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Are You Eligible to Live?

Posted May 09, 2008 12:00 AM by Sharkles

The possibility of a flu pandemic has been a topic of conversation for quite some time now. Whispered speculations said that an influenza pandemic is inevitable. Today, those same speculations are no longer whispered. Rather, health officials are taking steps to prepare for a pandemic. This planning involves deciding who gets medical treatment - and who doesn't.

"One day we will face a pandemic but we don't know when" says Keji Fukuda, coordinator of the World Health Organization's (WHO) Global Influenza Program. Now, a task force of influential has been set up to recommend who should receive medical treatment in the face of a flu pandemic or other mass medical disaster. Members of this task force are from prestigious universities, medical groups, and military and government agencies – including the U.S Department of Homeland Security, Centers for Disease Control, and the U.S. Department of Health and Human Services.

The task force has compiled a list for hospitals to use in case of a disaster. This list details which types of illnesses and situations should be treated. The recommendations were published in the May edition of the Medical Journal from the American College of Chest Physicians. Older patients (over 85), and others in critical conditions are some of the people on the list of those who would no longer receive care. Other recommendations include (but are not limited to):

  • Individuals with severe trauma – including victims of car accidents, shootings, etc.
  • People with severe mental impairment.
  • People with chronic diseases – including heart failure, lung disease, and "poorly controlled diabetes".
  • Burn patients over the age of 60.

While the list is only about recommendations, it is said that this information will provide guidelines for hospitals to make life-and-death decisions if and when a pandemic occurs. If the groups' recommendations are strictly followed, some disadvantaged citizens would be left without medical care.

Lawrence Gostin, a public health law expert from Georgetown University, refers to the report as "a political minefield and a legal minefield". Gostin believes that the recommendations would probably violate U.S. federal laws against age and disability discrimination.


Who is ready?

This is not the only preparedness plan in the world, of course. According to the WHO, more than 150 countries have some sort of national preparedness plan – whether as detailed as the United States, or merely an acknowledged threat. The WHO believes that all levels of society should be involved with preparing for a pandemic or disaster, so that they will know where to go for information and treatment.

The WHO continues to update its 2005 preparedness plan to include progress on the flu viruses and experiences with bird flu. This progress includes about 5 million antiviral treatments, which are on standby in case a pandemic breaks out. Over the past few years, enough research has been compiled to lead the WHO to believe that it's possible to stop a pandemic at the beginning of an outbreak – although it would be quite difficult.


Is A Vaccine Enough?

One of the reasons this year's influenza outbreak was so widespread was because the flu vaccine didn't work well against some strains of the virus. This year was reportedly the worst flu season since 1997-1998, when the vaccine wasn't especially effective. Since there is no way of knowing the exact strands of the flu virus that will circulate each year, health officials must make an educated guess as to which strands they may be. Sometimes, like this year, their guesses are off – this year's vaccine was estimated to be only 44% effective.

So, if the World Health Organization has 5 million vaccinations ready, will this be enough to save people from a global pandemic?

  • Do you think the preparation plans are justified? Or are they going too far?
  • Do you believe that we will see a global pandemic? Or are officials just trying to scare us?
  • Are there any other measures that should be considered?


Editor's Note:
I'd like to thank Slowpoke for bringing this very important issue to my attention!


Resources:
http://news.yahoo.com/s/ap/20080505/ap_on_he_me/pandemic_rationing_care
http://www.abcnews.go.com/Health/ColdFlu/wireStory?id=4673825
http://hstoday.us/index.php?option=com_content&task=view&id=3235&Itemid=149
http://ap.google.com/article/ALeqM5gsUwI119BFyoWS4Lb0LazXaA00VQD90G7KE0 http://www.kmph.com/Global/story.asp?S=82878800
http://cr4.globalspec.com/blogentry/5042/Thomas-Francis-and-the-Influenza-Virus-Part-1
http://cr4.globalspec.com/blogentry/5055/Thomas-Francis-and-the-Influenza-Virus-Part-2


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#1

Re: Are You Eligible to Live?

05/09/2008 10:35 AM

PANDEMIC Arrgghh panic everyone quick it's SARS or is it BIRD FLU..or is the sky falling in....

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#2

Re: Are You Eligible to Live?

05/09/2008 11:12 AM

According to the WHO?

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#3

Re: Are You Eligible to Live?

