Birdflu Mailing List: Bird Flu article draft editing RSVP

[William Weir (weirwilliam]

Draft of an article requested for publication (editing suggestions welcome !!!)

 

by Rev. Bill Weir, DB (ministry, U. of Chicago), MHA (healthcare 
administration, U. of Minnesota)

 

(Contacts:  cell phone 612-751-0445, email weirwilliam [at] 
msn.com<mailto:weirwilliam [at] msn.com>

Home phone 763-568-7022, address 10505 8th Ave N #111, Plymouth, MN 55441-4431)

 

The First Unitarian Society of Minneapolis has recently created a standing 
committee, which I chair, working on emergency preparedness.   The committee 
believes that the principal threat for which most people are not prepared is a 
pandemic influenza outbreak.

 

One key concern is for those who are most vulnerable. How best can we help them 
become adequately prepared?  How can our trained team of volunteers called 
"Caring Circles" best work with our ministers in reaching out to help them when 
the pandemic comes?

 

As chairman of the committee, I have given a good deal of thought to these 
questions.  So far, in consultation with its members, I have developed a few 
opinions that I believe to be true.

 

1>               What is the threat?  Our Minnesota State Epidemiologist 
predicts that about one quarter of our population would contract the pandemic 
flu: 1,250,000 people (MN Physician, 1/06).  This would be far more than could 
be hospitalized, even with extra beds set up in field hospitals.  So most of 
these people with this virulent flu could only hope to be adequately cared for 
at home.

2>               How virulent would it be?   Currently, more than half the 
people known to have contracted influenza A of this new type (H5N1) have died 
from it.  Some predict that when this type acquires the ability to spread from 
person to person, it will become less virulent.

3>               When will a vaccine be available?   Probably not for at least 
six months after the beginning of efficient person-to-person transmission of 
the virus.

4>               What about Tamiflu?   This anti-viral medication, massively 
stockpiled by the Federal government, has been tested in Vietnam, apparently 
finding that it does not stop this H5N1 flu when given in the usual dosage at 
the ideal time, soon after infection occurs.  Perhaps larger dosage will work.  
Its manufacturer, with former Defense Secretary Donald Rumsfeld as one of its 
significant investors, may sponsor more research showing how it can be as 
effective as in seasonal flu, where it stops the virus from breaking out of a 
human cell where it has multiplied, thus reducing the virus' attacks on other 
cells.

5>               Who are most vulnerable?   Surprisingly, it appears to be 
people with strong immune systems!   Comparing various age groups who have 
contracted this flu, most people are surprised to find the death rate is 
highest, over 70%, among those of age 10-19.   A common complication is a 
severe pneumonia (mucous in the lungs, which can interfere with exchange of 
oxygen and carbon dioxide with the blood), making it very difficult to breathe 
efficiently, perhaps to the point of suffocating the victim.

6>               What could explain this vulnerability?  Studies of flu victims 
and their medical records show that many with strong immune systems die from 
complications arising from the immune system over-reacting, creating what is 
called a cytokine storm that is fatal.

7>               How can a cytokine storm be prevented or abated so that the 
victim survives?  Recent reports suggest that this deadly storm can be 
prevented or sufficiently reduced by anti-inflammatory and/or statin medicines 
taken promptly and in sufficient quantity.

8>               How can we prevent the spread of this flu?   We may reduce the 
toll of this pandemic flu, to which almost no one is immune, by extraordinary 
precautions, even to the extent of closing schools and prohibiting indoor 
gatherings at churches, arenas and other venues.   Even now, individuals and 
families can improved their habits that will reduce the risk:   Hand cleansing 
should be done more thoroughly, preferable with alcohol-based gel or liquid, 
and more often, including every time we come home, before handling anything to 
be eaten, after shaking hands, handling a door knob or stair rail, etc.   Cover 
your cough and sneezes with tissue (and dispose of it instead of reusing it), 
otherwise with a sleeve at the elbow, tightly enough to prevent droplets from 
escaping.  

9>               What about wearing a mask?   Yes, wear a surgical mask if you 
are coughing or sneezing, but wear a well fitted respirator if you may be 
around anyone with this flu, such as an N-95 respirator covering nose and mouth 
such as housepainters wear, or an even better system for ensuring the air you 
breathe does not carry this flu virus.

10>                    So what are caregivers to do?   Be diligent in 
protecting your own health.  Have supplies on hand that may be needed for 
sanitizing, for nourishment (in case food supplies are interrupted), for loss 
of electric power, for loss of running water, for protecting others from 
infection, etc.   Check out the codeReady program recently published by the 
Minnesota Departments of Health and Public Safety that is helping people get 
better prepared.

11>                    What could be most helpful to those who are ill with 
this flu at home?  In preparation for a stop at the door, call to ask what 
would be most helpful, perhaps bringing medicine from a pharmacy, bringing a 
meal ready to eat, or simply bringing specific supplies from a supermarket.   
Come prepared with protective equipment including an adequate ventilator before 
going inside; otherwise, visit at the door or outside the home, staying upwind.

 

It would take much more space to share the many more details on how to prepare 
and how to respond to the coming pandemic.  

 

We all hope it never comes, but expert scientists, especially epidemiologists, 
are concerned that it may come soon and may be devastating, especially to those 
who fail to prepare.

 

Needless to say, we are mindful of those with various kinds of disabilities who 
may need more help from loved ones and other caregivers.    Those who are 
housebound may be at less risk.   Similarly, those with impaired immune 
systems, unable to over-react, unable to create a cytokine storm, may be at 
less risk though still vulnerable.

 

(Note: Mr. Weir is a member of the advisory group assembled by the Minnesota 
Departments of Health and Public Safety in connection with the codeReady 
program.)