Talking sense on H1N1 and H5N1 threats; "social distancing" may not work well in the U.S.
John M. Barry has an op-ed in the Washington Post today, Tuesday, June 23, “Pandemic Reality Check: What can be done – and what can’t – to protect against H1N1”, link here. This article appears shortly after WHO has officially declared H1N1 an international pandemic (which does not reflect virulence, only prevalence). Barry offers a measured discussion of the prospect for a vaccine, which may or may not be ready by October and which may or may not require more than one dose or be dependent on immune stimulation. We cannot anticipate how effective it would be.
But he also gives a sobering assessment of the containment measures – the “social distancing” – that were put into place in Mexico City. Compliance, he says, was much less universal than first reported. It would be even less so in the United States, where the economic and social consequences of shutdowns would be so dire. ISP’s might not be able to keep up with the demand from telecommuters or might not even be adequately staffed themselves. The same could be true of utility or cable companies.
In fact, the United States has not really had a disruptive social “shutdown” with such personal effects since World War II. It’s true, at one time, swimming pools were closed out of fear of polio, and there was enormous “health” disruption during the 1918 flu pandemic.
During the development of individualistic culture since the 1960s, we’ve tended to adopt the idea that one owns the moral responsibility for one’s own health, even as we engage in all this talk about public health. That was particularly true as a strategy for handling HIV in the gay male population when it erupted in the 1980s; for STD’s, an ideology of “personal responsibility” in a motivated population really will work, whereas that may be less so when we talk about easily transmitted infectious disease. There could be a lot of emphasis on “community values” if a deadly H1N1 or H5N1 epidemic broke out; people who had recovered or been vaccinated would be expected to help care for the sick, as there wouldn’t be enough nurses.
Barry is right about a couple of other things. We really have been careless with our vaccine industry, outsourcing it overseas and letting downstream liability concerns gut it. Congress should fix this (and use it as a warning for what could happen to the Internet). We ought to have developed the ability to make a reliable H1N1 or H5N1 vaccine in a few weeks by now, and we haven’t.
He also pointed out that in one day recently, Egypt announced 25 cases of H5N1 – the largest ever in a single day. That’s a word of warning, and not just in the latest little indie horror movie (like “Quarantine” or “Blindness” last year).
In 2009 I was living "at home" (in a family Drogheda) with mother, who was then 96 and starting assitance from hired caregivers (it started June 15, 2009). I still went to bars and discos and never gave the 'danger' that could pose much thought. I never developed symptomatic flu and neither did my mother nor any caregiver. The issue was never mentioned in various meetings. Both my mother and myself did get regular flu shots and would have gotten updated in Sept. 2009. What was mentioned was the idea that she should not be left alone once she was on memory-assisting drugs like Aricept. She never drove after July 2009 (she had started getting lost in 2008). She would pass away in a hospice at 97 on Dec. 14, 2010. I would also add that the atttitude of presenteeism used to be very strong in the workplace.