05/09/2008 6:22 PM

Thats real reassuring we can expect a epidemic while they can't even produce a flu vaccine that more then 45% effective. Nothing to say what they will have ready to inoculate any portion of the public will do any good anyway. 5 million doses is a drop in the bucket. If in fact they are preparing for the worst their choice of people to give the vaccine to is ridiculous. Most of which will not survive living in the world left afterward. Its like predicting bad weather or massive asteroid hitting the earth. The only thing we can do about it is make preparations to run and hide. So why worry.

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#4

Re: Are You Eligible to Live?

05/09/2008 10:53 PM

This is the month of MAY. Isn't this a little late to run around like Chicken Little peep peeping "The sky is falling, the sky is falling."

And far too early to know what vaccine to produce in large volumes and when it will be needed. Weather patterns affecting flu and flu victims another unknown and unprdictable variable.

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#5

Re: Are You Eligible to Live?

05/09/2008 11:31 PM

Yea, I'm not that worried either. I don't really care either. Everyone dies one day.

What this article seems to me is that someone isn't happy with how other people are deciding whether should they be saved or abandoned during a natural disaster.

The only way a pandemic would happen will be due to the widespread population of homosapiens throughout the globe, and the abilities to move from one place to another.

They seek medical treatment from different places via all kind of transports and inevitably spread the disease. If they just died off at wherever they got that epidemic, it wouldn't spread as badly. Well, it isn't humane.

I AM INHUMANE.

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#6

Re: Are You Eligible to Live?

05/10/2008 3:11 AM

This planning involves deciding who gets medical treatment - and who doesn't.

The task force has compiled a list for hospitals to use in case of a disaster. This list details which types of illnesses and situations should be treated. The recommendations were published in the May edition of the Medical Journal from the American College of Chest Physicians. Older patients (over 85), and others in critical conditions are some of the people on the list of those who would no longer receive care. Other recommendations include (but are not limited to):

  • Individuals with severe trauma – including victims of car accidents, shootings, etc.
  • People with severe mental impairment.
  • People with chronic diseases – including heart failure, lung disease, and "poorly controlled diabetes".
  • Burn patients over the age of 60.

While the list is only about recommendations, it is said that this information will provide guidelines for hospitals to make life-and-death decisions if and when a pandemic occurs. If the groups' recommendations are strictly followed, some disadvantaged citizens would be left without medical care.

This is evidence of a plan with triage restrictions pre-assigned, is S.O.P. for disaster relief/control efforts chillout...

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#7

Re: Are You Eligible to Live?

05/10/2008 3:28 AM

In the event of a pandemic (or any other global disaster) it won't be a case of 'women and children first'. Those in the lifeboat or with access to help will be politicians, the rich, and key-workers needed to keep them safe. Joe Public would do better to dig a big pit and acquire quantities of lime.

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#8
In reply to #7

Re: Are You Eligible to Live?

05/10/2008 5:40 AM

I agree whole heartedly with you Kris... A pandemic? Come on, it will be something cooked up on a petri dish somewhere that will have have a 100% rate of death (with the exception of those who are rich or "influential") in most areas of the world. Want to know what the WHO is capable of? Look up what they did with tetanus shots in Africa. Ever hear of the book/movie (by Steven King) the Stand? This situation could be like it...NO GOOD. Didn't some member of royalty over there in England say that they wanted to come back as a killer virus when they died, so they could kill off 80% of the earths population. Who could this have been...think the Queens husband maybe?

Cheers

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#9
In reply to #8

Re: Are You Eligible to Live?

05/10/2008 7:25 AM

Madness takes its toll, please have exact change...


Yep!!! You got that right.

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#10
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Re: Are You Eligible to Live?

05/10/2008 7:56 AM

Ha ! Sounds like him - some of his reported comments are so bad I wouldn't even want to report them (put it this way, I doubt he'd get a warm reception in Beijing). It would be quicker to count the number of people he hasn't offended.

Somewhere, in a dark satanic lab, a petri dish oozes. Kept, of course, purely for 'research'. Field tests may be earlier then expected if the safety record of UK bio-labs is anything to go by. Think I'll get me a NCB suit for Christmas - it won't save me for long, but I'd enjoy a short time to curse !

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#11
In reply to #10

Re: Are You Eligible to Live?

05/10/2008 8:09 AM

Think I'll get me a NCB suit for Christmas

You just like the rubber...

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#12
In reply to #11

Re: Are You Eligible to Live?

05/10/2008 9:45 AM

You told them all my secret ! Well I know who's been rubbing themselves up and down against a Yucca !

