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Flu Preparedness at the New York Academy of Sciences
By Molly Lee
The New York Academy of Sciences (see http://www.nyas.org) held a meeting yesterday on flu preparedness, covering topics such as non-pharmaceutical interventions, vaccines, and NYC's response plan should a pandemic occur. The overall purpose of the meeting was not to project doomsday scenarios, but rather to share knowledge gained from recent influenza research and to explain strategies for infection control.
First, an important distinction needs to be made between seasonal flu, avian (bird) flu, and pandemic flu:
•Seasonal flu occurs every year and is responsible for about 37,000 deaths and over 200,000 hospitalizations in the U.S. (the best protection against the yearly epidemic is a flu shot).
•Avian flu has been devastating to birds including poultry in parts of Asia but has been limited to fewer than 300 human cases (almost all of these infections occurred through close contact with diseased birds).
•A pandemic flu is a concern for scientists worldwide, and many believe it will happen if the H5N1 avian virus mutates into a strain of virus easily spread among humans.
The NYAS meeting started with a talk from Dr. Peter Palese from the Mt. Sinai School of Medicine who discussed the 1918 flu pandemic and what we can learn from it. The 1918 flu pandemic was the deadliest pandemic in history. It killed about 675,000 Americans alone and between 200 and 500 million worldwide. Recent research has shown that the H1N1 strain of flu responsible for the 1918 pandemic is vulnerable to both vaccines and treatment including Tamiflu, neither of which were around in 1918. The good news for today's Americans is that we have come a long way since 1918. Most Americans have been exposed to an H1N1 flu virus, and thus are likely to have some immunity to these strains. In addition, the 1918 pandemic caught everyone off guard. Most government agencies were distracted by WWI. Further, they weren't even sure what it was that was sickening so many people. Today, a pandemic won't surprise us, and we have modern technology including vaccines and antivirals to prevent and treat the flu.
If a pandemic of avian influenza does occur, an effective vaccine won't be available for about four to six months, though, according to Dr. Stephen S. Morse from Columbia University, who discussed non-pharmaceutical interventions. Many interventions we would use today are similar to the ones used in 1918. First, social distancing would be encouraged. This might include school and work closures as well as cancellations of public gatherings. The best place for a person to be if he or she doesn't feel well is at home. Although social distancing is important for curbing a pandemic, it is important to note that not everyone can stay home. Cities need to remain operational, and hospitals can't just shut down. For those in public service, hygiene education will be critical. Studies have shown that the simple act of hand washing can drastically reduce flu infection. In addition, stressing cough etiquette and introducing facemasks for healthcare workers may reduce infection rates. (For more information, see our publication Avain Influenza or "Bird Flu": What You Need to Know.)
The NYAS meeting addressed important issues for scientists and healthcare workers to consider when preparing for a pandemic. There is no telling how many Americans may be sickened, hospitalized, or killed. One of the lectures concluded with the Yogi Berra quote, "It's hard to make predictions, especially about the future." That's true in the case of pandemic flu, but the good news is that some of the best scientists worldwide are preparing for a pandemic, and this time it won't surprise us.
Molly Lee is the Earhart Foundation Research Intern at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
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