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State's pandemic simulation keeps things real

First, a big tip o' the cap to my buddy Mike Coston of Avian Flu Diary (http://afludiary.blogspot.com/).  His Saturday blog about the Alabama Public Health pandemic simulation planned for tomorrow is excellent, and needs no interpreting from me.  It makes me want to drive to Montgomery to watch things unfold.

Mike is absolutely right about the apparent turn toward a more realistic (fatalistic?) view of a pandemic.  As tabletop after tabletop unfolds, and the sheer magnitude of even a moderate pandemic becomes apparent, planners take a more (and necessary) pragmatic view of the management of same.  Mike mentions this at the end of his blog, and I absolutely agree.  Those rosy assertions that "So-and-so county is ready for bird flu" are being replaced with a much more sober assessment of what has to be done.

Whether or not anyone in authority is listening is another question.  Here is Mike's blog, reprinted in its entirety.

Alabama Pandemic Drill

Drill will simulate flu pandemic

http://www.al.com/news/birminghamnews/index.ssf?/base/news/1185007621186400.xml&coll=2

Saturday, July 21, 2007

The Alabama Department of Public Health has scheduled an exercise at Garrett Coliseum in Montgomery on Tuesday to simulate an outbreak of pandemic influenza. The one-day drill will simulate a situation in which large numbers of people become ill. Only the sickest patients will be sent to the hospital, and home care will be stressed. An alternative care site also will be set up to care for influenza patients who have no caregivers. Finally, the exercise will demonstrate the distribution of antiviral medications to priority groups.

The Montgomery City-County Emergency Management Agency, Alabama Hospital Association, Alabama Department of Public Safety, local hospitals, American Red Cross, volunteers and health department staff from the Anniston, Mobile, Montgomery and Selma regions are participating.

 Readers of this blog are certainly acquainted with the idea that, during a pandemic, most people will never see the inside of a hospital.   We have roughly 1 million hospital beds in the United States, 90% of which are occupied at any given time,  and a pandemic could simultaneously sicken millions across the nation.  

Even if hospitals could maintain their current staffing levels, something highly unlikely during a pandemic, the surge capacity simply isn't there to handle millions of flu cases.   We haven't the beds, or the personnel. 

At some point, even the sickest of the sick may be turned away from hospitals.    Most people will have to ride out the flu at home, cared for by their loved ones or friends. 

This hospital crisis will affect those without the flu as well.  Anyone who needs hospital care, whether it be for a heart attack, stroke, cancer, or trauma will find that the level and availability of care will be less than during normal times.    Elective procedures may be canceled, and lets face it, going to a hospital filled with sick and infectious people might not be the healthiest thing someone could do. 

The second thing that caught my eye was the statement that antivirals would be handed out to `priority groups'.  

 Exactly what that means is unclear.  But given the limited amount of antivirals we will have available, it isn't terribly surprising.   Whether antivirals are dispensed based on severity of symptoms, or some other criteria, there won't be enough to hand out indiscriminately.  

 Some surprisingly blunt admissions are creeping into the reportage of late.    The sort of things you'd only have read in a blog a year ago.

I wonder if anyone is paying attention?

Thanks, Mike.  Excellent as always.