The Bird Flu Pandemic

[Matt Flynn]

Could happen, most likely will not. If the strain acquires better human-to-human transmission ability, we are in for a wild ride. Conservative worst-case puts the kill rate at 2% in the U.S., including a lot of healthy young adults.

There are currently about 25,000 available unoccupied ventilators in the U.S. Up to a million people would require ventilation, and several hundred thousand certainly would in an almost-worst-case scenario.

The best way to prevent the disease is to prevent people from congregating, especially children. The very first major public health step should be to close all schools and day cares immediately. There is no mechanism for doing that in many states, and the decision power when it is defined generally resides in each state. Presumably the President could order it nationwide, but he is a politician and singularly bad at these kinds of assessments. He will delay.

If schools and day cares are closed, huge numbers of nurses will not be able to go to work unless alternative care is arranged. It would not be acceptable to have big day care substitutes in a hospital for obvious reasons. Many other hospital and ER staff would be affected as well. The system would have dramatically reduced throughput.

Even at full capacity, the health care system cannot handle a major pandemic. Thousands would simply not get seen, even people who are dying.

Tamiflu would reduce your chances of dying somewhat. There will not be anywhere near enough of it. Black market Tamiflu will get interesting.

With massive numbers of people staying home to take care of children and to avoid the disease, the economy would be seriously impacted. Food and fuel shortages could result.



Two good options in case of worldwide bid flu pandemic with a virulent strain:

1. Bend over, kiss rear end goodbye just in case. Get two holdem cards. If it's a pair JJ or higher, you get to find out if your religion is right.

2. Hole up on in Montana with a couple months' worth of provisions, several firearms, a fly rod, and an internet connection. Walk around with your 4-inch "gun" a lot. Paint your willow tree bases to protect them from bird flu-addled beavers.


One of the more interesting side stories in a pandemic: the country will run out of ventilators the first week or two. Then first question will be do you let those in vegetative states die in order to save healthy people, or do you sacrifice the healthy people and leave the vegetatives on the vents? Every person in a vegetative state left on the vent will result in an average of two healthy people dying. Second and more interesting question: many thousands will need to be ventilated but won't have ventilators. An Ambu bag, an oxygen bottle, a little training and several really close friends who will bag you around the clock without missing for longer than 1-2.5 minutes for 1-3 weeks will keep many alive who would otherwise die. You do not want to tap friends with ADD for the job, or people who aren't bright enough to self-correct when they aren't actually ventilating you.

Fun exercise: List those friends and relatives.