From simple to stupid

Epidemic: from the Greek, epi- (upon) + -demos (the people)

Pandemic: from the Greek, pan- (all) + -demos (the people)

Pandemic (according to the WHO): from external pressure and internal weakness, highly-virulent + "justified" panic + all + the people

The definition of a pandemic used to be simple: a worldwide outbreak of disease in excess of what would normally be expected (a global epidemic).  

The WHO even came out with a definition of worldwide spread (community transmission in 2 or more WHO regions).

But now, apparently, the WHO intends to change the definition of a pandemic from simple to stupid.

Bowing to pressure from member nations, the WHO is (according to the New York Times) going to change the definition to include the severity of disease, and will probably do so in such a way that the current H1N1 outbreak will never count as a pandemic (unless it becomes more virulent, which it very well might).

Now, you may remember that we've had three pandemics in the last century, one in 1918, one in 1957 and one in 1968... or, at least, that used to be true.  If this new definition goes into effect as described, we'll have to erase those last two from the list, because they were no more severe than this new H1N1 strain appears to be right now.

Whether a given outbreak is a pandemic or not is a separate question from how severe that pandemic is.  

If the WHO thinks a severity scale would be useful, then by all means they should create one. There are some good arguments against using a severity scale (flu viruses evolve so quickly, severity varies between and within countries, etc.), but it's possible a severity scale would help countries and communities to better plan for and respond to a pandemic... but the role of a severity scale should be to better describe an existing pandemic, not to determine whether an outbreak is a pandemic.

If the WHO goes through with this, there will be two definitions of a pandemic: One used by epidemiologists and other public health professionals, and one used by the WHO --because the WHO's new idea for a definition doesn't make any rational sense.  By setting up such a situation, the WHO will be undercutting its own credibility in a time when its ability to lead is more important than ever.

Instead of caving to the pressure of politicians from the member nations who feel that declaring a pandemic would cause "unjustified panic," the WHO should be using this as a teachable moment, to educate the public about what a pandemic is, what can be done about it, and why panic is never a justified reaction regardless of severity.

   

Pandemic Partners - A way to help each other during a pandemic

During a pandemic, we all know a lot of people are going to get sick.  

Whether they get treated in a hospital or recover at home, a lot of those who get sick are going to need some help... and not just with their illness.  Even the seasonal flu can knock you onto your back for a week or more, and a pandemic flu virus is likely to to be worse.  So a lot of people who get sick will also need some help managing their day-to-day lives until they're back on their feet, simple things like:

• Making sure there is food in the house
• Contacting healthcare providers  
• Helping provide care for children or other dependents
• Helping provide care for pets
• Contacting family members
• Picking up medicine from the pharmacy

But in today's society there are many of us who could fall off the map without anyone noticing right away.  In many cases, it's all too possible for a person to be home sick for weeks before anyone thinks to check on them, and this will be even more true during a pandemic.  

Because the same social distancing measures that will help to protect us from the flu (staying away from other people as much as possible, working from home if you can, etc.) will also reduce social interaction to the point that even those who would ordinarily be missed after a very brief illness will be at risk of falling through the cracks.

To help fix this problem, people can pair up with people they trust (friends, neighbors, family members, co-workers, members of their place of worship) to keep track of one another during a pandemic and help each other as needed.

The Reveres over at Effect Measure mentioned one program to do just that, a faith-based initiative called Flu Friends.

A similarly-alliterative initiative called Pandemic Partners is also under development to help people help each other through a pandemic.  Right now, it mostly consists of a set of forms people can use to share the information their "pandemic partners" will need to be able to assist them.

Copies of the form are available as a Word Document: Pandemic Partners.doc 

or PDF: Pandemic Partners.pdf

The forms are a work in progress, so if you have any suggestions for improving them, let me know and I'll pass them along.

H1N1 + H5N1 = ?

Until the surprise outbreak of what the CDC is now calling "novel influenza A (H1N1)" a couple of weeks ago, if you had asked which strain of flu virus was most likely to cause the next pandemic, most experts (and even news-consuming lay people) would have told you the same thing: H5N1

The H5N1 flu virus is either a panzootic in birds (a panzootic is just like a pandemic, but for animals), and has shown the ability to infect a number of other species in a more limited way, including the friendly neighborhood tom cat... and yes, the occasional human.

