Monday, February 05, 2007

Epidemic Spread - Who / How

This is obviously a very big and important question. In my previous post I mentioned how in an area (e.g., earth) where everyone is susceptible to a new "nasty," and it is being spread from human to human, that isolation and containment procedures are one way to slow down that transmission process and, hopefully, slow down the process.

So many questions with this. But two very practical questions are: by whom is it being spread (e.g., at what stage of infection) and what is the actual mechanism of transmission. If it is spread human to human, then who is more responsible for the spreading - which age group is more susceptible, e.g., children or adults.

With respect to the first question, I came across an interesting site (google search = pandemic isolation) where there is some evidence that it's a little of both but in significantly different ways. It turns out that school age children may spread it to more people in a geographic area (neighborhoods) but adults are more responsible for spreading it to potentially vastly larger numbers through going to work and thus exposing others at work to it, and those workers then go back into their various neighborhoods.

The even bigger issue was with the spreading that comes from transportation arrangements. It's one thing if you travel within the state for business, it's totally another thing if you fly, for example, on a business trip from San Francisco, to Toronto, To Boston, To Atlanta. It's easy to get that picture.

I remember a year or so ago when the SARS issue was prominent and how I was aware of a few people in my office building who had traveled to Hong Kong, Taiwan, China on a recent business trip. I didn't do anything different then, well maybe I didn't use the exit on their side of the building as often, but it got me thinking.

n.b. edited 5/31/08 for grammar and clarity.

5 comments:

Anonymous said...

You know how, on those Peanuts TV specials, the adults all sound like muffled trumpets when they talk? I hate to admit it (since my MPH may get revoked), but that’s what avian flying winged bird flu reports sound like to me.

Somewhere around 35,000 people already die in the U.S. of the flu each year, but we have more fun conjecturing about the less-than-100 people who have died worldwide of H5N1 to date. Sadly, my ability to get excited about hypothetical disasters vanished in 1998 when Armageddon and Deep Impact hit the theaters. Some of the red flags that have been raised since then include SARS, mad cow disease, and ebola virus, if I remember correctly. I’m sure I’ve missed a few.

Anyway, the truth is that if a pandemic hits the U.S. or anywhere, the same people will die that die in every disaster: the young, the elderly, the poor, and the minorities. It doesn’t surprise me that some of those groups didn’t make into the Dept of Homeland Security or CDC reports—we sort of take it for granted at this point that these groups are supposed to die. Who’ll have access to medical care? Who lives in tighter living conditions? Who can’t afford to be socially isolated?

I realize I have digressed from the point of the original posting, but there’s so much actual dying going on that it bears pointing out. And I can’t help but sometimes feel that these hypothetical “isolation” scenarios feed into that problem—we’re so busy trying to figure out how we can get away from everyone else that we forget that the best way to survive a disaster, in general, is to reach out to your neighbor. My recommendation to those of you who really want to protect yourself from a disaster? Go to your neighborhood barbeque. Hit church on Sunday. Invite a buddy over for coffee. I haven’t confirmed it, but I’ll bet a lot of those 35,000 flu casualties I mentioned above are in the grave because nobody could get them to the hospital or the doctor in time.

This isn’t to say that you shouldn’t prepare for a disaster. The 10 minutes you take to throw some bottled water, canned soup and batteries into a box may save your life some day. Do be a buddy, though.

Anonymous said...

Viruses are mother nature's way of "b!@#$ slapping" us when we get all high and mighty about ourselves. We created these problems. We want to be masters of the universe and yet find ourselves reduced to vomiting masses because our science can't beat a mutating virus.

For movies about plagues I would recommend:
"The Horseman on the Roof" (italian), "The Painted Veil" currently in theaters, and "28 days"

It is these pandemics that captures the imagination and make "Zombie" movies scary.
-P

Tim Hodgens said...

KDChrist: Welcome to the discussion. You bring our attention from the future possibility to the current reality. Both can be nasty and unpleasant. And with nasty and unpleasant it is so easy to slip into avoid and deny mode.

You may well be on target with an antidote to the dark side of isolation. You say: "go to a neighborhood barbeque...invite a buddy over for coffee" - in the current situation it improves your chances of caring for someone else and also for them caring for you. Hospitals are full of lonely people. In dire circumstances, that isolation / loneliness can be a lethal combination.

I've actually been thinking a lot about this whole idea of "catching" something and how to avoid that. If I had a choice to expose myself to someone in the infectious stage of hemorrhagic fever, you can be certain I would pass on it.

That's one extreme. On the other, I recently rode on a bus to another state to meet up with my daughter. On the bus there were several children with not good sounding coughs. As I walked by their seats I had a choice to hold my breath or not. I chose breath. And I also decided that I would take another long distance busride or train ride at some point in the future.

I'm still thinking about all this and will probably write some more about it.

What protected Father Danian who worked with the lepers on Molokai? Mother Theresa died of heart problems, I believe. For years she simply waded in and cleaned and bathed and held the poorest of the poor, the sickest of the sick. What protected her. Certainly not isolation.

Tim

viagra online said...

I think that the pandemic insolation is so importat to be careful because mant people have many problems with this sittuation.

pharmacy said...

I really like this site, it's so important to know more about this topic, keep it up and of course every time I have time I'll love to check out again