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More Hospital Beds Needed for Avian Flu
Birds infected with H5:N1 – avian flu – likely will arrive in the United States by September or October, according to the former director of the Office of Public Health Emergency Preparedness. But despite making some dire predictions, he said that media reports are promulgating "hilarious" prevention measures – and causing unnecessary panic.

By: Josh Cable

Donald Henderson, M.D., MPH, resident fellow at the Center for Biosecurity at the University of Pittsburgh Medical Center, told attendees at the 2006 American Industrial Hygiene Conference and Expo in Chicago that "as of now there is cause to be concerned" about a possible avian flu pandemic. But he also blasted press reports that have predicted a multi-year bird flu holocaust that would cripple the economy and keep as much as 40 percent of the U.S. work force at home. "That's not the way it works," Henderson said. Based on what we know about previous flu pandemics, "it's 10 to 12 weeks that you have a real problem. Then it's effectively back to normal."

Henderson, who once served as the country's principal science advisor under President George H.W. Bush, suggested that we could expect perhaps 15 percent of U.S. workers to stay home during the pandemic – either because they are infected with the bird flu themselves or they are caring for infected family members. He said that the country's economy and vital public services could carry on, even with 15 percent of the work force absent.

"We do it all the time," Henderson said, cautioning, "[but] this is a virus we've never seen before, so we don't know how it's going to behave in [the] future." He called the H5:N1 avian flu strain "unprecedented" because 50 percent of the 200 people who have been infected have died. By comparison, in the 1918 flu pandemic only 2 percent of infected people died.

Slowing the Bird Flu: 'Simply Pipe Dreaming'

Henderson said that he has come across some "hilarious" suggestions on how to stop or slow the spread of the bird flu, if indeed a pandemic occurs. Some of those proposals include quarantining infected people in their homes, stationing workers 3 feet apart, shutting down the borders and screening international air passengers for the flu virus. "Based on our experience on what we've seen in the past, there are no quarantine measures anyone can identify that can do anything whatsoever to stop or slow the spread of pandemic flu," Henderson said.

Trying to quarantine sick people is a lost cause, Henderson noted, because "the big problem with flu is the person begins spreading it 1 or 2 days before the symptoms start to occur." He pointed out that the office worker who stays home sick probably has already spread it to everyone he is going to spread it to anyway. "We're not going to get much from isolation," Henderson said.

Quarantines also would serve to cripple vital public services by cutting down on the number of workers available, according to Henderson. "This is what's going to drive panic and chaos," Henderson asserted. "This is not the way to go."

Vaccine Will Not Be Ready

While Henderson assailed some media reports for fueling paranoia and panic, he said that others have presented an "overoptimistic" viewpoint by hanging hopes on a bird flu vaccine. He said that a bird flu vaccine would not be ready until 6 months after an outbreak occurs. "You can't begin producing it until the strain goes from person to person," Henderson said. "Unless you match the strain with what's going from person to person, you get very little protection."

Complicating matters is that efforts currently underway to develop a vaccine have not gone well, turning up "one surprise after another." "There will be no vaccine produced for this 2006-2007 season," Henderson said. "And we won't have nearly enough for 2 years from now."

More Hospital Beds, Planning Needed

Henderson said that the best strategy to prepare for a possible bird flu pandemic is to engage in "a lot more planning." In particular, the United States needs to start planning on how it will care for those who become ill. "We know in a short time that every hospital bed will be filled," he said. Henderson added: "We've done almost nothing to figure out how to take care of patients in the event of a pandemic flu."

Disseminating accurate information – which he considers one of his roles – will be critical. "I think we can, however, create chaos by ill-informed and ill-advised activities, and these are still being promulgated in the press," he said.

Also, he emphasized that people will need to do their best to continue their regular pattern of life, in order to minimize chaos and panic and to keep the country's economic and health care infrastructure intact. "Providing care for those who are ill," Henderson concluded, "that's where our emphasis should be put."

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