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#14
In reply to #10

Re: Are You Eligible to Live?

05/10/2008 12:13 PM

Load several syringes with atropine and you may survive.

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#15
In reply to #14

Re: Are You Eligible to Live?

05/10/2008 2:11 PM

Yeah, if I can get to the right politicians and insert a syringe throught the ear.

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#16
In reply to #15

Re: Are You Eligible to Live?

05/10/2008 4:02 PM

and insert a syringe throught the ear.

Or is that Rear!!!

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#23
In reply to #16

Re: Are You Eligible to Live?

05/11/2008 2:09 AM

They talk from both ends, so I might get confused like that !

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#28
In reply to #8

Re: Are You Eligible to Live?

05/12/2008 8:06 AM

Madness takes it's toll - please have exact change....

Yeah, that is pretty good. I guess that puts us on the "you're gonna die" list.

Anybody want to bet that the people who made the list are on the list? Certainly anybody with enough ego and gall to even consider making such a list deserves to be treated! Sort of like the ubermensch of the reich.

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#29
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Re: Are You Eligible to Live?

05/12/2008 10:26 AM

That's a good point - when the **** hits the fan, would you want to be in the lifeboat. Full of politician, 'rich' people, and every sort of useless fart you can think of. In that situation, drowning doesn't sound like a bad option. Imagine the agony of trying to organize such people to do anything useful - " yep, your left foot goes here, then the right foot.........stop bickering...........cut bait or fish......". Strewth, I think I'd rather be dead.

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#13

Re: Are You Eligible to Live?

05/10/2008 10:02 AM

Back in 1967 I was in US Navy boot camp at Great Lakes, IL, USA. When I had mess cook duty we had old salts who came to the base chow hall and they told stories of having been at that base (barracks located across the road and now torn down, some of the barracks were abandoned before the 1960's) during the 1919 Flu Pandemic. The stories were of bodies piled on skids like cord wood. So for some reason(s) the people I met survived, maybe they were not exposed to the virus?

In the 1960's every cold was treated with salt to gargle with, the bag they put the salt in split open in your pocket, don't ask me why but the drill sargeants were compelled to check your coat pockets and found the salt, then you got push-ups to go along with the cold.

The swimming pool which we were required to swim across to get out of boot camp, was like ice water (in February-March), when you hit the water fully clothed it sucked the breath right out of you. The only thing a body wanted was out at the closest place, which was where you jumped in! Kind of like why the hell am I leaving a perfectly good ship?, that drill sargeant just does not share my best interests!

I want a blog that discusses sound, vehicle noise has become rampant here in the states and in some Canadian provinces, it gets down to every couple minutes a noise interrupts, sleeping in motels about 50% of the year and in a noisey village the rest shortens one's attention span due to lack of sleep. I was driving last Saturday and a motorcycle roared past, he pulled into the lane ahead of me, then he roared past the cars with there windows open to show how much of an asshole he really was. A single consistent sound law for all noise sources is needed. The police need training and an instrument (like a radar gun) to enforce the sound law. The canyons of our cities do create echo chambers. "Bang your deaf" was an article in the recent American Legion magazine. Organizations appear to give give lip service to hearing and sight, but the answer isn't bigger ear plugs, it is stop the noise polluters. Those who intentionally and willfully destroy the peace.

So to apply that to a virus, the science of mutation,

Thanks for the opportunity to vent!

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#17
In reply to #13

Re: Are You Eligible to Live?

05/10/2008 6:39 PM

As a person suffering from multiple chronic diseases I have on more than one occasion had night mares that I was living in Nazi Germany and it was determined that I was a load on society and therefore sent to a concentration camp to be disposed of. Am I now going to have the same nightmares about being worth saving in a civilized society too?


I understand the importance of triage in the allocation of scare medical resources, it is just kind of scary to be on the negative end of the process.

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#18
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Re: Are You Eligible to Live?

05/10/2008 8:12 PM

Are you your brothers keeper ? Can you "buy" a life saver for him?

Is the government your keeper? The government will decide if you are sane, need medical care, are safe, ...

I had a neighbor who had a concentration camp tattoo, there are no concentration camps in North America, so you might have a foreign vacation to look forward to? Due to the chronic diseases, Probably not safe to fly you, so you'll probably get an ocean cruise. Maybe to some tropical island? In the South Pacific. The islands that glow in the dark are the one's where they held the nukie tests, with Navy ships all around, lots of sailors exposed, I was on one of those ships 20 years after the tests.

