Who might live in a pandemic

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Who might live in a pandemic

A lot of odd things happen within humanity. For example, if you have direct forebears who had the plague and survived, you likely inherited a strand of DNA which makes you virtually immune to AIDS.

While an interesting factoid, what does this have to do with a pandemic? In order to understand this, you have to understand how an influenza pandemic differs from normal flu. In an average year roughly 36,000 Americans die of the flu, and roughly 200,000 Americans are hospitalized because of the flu. Most of those who die are the young, the old, and the infirm, whose immune systems are too weak to mobilize to fight the virus.

Death in a pandemic is different. In a pandemic the majority of those who die are the healthy, not the less-healthy. Why is this? Because in a pandemic your body looks at the unfamiliar virus, realizes it doesn’t know how to deal with it, and throws every defense it can muster at dealing with it. If you die from your lungs filling with liquid, it is your immune system that has killed you, not the virus.

But what happens if your immune system is weak from being young, or old, or from an immune system disease such as AIDS? It is posited that people with deficient immune systems may die from the flu in roughly the same numbers as if it were not a pandemic. Those who are healthy, however, and who would normally recover, are likely to die during a pandemic, and to die at a much higher rate.

We like to think that there will be no influenza pandemic.

Failing that, we like to think that there will be a flu shot available that will help ameliorate the effect of any pandemic. We know that, even with 65,000 dead from flu in a normal year, vaccines are not a high priority, but in FY 2006, the President announced an emergency budget request of $7.1 billion, of which $6.7 billion was for HHS pandemic influenza activities. The goals are to:

• Produce a course of pandemic influenza vaccine for every American within six months of an outbreak;

• Provide enough antiviral drugs and other medicals supplies to treat 25 percent of the U.S. population; and

• Ensure a domestic and international public health capacity to detect and respond to a potential pandemic.

While not tied to the $7.1 billon request, a collateral goal was to stockpile enough pre-pandemic influenza vaccine for 20 million persons.

Failing that, we like to think that medicine has progressed enough in the last century that our public health infrastructure will be able to handle a pandemic.

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