Op-Ed
The Chicago Sun-Times
(Chicago, IL)
Published in Chicago Sun-TimesOct. 29, 2005
Until government gets a clue, here's what to do about flu
For the moment, the paramount threat of avian influenza is psychological — fear, ignorance, irrational behavior, panic. While pandemic bird flu may run its course, spreading death and illness beyond our control, there are specific things we can do. For instance, instead of wringing our hands, we could start washing them more often.Because of a narrow focus on production, stockpiling and distribution of vaccines and anti-viral medications, almost everything this newspaper has put on the front page about the threat of avian flu could well have been assigned to the business section. Yet the genuine Page One news is that while the prospect of widespread disease in America is speculative, there are real things we ought to do to minimize any outbreak. And it involves even less effort than stocking up on duct tape and plastic sheeting.
On a large scale, pandemics are just the kind of crises that require political leadership as well as the expertise of the public health community.
But at the moment, authorities here and in other countries seem helpless. There is not enough vaccine to go around, no chance that any new vaccine can be produced in less than 18 months, and no assurance that mass inoculations would confer continuing immunity against highly resistant germs.
In the United States, we are looking for answers from a government that botched responses to swine flu, anthrax, terrorism alerts and hurricanes. Perhaps Katrina will have had a silver lining, after all, if national authority is thoughtfully invoked.
In governments all over the world, "People are trying to do the right thing, but nobody knows what the right thing is," Laurie Garrett, head of the Global Health Program at the Council on Foreign Relations, said in a recent newspaper interview.
In the same article, Dr. Mike Ryan, the World Health Organization's flu czar, warned, "Preparedness is not just about stockpiling, it's about having an actual plan."
Part of the plan ought to be not frightening people unnecessarily about a disease that is low risk in humans, affects only those who live in close contact with poultry, and still is mostly Asian in prevalence.
Whatever the plan is will require government openness, speed and good reporting — by both disease trackers and by journalists.
One obvious step for public health authorities is to vaccinate health-care workers first. But until and unless governments come up with reasonable planning, using what we already know about the spread of disease and using a little common sense might work.
For example:
- Get a regular seasonal flu shot now — not only for its own sake but because if you later get the flu, epidemiologists will know it is a new strain, and you can begin prompt treatment.
- If you have the flu, don't go to work (although that is not easy to recommend to about half the working Americans who get no paid sick days). Astonishingly, during the 2003 SARS outbreak in Toronto, 11 percent of health-care workers later surveyed said they reported for duty while feeling sick.
- Don't send your sick children to the petri dish of day care.
- And, again, wash your hands frequently, using soap and water, not antibacterial preparations.
The experts also told us about 30 years ago that because of antibiotics, vaccines, pesticides and better public health responses, we had seen the end of infectious diseases. They were wrong, and instead of dying out, 30 new ones have emerged. Why? Ecological and environmental conditions — i.e., human behavior — changed, and so did the microbes.
We now live in an era of global trade and global travel, yet we are still slower to adapt and more provincial than mutating viruses. As a result, the chickens are now coming home to roost. With a vengeance.
Dr. Jessie Gruman is president of the Washington-based nonprofit Center for the Advancement of Health.
