What to do in a flu pandemic

Besides running in circles pulling your hair and screaming that we're all going to die. Let Fox News do that part. (Update: CDC's site here.)

ATLANTA, Feb. 1 — In the event of a severe flu outbreak, schools should close for up to three months, ballgames and movies should be canceled, and working hours should be staggered so subways and buses are less crowded, the federal government said Thursday in issuing new pandemic flu guidelines to states and cities.

Health officials acknowledged that such measures would greatly disrupt public life, but argued that they would provide the time needed to produce vaccines and would save lives because flu viruses attack in waves lasting about two months.

“We have to be prepared for a Category 5 pandemic,” said Dr. Martin S. Cetron, director of global migration and quarantine for the federal Centers for Disease Control and Prevention, in releasing the guidelines. “It’s not easy. The only thing that’s harder is facing the consequences. That will be intolerable.”

[snip]

Category 1 assumes that 90,000 Americans would die, Glen J. Nowak, a spokesman for the disease centers, said. (About 36,000 Americans die of flu in an average year.) Category 5, which assumes 1.8 million dead, is the equivalent of the 1918 Spanish flu pandemic. That flu killed about 2 percent of those infected; the H5N1 flu now circulating in Asia has killed more than 50 percent of those infected but is not easily transmitted.

The new guidelines advocate having sick people and their families — even apparently healthy members — stay home for 7 to 10 days. They advise against closing state borders or airports because crucial deliveries, including food, would stop.

The report urges communities to think about ways to continue services like transportation and meal service to particularly vulnerable groups like the elderly and those who live alone.

The guidelines are only advisory, since the authority for measures like school closings rests with state and city officials, but many local officials have asked for guidance, Dr. Cetron said. The federal government has taken primary responsibility for developing and stockpiling vaccines and antiviral drugs, as well as masks and some other supplies.

Update: Epidemiologist says these guidelines will not help poor workers who cannot afford to stay home. He says we are repeating the failures of Katrina:

"In particular, the guidelines acknowledge but do not provide any means to account for the great social inequalities that exist based on race and class," he said.

In the event of a major pandemic (Category 4 or 5 according to the new, hurricane-based, classification scheme) workers who are sick with flu symptoms should stay home.

"Many workers have little or no paid sick time and those who live paycheck to paycheck will not be able to do this. The government proposal that employers voluntarily provide pay to workers who stay home is not serious."

"Similarly, the idea that workers telecommute or avoid public transportation shows that the planners are not sensitive to the fact that lower paid workers have jobs that make this impossible and that many don't have access to alternate transportation."

Dr. Cohen pointed out that the New Orleans approach to rely on voluntary evacuation directly led to the disaster of people without the means being stranded.

"It is ironic," he said, "that the government's main stated public health goal is the elimination of health disparities by 2010 and yet these guidelines completely ignore the social disparities."