I've been to/thru Edmonton to Fort Mc Murray and started a hydro powerplant on the Green River (as I recall) near Edmunston. Thus I also have a Canadian Card of some kind.

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#20
In reply to #18

Re: Are You Eligible to Live?

05/11/2008 1:02 AM

there are no concentration camps in North America

You should take a long look at what FEMA's primary responsibility actually is...has nothing to do with disasters

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#21
In reply to #20

Re: Are You Eligible to Live?

05/11/2008 1:17 AM

I suppose it depends upon the definition of the word "is"

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#22
In reply to #21

Re: Are You Eligible to Live?

05/11/2008 1:24 AM

That's lame you can do better...you could have figured it out during your fall

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#19
In reply to #17

Re: Are You Eligible to Live?

05/11/2008 12:59 AM

Cheer up you have many peers

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#24

Re: Are You Eligible to Live?

05/11/2008 3:34 PM

I think the "Let-'Em-Die" list should consist of those members of the World Health Organization's Global Influenza Program responsible for this paltry inventory of antivirus treatments. Five million treatments? That's it? From an organization whose charter concerns world health and whose membership consists of more than 150 countries worldwide?

Imagine a Toyota or a GM with that kind of production record:

"Sorry, son. Get used to walkin', cuz they only make 20 of these trucks a year. Besides, you're just a nobody and there are much more important, much wealthier folks who want one o' these, too! You know, public servants?

e

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#25

Re: Are You Eligible to Live?

05/11/2008 8:37 PM

The WHO will probably think they will be the more important part of the human society thus they should use it. :D

Follow by UN, leaders, blablabla..

Well and maybe those who will make the vaccine. (Good for them though)

If human society really do drop to that level, yeah, they should be susceptible to diseases and die off from it.

It will be the glorious age of bacteria! (again)

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#26

Re: Are You Eligible to Live?

05/11/2008 10:36 PM

and the engineering issues we have identified are?????

milo

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#27
In reply to #26

Re: Are You Eligible to Live?

05/11/2008 10:48 PM

Well, I'm not sure either. Maybe it is part of acturial science? or statistical science?

The way they engineer a plan to decide who lives or die?

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#30
In reply to #26

Re: Are You Eligible to Live?

05/12/2008 10:40 AM

and the engineering issues we have identified are?????

None whatsoever. But Kate started it!

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#31
In reply to #30

Re: Are You Eligible to Live?

05/12/2008 10:48 AM

Hey! I admit it, I did start it. I know this topic doesn't have any Engineering issues, but I thought it was important enough to feature. I think it's horrifying that certain people get to make these kinds of decisions just because of their positions in the world.

I apologize to those of you looking for an Engineering story this week - sometimes I feel so strongly toward something that I feel it needs to be brought to the attention to everyone else. I hope you enjoyed the post for what it was regardless!

-Kate

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#32
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Re: Are You Eligible to Live?

05/12/2008 10:52 AM

I agree that it's worth discussing. Sometimes the engineers do need to get out of the lab....

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#33
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Re: Are You Eligible to Live?

05/12/2008 12:39 PM

Sharkles/ Kate.

Not to worry. Its actually a wonderful topic.

Every topic has a potential engineering angle, but this one's has so far escaped our august forum.

Given that potential for such a pandemic exists, how can we engineer a solution using what we know of network theory, efficacy of medicines and sanitizers and hygene, and controlling access to airports.

Just like antivirus software is critical for windows computers, because of their frequency in the installed base , while the mac/apple folks have less to deal with because the tipping point doesn't exist for self perpetuation.

Personally, I'd start with Flu vaccine for all pilots, cabin attendants , airport employees and frequent flyers at the gold level. That might reduce the carrying (vectors) population and initial beachead exposed population sufficiently to prevent the pandemic from ranging. suspension of team sports at schools, and dividing school populations into segments with alternating weeks off could make spreading more difficult as well. Obviously getting public sanitation to be effective, as opposed to the minimum wage levels we currently accept from our janitors would be part of an engineered solution.

Telecommuting makes perfect sense in such a scenario, as well as schooling from home. Internet access is ubiquitous.

ENgineering insights along these lines were what I am sure you had hoped to elicit.

In aninterconnected world, how can we contain the spread?

Please don't take offense at my comment.

Your topic a relevant one. Its just that actual engineering thought seemed a mite absent in the responses so far.

milo reminds me of the story about the first interstellar gates in tunnel in the sky by RAHeinlein.

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