Discussion: Hospitalization and Medical Care during a Pandemic

[Laidback Al]

A Lesson from the Recent Human Avian Influenza Cases in China

Since December there have been eight reported human infections in China. Six of those individuals died. It is wonderful that the remaining two survived. But they only survived because of heroic, around-the-clock, intensive hospital care for an extended period for both of the survivors. Zhou, 29, from Guizhou Province, was hospitalized for 22 days and Peng, the young 2 year old girl, was hospitalized in Shanxi Province for at least 21 days.

It is time for a reminder that intensive hospital care will not be available once a pandemic starts. Hospitals and medical facilities in the US are already at there maximum carrying capacity. There is little excess surge capacity. The millions of infected people that will need medical care once a pandemic starts will simple overwhelm all of the hospitals and health care facilities. It will not be possible to provide weeks of intensive care for every sick individual that requires such care.

Public health specialists need to anticipate this problem. They need to inform and prepare the public that their loved one will simply not be taken in at these facilities once a pandemic starts. The public needs to be informed about how to care for individual in a home setting without spreading the infection.

There needs to be an information campaign to mentally and emotionally prepare home care givers for the deaths that will most certainly occur. At the local level there needs to be a plan, training, and supplies for the disposal of the bodies to minimize additional infections. And perhaps most importantly, there needs to be a plan to explain how to administer palliative and hospice care when a sick or dying individual has little chance of recovery.

The current CFR is over 60% for human H5N1 infections. Even a 1918-like pandemic event with a CFR of ?only? 2.5% will results in 1-2 million deaths in the US alone. Most of these deaths won?t take place in a hospital setting; theses people will die at home, being attended by loved ones and friends. It is unconscionable not to warn the general public ahead of time of the tragedies that await us once the next pandemic starts.

 

[mixin]

Re: Discussion: Hospitalization and Medical Care during a Pandemic

People were more accustomed to caring for their sick back in the 1900's than they are now, that's for sure. We're pretty spoiled in that we have access to emergency rooms.

When my grandmother was still alive, she began hemorrhaging from the nose one day. Neither my mother nor I had ever even had a mild nose bleed, so we took turns panicing until we got her to the hospital. It really was a horrific experience.

Having a good medical book in each household will be helpful. We get used to having the net as a resource, but that may not always be an option during a pandemic. And when a person is in a panic because a loved one is critically ill, that's not a good time to try to filter through pages of info.

There are very good resources here on the site that could be printed out. I remember seeing an excellent article regarding what to do when there is no dentist available. An untreated tooth abcess can make you feel like banging your head against a wall.

 

[Farmer]

Re: Discussion: Hospitalization and Medical Care during a Pandemic

A Lesson from the Recent Human Avian Influenza Cases in China

/snip/

Public health specialists need to anticipate this problem. They need to inform and prepare the public that their loved one will simply not be taken in at these facilities once a pandemic starts. The public needs to be informed about how to care for individual in a home setting without spreading the infection.

There needs to be an information campaign to mentally and emotionally prepare home care givers for the deaths that will most certainly occur. At the local level there needs to be a plan, training, and supplies for the disposal of the bodies to minimize additional infections. And perhaps most importantly, there needs to be a plan to explain how to administer palliative and hospice care when a sick or dying individual has little chance of recovery.

The current CFR is over 60% for human H5N1 infections. Even a 1918-like pandemic event with a CFR of ?only? 2.5% will results in 1-2 million deaths in the US alone. Most of these deaths won?t take place in a hospital setting; theses people will die at home, being attended by loved ones and friends. It is unconscionable not to warn the general public ahead of time of the tragedies that await us once the next pandemic starts.

I agree that the need is there. But how to effectively accomplish such a difficult communication objective?

I am reminded of the public ridicule that followed publication of local and national public health professionals' warnings of the potential for a severe pandemic and the need to prepare by stockpiling a modest collection of food and water. This was 3 years ago during a time of relative economic prosperity. Such warnings were alternately accused of being silly or alarmist.

I think that especially in this economic downturn, there is little political will to further alarm the public about potential failures of 'the system', be it banks, hospitals or the supply chain.

We are in a very sensitive period, during which risk communication is certainly needed, but much more challenging to implement effectively.

I keep thinking of the flyer that was mailed to each American household during the early years of the AIDS epidemic. It was very controversial at the time, but I believe that it represented an initial turning point in public perception of the epidemic.

IMO mailing out a pandemic preparedness booklet to every household would get information into the hands of every householder and would emphasize the potentially serious nature of the threat. It would also be a good first step to encourage more community dialog and preparedness activities.

 

[Amish Country]

Re: Discussion: Hospitalization and Medical Care during a Pandemic

In the aftermath of Katrina and the ice storms that are still effecting the south and central United States I would hope that the current administration ups the recommended amount of stored shelf stable foods, for all hazard emergencies, from a few weeks to at least 3 months. That could possibly cover one wave of pandemic flu.

 

[AlaskaDenise]

Re: Discussion: Hospitalization and Medical Care during a Pandemic

In past discussion of this issue, one idea was pre-recorded short TV programs on necessary home care. Hopefully, HHS or CDC has such programs on the shelf and possibly distributed to TV stations.

This could be similar to those available to hospital patients. YOu can tune your room's TV to in-facility programs on childcare, newborn care, nutrition, etc.

I can envision a schedule of short programs running everyday on various needed topics, e.g., isolation SOP, biosecurity, make-do menus, body disposal, alternative medications, etc.

.

 

[kiwibird]

Re: Discussion: Hospitalization and Medical Care during a Pandemic

Thats a really good idea AlaskaDenise. I bought the book Where there is no Doctor and it is very informative. Major shortcoming is that for a number of really difficult situations the reader is urged to bundle victim up and seek medical help. I imagine the authors do not want unskilled people attempting complicated/dangerous treatments - but if there is no alternative....

 

[tropical]

Re: Discussion: Hospitalization and Medical Care during a Pandemic

I agree with Farmer.

#4:
"I am reminded of the public ridicule that followed publication of local and national public health professionals' warnings of the potential for a severe pandemic and the need to prepare by stockpiling a modest collection of food and water. This was 3 years ago during a time of relative economic prosperity. Such warnings were alternately accused of being silly or alarmist."


Nothing would be realy done, only playing tactics and relying/praying that nothing happens.

And if it happened, firstly it would be downplayed, and only than, when it would be obvious that it is down the road, it would be declared.

When nothing adequate is realy newly invented, produced and prepared, nothing enaugh heavy funded, and after the almost 5 years of Fumento wining the bet on the chicken-little, the resulting outcome would be an near nothing.

There would be little places prepared for any kind of novel pandemic.