And we've been quite lucky that it's only been the occasional human, because of the 421 confirmed cases we've seen over the years, 257 have been fatal.  That's a case fatality rate (CFR) of just over 61%.  It's a mean and nasty bug.

So, at this moment when much of the world is learning about recombinant flu viruses for the first time, it's not surprising that a lot of people (or at least a lot of the people who post comments in blogs and bulletin boards) are wondering whether the H1N1 virus and the H5N1 virus could combine to create a virus far more lethal than H1N1 and far more capable of human-to-human transmission than the H5N1 virus.

The bad news is that, yes, it's possible.

The good news is that it's not terribly probable, because -while the H5N1 virus is capable of infecting humans and a broad range of animals- for the most part it continues to be a disease of birds.  It typically doesn't reproduce very well in pigs at all, and humans seem to be a dead-end host for the virus so far.

The Novel Influenza A/H1N1 virus, of course, is mostly a disease of humans (though it is apparently willing to move back in with the pigs too).

In an interview with Science Insider, virologist Yi Guan of SARS fame shared his thoughts on the possibility:

Discussing the our inability to predict whether the H1N1 virus will become more virulent....

Q: It depends on further mutations?

Y.G.: It depends on mutations and whether the virus further reassorts with other viruses—like H5N1. That could be a super nightmare for the whole world.

Q: You’re talking about the Armageddon virus?

Y.G.: The chance is very, very low that these two viruses will mix together, but we cannot rule out the possibility. Now, H5N1 is in more than 60 countries. It’s a panzootic, present everywhere except North America.

Q: If the nightmare comes true?

Y.G.: If that happens, I will retire immediately and lock myself in the P3 lab. H5N1 kills half the people it infects. Even if you inject yourself with a vaccine, it may be too late. Maybe in just a couple hours it takes your life.

Sounds pretty scary, and it could be... but you'll recall that he said the chance of it happening is very, very low.  

This is a good illustration of the difference between a hazard (something that can cause harm) and a risk (the likelihood of that harm actually occurring).  

An H5N1/H1N1 recombinant virus represents a serious hazard, but the risk of it actually happening is thankfully rather low.

That doesn't mean we can afford to take our eyes off the ball, however.  The H5N1 virus is no less of a threat today than it was before the H1N1 outbreak began, and we ignore it at our peril.  President Obama says that the President of the United States needs to be able to walk and chew gum at the same time, and he's right.  Here's to hoping the global public health preparedness community can do the same.

Morbidity vs. Mortality

A Wall Street Journal article by Ron Winslow and Avery Johnson opines that a deadlier strain of flu virus would overwhelm the US healthcare system.

Sadly, it won't even take a deadlier strain to accomplish this.  Even if every single person who gets the virus recovers, a pandemic will cause a surge in the number of people sick enough to require hospitalization.  And that alone will wreak havoc on our healthcare infrastructure.  

We have, essentially, zero excess capacity in our healthcare system tpday.  I was involved in a full-scale emergency response exercise a few years ago and the local ambulance company did not expect to have any ambulances to spare for use in the exercise.  (They did eventually manage to find exactly one, but the real response to such a disaster would have called for many more.)

When I was helping the same health department with their pandemic response plan, we polled the local nursing homes to see what they had in terms of excess beds and respirators.  The answer was, "none to speak of."  --And hospitals are the same way.  

Severe economic pressures force these organizations to grow leaner and leaner all the time, to trim excess capacity wherever they find it.  And we haven't developed any worthwhile incentives to reverse that trend.

So people don't have to die in large numbers in order to overwhelm our healthcare system; they just have to get sick enough to require care.  Indeed, the sad truth is that those who die during a pandemic may use up fewer "bed days" than those who get sick, but pull through. 

Most hospitals right now couldn't deal with the results of a bus crash by themselves.  In order to meet the needs of an influx of patients like that, hospitals rely on their ability to transfer (or divert) patients to other nearby hospitals.  During a pandemic, however, this won't be an option, because those nearby hospitals will be equally overwhelmed.

