a new flu virus found in India, believed to come from Australia.

Yet a third virus found: “New Unknown Virus Killed 35 in India and 30 in Ukraine”.
 

 
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