Immunity and the Avian Flu
"Bring out your dead." That was the call heard through the streets during the 1918 flu pandemic, when the deaths surpassed modern resources and casket shortages forced families to surrender their loved ones to a wagon piled with bodies. Not a pretty image. Now, we're faced with the likely possibility that another flu pandemic will arrive on the wings of infected birds.
According to Alysia Mihalakos, MPH, deputy chief of the Center for Emergency Preparedness and Response, part of the Rhode Island Department of Health, presenting at AMT, the risk is so great because we lack immunity. Because no one has been exposed to the H5N1 strain currently affecting Asian countries before, we don't have any antibodies or immunity to the strain, leaving us all susceptible. For the same reason, an H5N1 vaccine could kill more people than it would protect.
For Mihalakos and her colleagues, all they can do is plan and prepare as best as possible. Using the 1918 flu as a model, experts predict in Rhode Island, a state of about 1,000,000 people, 300,000 will be infected in a pandemic. Of those, about 7,000 will die. The majority, however, will live, and will require more beds, ventilators and caregivers than the small state has to offer. Figure on three times your typical patient load, with about a 40 percent reduction in staff, Mihalakos told attendees.
Rhode Island, like many states, is making efforts to close the gap between available and needed resources, by purchasing portable ventilators, creating videos to teach family members and others how to operate them, and making arrangements with local ice rinks to be used as temporary morgues.
But it's not all bleak. Seven thousand deaths means 293,000 will survive the first wave, Mihalakos stressed--293,000 who have now been exposed and are immune.