Monday, May 5, 2008

US offers triage analysis for potential pandemic; other countries likely to do the same


Lindsey Tanner of the Associated Press has a disturbing story today “Who should M.D.’s Let Die in a Pandemic? Report Has Answers.” The report was compiled from a number of government agencies including the CDC, HHS, and the Department of Homeland Security. The link is here.
The recommendations for triage and rationing of life-saving care are rather specific.

AOL carried the story today with a headline that was a little less sensitive, “Who should not be saved in a pandemic?” (The title may have religious objections to some.) There is a survey that so far offers surprising results; most Americans recognize that lines will need to be drawn and even they or their family members could get excluded.

It is expected that other western countries will have similar reports, as these scenarios have been demonstrated in a number of films.

The largest concern is that H5N1 or a similar virus could mutate in such a manner as to become more transmissible human-human. The danger of such mutation is greater in parts of the world where people live in close proximity to poultry and cannot afford good hygiene, but the effect could be rather quick and global because of travel. It is not likely that there would be a single “index case” as in the movies. The Spanish flu in 1918 appeared simultaneously in several parts of the world at the same time, a circumstance never fully explained.

China had a scare with this sort of problem with SARS in 2003, which was contained.

Persons who had recovered would be expected to “volunteer” to help care for the ill because of the shortage of medical personnel and overwhelming caseload, and recovered people would be naturally immune.

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