Letter Re: Simulation of Pandemic Influenza – Preparedness Implications

I appreciate everything that you and your readers are doing to help change the mindset of people around the world.
I was reviewing the May/June issue of a health care trade magazine that contained a report on a simulation carried out in Philadelphia at the start of this year dealing with pandemic influenza. While much of the discussion was relevant only to health insurers, the scenario that served as the simulation is detailed below. Readers can draw their own conclusions of the type of things that they should prepare for.

The following is exerted from: Raymond, A.G. (2008). Pandemic Influenza. AHIP Coverage. 49(3), 18:

A Simulation: Twelve “All-Too-Real” Weeks of Pandemic Influenza

After years of warnings a deadly flu grips the city [Philadelphia]. As the simulation begins, 2,000 suspected cases of pandemic flu have been reported in the Greater Philadelphia area, with at least 13 deaths. State and local health officials are starting to carry out the CDC‘s recommendation to isolate and treat with antiviral medications anyone with confirmed or suspected pandemic influenza, and encourage people to reduce contacts that might spread the virus. People who are infected can be contagious for a day or more before they develop symptoms, which range from fever, cough, sore throat and muscle aches, to severe respiratory diseases and other life-threatening complications.

Soon, doctors’ offices and hospitals are inundated with the sick and “worried well”. Hospitals report ER waiting times as high as 15 hours with few beds available for new admissions. Medical personnel are stretched to the limit, and some are showing signs of infection.

Businesses are experiencing high rates of absenteeism, and schools are closing. Domestic and international travel and shipments are slowed or cease entirely. Groceries and pharmacies are quickly emptied of essential supplies and restaurants and malls are empty.

The medical, economic and social consequences are devastating.

After nine weeks, the number of cases in the Philadelphia area has escalated to more than 100,000, deaths are in the thousands, and the city’s hospitals and clinics are overwhelmed as they try to provide adequate care for huge numbers of victims along with their usual patient population. Morgues, hospital mortuaries, and funeral homes are challenged in their ability to care properly for the soaring number of dead.

Public safety and sanitation are major concerns, critical medical and food supplies are running low, and much of the economy has come to a standstill because of high employee absenteeism and a lack of customers. Internet and cell phone service is disrupted as home workers create system overload, and service workers are unavailable to respond. Normal everyday activities end as people avoid shopping, dining out, and social gatherings of all kinds.

The first wave is ending; attention turns to recovery and preparation for a second.

At week 12, the number of new infections is subsiding, but a second wave of pandemic flu is spreading overseas. In the USA, an estimated 40 million people have been infected and nearly one million have died, including 25,000 in the Greater Philadelphia area.

The economy is in free fall. As consumers limited their spending, business have cut back production and laid-off workers, and small businesses are closing altogether. Antivirals and antibiotics are scarce, vaccines for the pandemic strains are still months away, and the medical system is still short on staff, beds and supplies. Fear and isolation have taken a heavy toll on the public, with increasing accounts of depression and other signs of stress. Can the city begin to recover and also prepare for a second-wave pandemic?

For now, this is only a simulation. – Dave in Alabama.