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« The Idiocy of Biodefense in a Country That Can't Stop Annual Influenza Epidemics | Main | Escaping the Flu? Experiences from 1918 »

Biodefense and common sense.

Category: Biodefense
Posted on: December 12, 2008 2:33 PM, by Janet D. Stemwedel

Mike notes that protecting a population against a virus requires a good public health system, in particular, one that can produce effective vaccine in sufficient quantities and with sufficient lead-time to vaccinate enough of the population that the virus can't find a host. Mike also notes that, in anti-influenza efforts in the U.S., we manage to fall down especially hard on getting enough people vaccinated, in part because flu shots are an out-of-pocket expense and in part because the people getting those shots aren't necessarily the ones most likely to spread the virus.

Beyond fixing these structural problems in our vaccine production and distribution -- something I agree should happen, but will probably require political wrangling -- what else can we do to keep viruses, whether naturally occurring or intentionally introduced, from spreading like wildfire and killing lots of people?

Some of our options, I think, come down to common sense.

First off, since viruses tend to spread when one carrier is in proximity to a potential carrier, we need to get people in the habit of not going to work or school when they're sick. Yes, this sounds like crazy talk -- we have to go to work or school even if we feel lousy! At least, that's what it seems like we've been trained to do by bosses and especially by principals who point out that the state only gives the school funds for the days each student's butt is in the chair.

Maybe this is a good attitude to take if you want to reduce absenteeism. It's not obvious, of course, that sick people add much to productivity. And, by way of the germs they carry, they can make more sick people! Protecting healthy workers and students from sick ones seems like it might yield better net returns than making people haul their germy selves in.

We probably also need to get in the habit of altering our travel patterns while sick and shedding virus. It would be a wonderful thing if those coming down with the flu routinely canceled their flights, whether for business or pleasure. Of course, if those flight plans involve non-refundable tickets, people have a strong financial incentive to sit in that snug metal tube and spread their germs to others on their flight.

What if airlines charged no penalty, or a minimal one, for cancellations due to flu or other contagious illness? What if they set up a priority-standby or priority rebooking for people who did not make their originally booked flights because they didn't want to get their fellow passengers sick?

You know where else sick people hang out spreading their germs to others? Doctor's office, medical clinic, and hospital waiting rooms. I don't know how many people catch communicable diseases while waiting to see a health professional for something else, but if the numbers are (or become) significant, it might be time for the return of house calls. Medical professionals are more likely to be up to date on their vaccinations and knowledgeable about how not to spread germs from one patient to the next, so putting them in motion rather than the sick people might keep more of the population healthy.

In a flu pandemic, it should be noted, even people who do not get sick are likely to get hurt. The sick people may include those who bake our bread, or drive the trucks to get it on the supermarket shelves, those who work in the power plants that provide our electricity, and so forth. There may be flu-related interruptions in things we take for granted. Thus, building a "flu kit" (which could also function as an earthquake kit or zombie apocalypse kit), with non-perishable food, big jugs of water, flashlights, first aid supplies, a hand-crank radio, and such, seems like a sensible step all of us could take to ride out the interruptions.

Germs are good and spreading and reproducing, but they usually depend on us to schlep them around to their next victims. We don't have to be so helpful to them. It's time, as a society, to change our patterns to be less convenient for the germs.

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Comments

1

Working class people in this country have very little sick leave to work with, and so they usually work sick with respiratory illnesses. This class includes police, hospital workers, firefighters, paramedics, EMTs, school teachers, school cafeteria workers, and bus drivers.

Asking them to take off when they're sick is pointless: they are not allowed to take the time they need, only the time they are allowed.

You ask me, we're just asking for a pandemic.

Posted by: Ken Shabby | December 12, 2008 4:35 PM

2

Also, do it like Asians and wear an mouthmask when you go out with a flu or cold.

It looks only stupid when you aren't used to it yet.

Posted by: mo | December 12, 2008 4:43 PM

3

Want to do something? This wendenssay teh US dept of health has an interactive webcast where you can email your questions and see the other 7 previous web casts.

Source: pandemicflu.gov

There are many problems - we are many people.

If you think you can do something about gloabal warming, know we can do something about this.

BTW - H5N1 is spreading in India, Cambodia and HongKong so this will not wait.

Kobie

Posted by: Kobie | December 12, 2008 8:51 PM

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