Like many others who are looking at this problem for the first time, the authors of this article are putting an undue emphasis on mortality (death) versus morbidity (sickness) when it comes to the effects on the healthcare system.  In many ways, mortality is the most important thing about a pandemic.  It's certainly what worries me the most on a personal level.  But when it comes to the healthcare arena, it takes a back seat to morbidity.  

Because the thing that's going to transform the healthcare infrastructure from a moderately well-oiled machine into just a greasy pile of slag isn't the number of people who die, but the wholly unmanageable number of people who get sick.

Too soon to say

Suddenly, stories like this one abound, implying that the outbreak of H1N1 Swine Flu may not be such a big deal after all.

Of course, we all hope it turns out not to be a big deal, but as they finally got around to mentioning in paragraph 5 of the new article, it's "...too soon to be certain what the swine flu virus will do."

We are so early in this outbreak that we really don't know much about the epidemiology of this virus at all.  

• How many people have the disease?
• How many people have died?
• How readily is it transmitted from person to person?  
• What risk factors are there for infection (does it spread well among people crammed into the same airplane for several hours, but poorly in more open settings; are smokers or the elderly or some other group more likely to catch it)?  
• How lethal is the virus to those who catch it?  
• Who is most at risk of severe disease?
• When it does kill people, is it the flu infection itself (primary viral pneumonia) that causes death or is it secondary bacterial pneumonia that moves in after the flu virus is gone?
  

And it will be awhile before we have many of the answers.  In the UK, they are waiting for the results of more than 600 tests for the virus.  Mexico has a backlog of over 35,000 samples waiting to be tested, and their total number of confirmed cases shot up by nearly 250 overnight to 397 as a result of additional testing (not necessarily correlated to any new cases).  In the US, it's taking 4 days to get test results, which -with a virus that has only a 24 to 96-hour incubation period- means that our picture of confirmed cases here at home is far behind the times, as well.

And all that only goes to the epidemiological situation now.  The situation is likely to change over time, as the virus mutates.  In the case of the 1918 Pandemic, for instance, the first wave of infections spread around the world in the spring, and it was pretty mild.  It wasn't until the fall, when the next wave of infections struck, that the virus became so frighteningly lethal.

So I'm very pleased that the CDC, the Department of Health and Human Services, and the Department of Homeland Security are all continuing to take the situation very seriously and are doing an excellent job of letting the public know what we do and don't know.  

Dr. Besser, Acting Director of the CDC, has done a particularly good job of communicating the expectation that the government's response, the guidance to the public and the guidance to healthcare professionals will all continue to change as the situation evolves --and that that's a good thing. 

Yesterday's webcast on the swine flu outbreak

Here is yesterday's webcast from the Department of Health and Human Services and the Department of Homeland Security.

 
Dr. Besser, Acting Director of the CDC, Secretary Sebelius of the Department of Health and Human Services, and Secretary Napolitano of the Department of Homeland Security did an excellent job of answering questions from the public.

Reality wins

Yesterday, the WHO moved to increase the Pandemic Alert Level to Phase 5 (defined below).

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

I'm glad they have finally chosen to acknowledge reality and follow their own guidance.  We will need the WHO to be a credible player if we are to have any hope of coordinating a global response to the pandemic.

Phase 4 Pandemic Alert - Is this the right level?

Yesterday, the World Health Organization (WHO) in an emergency meeting raised the pandemic alert level to Phase 4 (statement here).  

The practical difference in the US was pretty much nil, since we have active cases to contend with already, but in some countries this is likely to lead to a stepped-up response.  

Because the WHO's pandemic alert level is written into some national pandemic flu plans as a trigger point for specific actions, it is a relevant issue and it's worth considering whether Phase 4 is the right level at this time.

Here is the definition for Phase 4:

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

We certainly seem to meet this criteria with the outbreaks in Mexico, but let's take a look at Phase 5:

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

We meet this criteria, as well, with the outbreak in Mexico and laboratory-confirmed human-to-human transmission from husband to wife in Kansas.  Both countries are in the Americas Region.

We don't yet meet the criteria for Phase 6 --or at least we can't confirm that we do:

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

As they said over at Effect Measure, "... [the] WHO has been timid and slow" in responding to this crisis, and with this decision it seems they're continuing in that pattern.  

