“We’re a little overdue for a pandemic,” says Marge Sidebottom, emergency planner for the UVA Health System. Three influenza pandemics have struck the U.S., most notably in 1918, but also in 1957 and 1968—the 1918 pandemic alone killed at least 50 million people worldwide. The potent avian flu hasn’t yet spread to the United States, but local authorities from the City, County, State and UVA are working to create an emergency plan in the event of pandemic flu—or any other debilitating disaster, like a terrorist attack or a natural disaster. Based on conversations with planners at the County, UVA, Martha Jefferson, and the Thomas Jefferson Health District (www.healthspace.ca), here’s a glimpse at what might happen if an influenza pandemic struck locally:
At least 50 million died in the 1918 influenza pandemic—local health officials are trying to pin down how to respond in the event of the next pandemic. Best way to prepare? Stockpile food, water and supplies, say emergency planners.
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It starts with a phone call. A doctor in Charlottesville encounters a patient who she thinks might have the flu; she calls Lilian Peake, director at the Thomas Jefferson Health District. Immediately, Peake dispatches an emergency courier from the State laboratory in Richmond to confirm the case in a matter of hours.
Once confirmed, the Health District blast-faxes area doctors, asking them to look out for suspicious cases and contact the Health District if they find any. The sick are asked (and could be legally required) to remain isolated. The Health District calculates their period of contagion and asks those who have come into contact with them during that period to remain quarantined.
But, by definition, a pandemic flu is easily spread, and when it gets beyond the Health District’s manpower to contact all the sick and exposed, it’s time for a huge public education campaign. Media outlets, doctor’s offices and any other local information sources start shouting the news and recommendations for prevention. As soon as a vaccine is available, it’s distributed to those most affected by this particular strain of flu. (Seasonal flu usually hits the very young and very old, but part of why the 1918 strain was so deadly was that it was most damaging to those with strong immune systems, which over-responded and stripped the lungs.)
Still the disease spreads. UVA opts to cancel classes, housing those who can’t go home in certain dorms on campus. Public gatherings, like basketball games and concerts, are cancelled and people are expected to remain home. As it continues, local governments trim back to essential services, like fire and police or financial duties like payroll and welfare. Public schools are cancelled.
For the six to eight weeks from the beginning to the end of the flu wave, the graph charting the number of infections resembles a bell curve. During that peak, 40-50 percent of workers fall ill and must stay home. Beds fill at Martha Jefferson and the UVA Hospital, though the real trick is keeping enough staff on hand. To plug the staffing gaps, administrators call on the UVA Medical Reserve Corps, composed of health workers of all stripes, from the recently retired to medical students.
There will likely be a second, and possible a third, wave to weather. When it’s all told, up to 6,300 are dead in Virginia—and up to 207,000 in the U.S.