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Why the Public's Trust and Help Matter in Health Emergencies D.A. Henderson Speaker biography | Summary | Transcript | Audio | Q&A audio Transcript
Joe Dudley:
Dr. Henderson, I'm Joe Dudley from EAI Corporation. In the past year, the number of countries where there have been human H5N1 [cases] have increased from around four or five fatal cases in a least ten countries. The number of countries where the bird flu has been in animals has increased from less than a dozen to more than 50. Given that the numbers-when the original pandemic influenza plan was written last November-have about tripled during the last six months in terms of human cases, countries, and animal cases, do you think that the current plan is still sufficiently broad and targeted to address the current level of threat? Thank you. Dr. Henderson:
Your point is well taken. I think what we are all concerned about what is going to happen with the H5N1 [virus]. At this point in time, it does not seem to spread at all well from person to person. The analyses that have been done suggest that it is not very far away genetically from what one thinks would make it for an easier spread. What is going to happen from here on, I think, one, it certainly has spread, as you indicate. There is some solace taken at the moment because it doesn't seem to be spreading so much into Europe at this point in time in the year, but then, influenza doesn't spread so easily in the summer months. So, what does this mean? I must say we are still very much in the dark about it. So far as preparations are concerned, I think there is still a lot of thinking to be done about this. There is a national influenza plan, but it leaves a lot of loose ends in that. For example, do we use Tamiflu for prevention or for treatment? If we use it for prevention, you would use the equivalent of ten treatment doses for each individual, because you have to give it every day for roughly ten to twelve weeks, and we don't have that much. Are we going to do as the British do? Their policy is to use it only for treatment, not for prevention. The plan is indefinite about this. It just sort of leaves it open. It's going to be, I think, very difficult if some areas do it one way and some another way; there ought to be at least some national recommendation on this. Another thing on this, do we, for example, recommend closing all schools for the duration of an outbreak? That would be at least three months in a community. At a conference just last week, it was suggested we do it as long as it is in the United States, and suggesting it might be six or seven months [that] you'd close the schools. One of the people leaned over to me and said, "And the murder rate will go up. If you've ever had your kids home for all of the Christmas holiday, then you're ready to send them back!" It's a totally unrealistic recommendation, but we are still wobbling around. Most important, however, is what we have really not done-I know of no community that has really taken seriously the question of what we do in a surge situation, where we really need a lot of beds, and we have to take care of a lot of people. And not people just sick with flu. You're going to have diabetics that are decompensated. You're going to have people with heart disease or lung disease. Liver disease is going to be much worse. It's going to be difficult to take care of those people. You can't just close the hospitals and say, "We're full up. We can't take any more." That leads to real problems. I think one of the sessions here is going to be given to that very subject because this is a terribly important area, and pretty much in U.S., it's neglected. I think the Canadians are doing a little bit better than we are. They have a systemw we don't have a system. We don't have a health system. We have a series of entrepreneurial hospitals, that's it. So it's a different situation altogether. This is where we really need some help in particular. Dr. O'Toole:
Thank you again Dr. Henderson. It's been a real pleasure, and also for you to represent our experience with modern epidemics and the important role that the public plays in dealing with those types of health emergencies. Again, thank you D.A. [Applause] Proceedings of the May 23, 2006 Summit: Disease, Disaster, & Democracy Transcription by CastingWords |