I realize that there are political and economic costs attached to moving to Phase 5 and that, with the world economy in shambles, this is an especially difficult time for the global community to have to face those costs.  But what does it do for the credibility of the WHO when anyone who can read can plainly see that we should be in Phase 5 by the agency's own definition?  

The World Health Organization does a tremendous amount of good in the world and they have an important role to play in managing this outbreak.  It's time for them to refocus and re-emerge with the courage to do this job as only they can; they should start by following their own guidelines.

Bogus: Bioweapon claims for H1N1 Swine Flu

Some segments of the blogosphere are all atwitter (pun intended) with the theory that the H1N1 Swine Flu must be the work of some nefarious group of bioengineers because the virus contains segments from 4 different progenitor viruses --2 different swine flu viruses, an avian flu virus and a human flu virus.  Some even seem to imply that US government researchers working on the 1918 pandemic flu virus (which was also an H1N1 virus, though very different) might have been involved in weaponizing it.

Much of this seems to be driven by a story written by Wayne Madsen of Online Journal:

It turns up all over the place, at PrisonPlanet.com, Know4Life, InTheseNewTimes, and elsewhere.

Jeff Denmark at Drudge Retort quotes the article:

"According to two mainstream media journalists, one in Mexico City and the other in Jakarta, who spoke to WMR on background, they are convinced that the current outbreak of a new strain of swine flu in Mexico and some parts of the United States is the result of the introduction of a human-engineered pathogen that could result in a widespread global pandemic, with potentially catastrophic consequences for domestic and international travel and commerce." 

And goes on to say: "WMR has been informed that the CDC and U.S. Army dug up the body of an Inuit woman who died in 1918... from an outbreak of Spanish flu. . . . . WMR has been told the genetic material recovered by the U.S. government from the corpse of the Inuit woman provided the basis for the development of the H5N1, or bird (avian), flu strain at the U.S. Army Medical Institute of Infectious Diseases (USAMRIID) laboratory at Fort Detrick, Maryland, the point of origin for the Ames strain of anthrax used in the 2001 bio-war attacks against the U.S. Congress and the media."

This is, as they say in Jolly Olde England, complete rubbish.

"How, then" you may ask "did a brand new virus that's made up of four different viruses suddenly spring into being and spread all over the world? Doesn't it have to be the result of bioengineering?"  

...Actually, no.

This is exactly the sort of thing we've been expecting for years.  

If more than one strain of flu virus infects the same cell, the two strains can mix up their genes, leading to what is called a recombinant virus.  That simply means that the genes from the two (or more) viruses have recombined to create a new strain.  In effect, it's a lot like sexual reproduction in humans; parents mix up their genes with the result that a child might have her mother's hair and her father's eyes.

This recombination happens especially easily in pigs, because they can be infected by swine flu viruses, avian flu viruses and --you guessed it-- human flu viruses.  The pig as a "mixing vessel" scenario is something we've long known to be a threat when it comes to pandemic flu.  In fact, this is believed to be what caused the last two pandemics, in 1957 and 1968, as this figure illustrates.

This is perfectly natural and expected.  That doesn't make it good, of course, but there's no hidden conspiracy behind it.  The virus arose naturally and the epidemiological evidence seems to show pretty clearly that it's spread so quickly because of air travel --something else we knew to expect-- not because it's being used as some kind of very inefficient bioweapon.

We humans are all on the same side on this one.

Protecting yourself

Although things aren't looking good so far, it's still too early to say for certain whether the swine flu outbreak will mushroom into a pandemic.  But it's a good idea to start giving some thought to how you can protect yourself and your family from infection, if the virus should continue to spread.

Here are some evidence-based protective measures you can take to help prevent infection:

1. Wash your hands

...then wash your hands some more.  In fact, one of the studies examined in the relevant Cochrane Review showed that simply washing your hands at least 5 times a day cuts the risk of coming down with a respiratory infection by almost 50%.  

Handwashing is one of the most important things you can do both to keep from getting the virus and to keep from spreading it, if you happen to be infected.  --And it's important to understand that you may well be contagious for 24 hours before you show any symptoms.  That's one of the reasons why influenza is so much harder to control than the SARS epidemic was.

Most people, even those who have the training to know better, don't wash their hands correctly.  For instance, did you know that every time you wash your hands, it should take you 20-30 seconds to scrub them thoroughly (long enough to sing the alphabet song once or the "happy birthday" song twice)?  For more on how to wash your hands correctly, see the CDC's video "Put Your Hands Together."

