welcome to usaapay.com

2020-

2020-08-30 d
THE COVID-CON - III (Unlearned Lessons from Influenza)

Disease mitigation measures in the control of pandemic influenza

In brief, models can play a contributory role in thinking through possible mitigation measures, but they cannot be more than an ancillary aid in deciding policy…

A major challenge for all authorities charged with managing a pandemic will be how to allot scarce, possibly life-saving medical resources and how to maintain hospitals’ capacity to care for critically ill flu victims while continuing to provide other essential medical services…

The negative consequences of large-scale quarantine are so extreme (forced confinement of sick people with the well; complete restriction of movement of large populations; difficulty in getting critical supplies, medicines, and food to people inside the quarantine zone) that this mitigation measure should be eliminated from serious consideration…

Home quarantine also raises ethical questions. Implementation of home quarantine could result in healthy, uninfected people being placed at risk of infection from sick household members. Practices to reduce the chance of transmission (hand-washing, maintaining a distance of 3 feet from+ infected people, etc.) could be recommended, but a policy imposing home quarantine would preclude, for example, sending healthy children to stay with relatives when a family member becomes ill. Such a policy would also be particularly hard on and dangerous to people living in close quarters, where the risk of infection would be heightened…

It is reasonable to assume that the economic costs of shutting down air or train travel would be very high, and the societal costs involved in interrupting all air or train travel would be extreme…

Implementing such measures would have seriously disruptive consequences for a community if extended through the 8-week period of an epidemic in a municipal area, let alone if it were to be extended through the nation’s experience with a pandemic (perhaps 8 months). In the event of a pandemic, attendance at public events or social gatherings could well decrease because people were fearful of becoming infected, and some events might be cancelled because of local concerns. But a policy calling for community wide cancellation of public events seems inadvisable…

Schools are often closed for 1–2 weeks early in the development of seasonal community outbreaks of influenza primarily because of high absentee rates, especially in elementary schools, and because of illness among teachers. This would seem reasonable on practical grounds. However, to close schools for longer periods is not only impracticable but carries the possibility of a serious adverse outcome. For example, for working parents, school serves as a form of day care and, in some areas, a source of nutritional meals for children from lower-income families. In 2005, some 29.5 million children were fed through the National School Lunch Program; 9.3 million children received meals as part of the School Breakfast Program. A portion of America’s workforce would be unable to go to work as long as children were out of schools. Heightened absentee rates could cripple essential service industries. Teachers might not be paid and a great many hourly workers (mall and fast-food employees; school janitorial, security, and kitchen staff; bus drivers) would face particular financial hardship…
...
An overriding principle. Experience has shown that communities faced with epidemics or other adverse events respond best and with the least anxiety when the normal social functioning of the community is least disrupted. Strong political and public health leadership to provide reassurance and to ensure that needed medical care services are provided are critical elements. If either is seen to be less than optimal, a manageable epidemic could move toward catastrophe. (read more)

______________________

Permission is hereby granted to any and all to copy and paste any entry on this page and convey it electronically along with its URL,
______________________