During this cooler than normal summer, I have been struck by the amount of talk, press, and television time that the H1N1 virus has garnered. When do you remember seeing news about influenza the day of baseball’s All-Star game? We have since seen predictions of the severity of the Pandemic. The World Health Organization sends out daily reports with the facts and figures. There are certain truths that are known:
1. The severity of the H1N1 pandemic will be accurately known only after it is over. There is never a guarantee that the virulence or communicability of the H1N1 will remain constant. Mutations may very well occur, changing the properties of the virus.
2. The population between the ages of 20 and 40 years will be hit the hardest. The immune system of our young adults is at its strongest. The novel virus elicits a response from the immune system so strong that the body’s own tissues suffer.
3. Social distancing is effective in slowing the spread of the virus and can aid in the minimization of deaths. This subject is covered in an article previously published in this journal. 1
4. Our economy is much more vulnerable than in previous pandemics. The new Global Economy is much more susceptible to disruption due to decreased suppliers for many items and decreased warehousing of all goods. The current “just in time” way of delivering goods means there is a much smaller reserve of everything.
5. At the very worst (1918 pandemic levels) two more excess deaths per 100 would occur from the virus. That is not to say that deaths could not occur from causes secondary to the disruption of our normal way of life. Today the possibility of a bio-terror attack is very real. The timing of such an attack in conjunction with the first or second wave of the pandemic would indeed introduce more chaos. The bio-agent would, at first , show influenza-like symptoms. The introduction of this bio-agent with the pandemic would likely cause a longer time before the attack is recognized as such and cause greater sickness than if it was a stand-alone attack.
6. Experts will be hard pressed to do a better job of predicting the outcome of this than you or I. There are too many factors that are variable to be able to predict any of this with a high degree of certainty. To fracture a quote: “The future of the H1N1 ain’t what it used to be.”
Taking appropriate precautions would be easy if we knew the outcome of the pandemic beforehand. One shortcut that is available to all residents of Minnesota is found at CodeReady.org (http://www.codeready.org/). At this website a personal/family preparedness plan and kit can be generated. If all the family’s medical information is readily at hand, the plan and kit can be finished with about one hour.
Information can be found at the CDC website (http://www.cdc.gov/), and at the Minnesota Department of Health website (http://www.health.state.mn.us/oep/prepare/index.html).
These are the things we know for sure. Others change during the course of the pandemic. We need to work in order that we can discern what is real and true, and discard all that is false. Good luck to all of us. We will need all we can get.
1. Nolting, Frederick W: The Pandemic of 1918: A Tale of Two Cities. Northwest Dentistry 87(3):47, May-June 2008.
*Dr. Nolting is Chair of the Minnesota Dental Association Disaster Preparedness Subcommittee, and a member of the American Medical Association National Disaster Life Support Educational Consortium. He is a general dentist in private practice in Byron, Minnesota.