2. Stay away from infected people (and stay home if you're infected)

This is called "social distancing" and it sounds pretty obvious, but it's one of the hardest recommendations to stick to.  That's because during a pandemic simply going to work, going out to buy groceries, going to a doctor's appointment or going to school could put you in contact with infected individuals or put others at risk if you're infected.  

And, as I mentioned above, people (yourself included) can be contagious for 24 hours before showing any symptoms.  When it comes to a flu pandemic, the fact that people feel well or look well is not a reliable measure of the risk they pose to others.  

If this does become a pandemic, the safest thing you can do is stay home and avoid contact with others as much as possible.

3. Use personal protective equipment (PPE) when you might come into contact with infected individuals

Masks

There has been a lot of talk over the last few years about the use of N-95 particle respirators as a way of avoiding infection, and they have been shown to work pretty well when used correctly... but the Cochrane Review I mentioned earlier found that there was no statistically significant difference between their performance and that of simple surgical masks.  Another study found that using nylons (AKA pantyhose) to hold the surgical mask tighter against your face improved their performance even further.  This is a more foolproof form of protection than the N-95 mask, which must be correctly fitted and it may be more comfortable, as well, which has implications for compliance.  --Paper masks were not shown to be effective.

Goggles

Eye protection (in combination with masks) was also shown to be effective by the Cochrane Review.  It's not clear whether this is primarily because goggles protected users from airborne droplets or because it prevented them from rubbing their eyes and thus introducing infectious material from their fingers into their eyes, but either way they made a difference.

Gloves

The same Cochrane Review showed that gloves were highly effective in preventing infection. The studies on this topic took place in a hospital setting, where healthcare providers changed their gloves after seeing each patient, so wearing the same pair of gloves all day isn't likely to help.  It's also very important to understand that wearing gloves does not eliminate the need for handwashing.

Gowns

Protective gowns (e.g. surgical gowns) were also shown to significantly reduce infection.  Again, this was in a hospital environment, but it highlights the importance of clothing as a possible fomite (an inanimate object that can transmit infection).  Surgical gowns may not end up seeing much use in day-to-day interactions outside the hospital, but this finding implies that it might be worth changing your clothes after coming into contact with someone who may be infected. 

All of the above, plus handwashing

Not surprisingly, the most effective intervention was a combination of all the forms of personal protective equipment above plus frequent and thorough handwashing.

4. Thoroughly disinfect surfaces where you live and work

Doorknobs, computer keyboards and mice, telephones, tables, kitchen counters and other surfaces can all transmit infection.  Thoroughly cleaning these surfaces with disinfecting agents can help reduce the spread of a flu virus.

5. Use a humidifier

This study (and a few others) suggest that humidifying indoor air may reduce the risk of flu transmission.  The evidence is fairly limited here, but the argument seems sound to me.

6. Practice good cough and sneeze etiquette 

Don't cough or sneeze into your hands.  If you don't have a tissue available, cover your cough or sneeze with the crook of your elbow instead of your hands.  That way, you won't be spreading germs to everything you touch.  If you do have a tissue available, you can cough or sneeze into that, then throw it away and wash your hands as soon as possible.  

7. If you have children, make sure they do all of the above

Children are especially good at transmitting the flu virus, which is why schools are likely to be closed down during a pandemic.  Making sure that your children learn to take the above precautions (especially frequent and thorough handwashing) can help to keep them safe... along with everyone around them.  

Time to update your pandemic flu plan

With the H1N1 “swine flu” outbreak unfolding across the globe, the threat of a flu pandemic is higher than it has been in decades.  We don’t yet know whether this new virus will become the next pandemic or (as we all hope) simply fizzle out, but now is a good time for families everywhere review their plans for coping with a pandemic and make sure they’re up to date.

What is a flu pandemic?

A flu pandemic is caused by an Influenza A virus, the same type of virus that causes the seasonal flu we deal with every year.  The difference is that a pandemic flu strain makes a lot more people sick than the seasonal flu and that it doesn’t just occur during the regular flu season. –A pandemic may last 18 months or more.  One other important difference is that, unlike the seasonal flu, which is normally only dangerous to infants and the elderly, pandemic flu strains often cause severe illness among teenagers and young adults, as well.  This is a pattern we’re seeing in the preliminary data from the swine flu outbreak, which is cause for concern.

Three conditions must be met in order for a flu virus to cause a pandemic:

1. It’s new to humans so that we have little or no pre-existing immunity to it
2. It readily causes significant disease in humans
3. It spreads easily from person to person

  “Swine flu” is a flu virus that normally infects pigs, and most swine flu viruses only meet the first of those three criteria: we’re not immune to them, but they don’t easily causes disease in humans (and such diseases are usually mild when they do occur) and they are rarely ever transmitted from person to person.  While the virus implicated in this outbreak is causing significant disease in humans and, based on early reports, is probably spreading from human to human, it is too early to say whether it is doing so at a level that could cause a pandemic to occur.  But whether this is the start of the next pandemic or not, it’s an important reminder about the importance of having a plan in place for keeping your family safe when a pandemic does strike.

How should you prepare?

The website www.pandemicflu.gov is the federal government’s one-stop source for pandemic flu-related information, and it offers useful advice on how to prepare.  The following checklist comes from that site and will help you to make a good start toward doing what you can to keep your family safe:

 1. To plan for a pandemic:

¨ Store a two week supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand. This can be useful in other types of emergencies, such as power outages and disasters.

¨ Periodically check your regular prescription drugs to ensure a continuous supply in your home.

¨ Have nonprescription drugs and other health supplies on hand, including pain re­lievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.

¨ Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.

¨ Volunteer with local groups to prepare and assist with emergency response.

¨ Get involved in your community as it works to prepare for an influenza pandemic.

2. To limit the spread of germs and prevent infection:

¨ Teach your children to wash hands frequently with soap and water, and model the correct behavior.

¨ Teach your children to cover coughs and sneezes with tissues, and be sure to model that behavior.

¨ Teach your children to stay away from others as much as possible if they are sick. Stay home from work and school if sick.

3. Items to have on hand for an extended stay at home:

Examples of food and non-perishables

¨ Ready-to-eat canned meats, fish, fruits, vegetables, beans, and soups

¨ Protein or fruit bars

¨ Dry cereal or granola

¨ Peanut butter or nuts

¨ Dried Fruit

¨ Crackers

¨ Canned juices

¨ Bottled water

¨ Canned or jarred baby food and formula

¨ Pet food

¨ Other nonperishable foods

Examples of medical, health, and emergency supplies

¨ Prescribed medical supplies such as glucose and blood-pressure monitoring equipment

¨ Soap and water, or alcohol-based (60-95%) hand wash

¨ Medicines for fever, such as acetaminophen or ibuprofen

¨ Thermometer

¨ Anti-diarrheal medication

¨ Vitamins

¨ Fluids with electrolytes

¨ Cleansing agent/soap

¨ Flashlight

¨ Batteries

¨ Portable radio

¨ Manual can opener

¨ Garbage bags

¨ Tissues, toilet paper, disposable diapers

How can you help?

If you are interested in helping your community prepare for and respond to a possible flu pandemic, consider volunteering through your local Medical Reserve Corps unit.  You don’t need to be a medical professional to join; you just have to be willing to help. You can find out more about the Medical Reserve Corps and how to contact your local unit at www.medicalreservecorps.gov.

You can also volunteer through the American Red Cross (http://www.redcross.org/en/volunteertime), your local Community Emergency Response Team (CERT) (http://www.citizencorps.gov/cert/) or any of the national, state or local Voluntary Agencies Active in Disaster (VOADs) found here: http://www.nvoad.org/.

Take home message

There’s no need to panic.  Right now, we don’t know whether this new swine flu virus will become a pandemic or just fizzle out.  It’s just too early to tell.  But either way, now is a good time to review your plans for keeping your family safe during a flu pandemic.  Make sure you have two weeks worth of non-perishable food and water at home.  Make sure you have a continuous supply of any medications you rely on.  Keep up to date with the latest information and advice at www.pandemicflu.gov, and consider volunteering to help your community in the event of a public health emergency.  Because even if this isn’t the next flu pandemic, eventually there will be one.  Being prepared before it strikes could make all the difference for you and your family.