Will you work during a Pandemic?

[Goju]

admin note: we just added a poll to this thread today, april 25, 2008, please take a second and vote in the poll so we can have a graphical representation of the responses. thanks

scenario:

h5n1 (the bird flu) mutates to become efficient at transmitting human to human causing a pandemic, with a case fatality rate of 60% and with 80% of the cases in the 0-40 year old age range.

see:

http://www.wpro.who.int/nr/rdonlyres/fd4ac2fd-b7c8-4a13-a32c-6cf328a0c036/0/s4_1113.jpg

hospitals will be quickly overrun. hospital staff shortages are 50%. the government orders all nurses to work. there is not enough personal protection equipment (n95 masks, gloves, goggles, tamiflu, vax, etc)

home quarantines become common (in the fed plans).

your family is also quarantined in your home. you are running out of food and the government promises you will be "taken care of" if you report to work.

will you go?

[HippyGreenPeaceChick]

Get proper rest, eat well, stay hydrated, take vitamins and vit C for your health, Keep you immune system in top fighting form. I live and swear by this formula.

[winterbot428]

I will go but will petition to have my wife stay with the kids (she will soon be a nurse also.)

[Dragonnurse1, ASN, RN]

I will go but will petition to have my wife stay with the kids (she will soon be a nurse also.)

I think you are very astute winterbot428, when both parents are involved in health care or public protection (ie fire dept. police, medics) only one parent should go not both.

Bless you and I hope your wife does well.

[lamazeteacher]

Over Reacting on the part of the WHO

In what regard is WHO overreacting? It's their mission to gather information, and report it regarding pandemics.

[Girl Scout]

Perhaps a forum moderator could be asked to change the subject line of this thread to read something more like "Will you work in a pandemic (please read first post before posting)" because I'm getting the impression that many of the misunderstandings happening here are due to people who are posting thinking that it's in reference to the current H1N1 situation, instead of a hypothetical H5N1 pandemic.

[Laidback Al]

Perhaps a forum moderator could be asked to change the subject line of this thread to read something more like "Will you work in a pandemic (please read first post before posting)" because I'm getting the impression that many of the misunderstandings happening here are due to people who are posting thinking that it's in reference to the current H1N1 situation, instead of a hypothetical H5N1 pandemic.

When Goju first posed his question in 2007 the mostly likely influenza virus to cause a pandemic was H5N1. His hypothetical question really had two questions rolled into one. Will you work during a pandemic and will you worked during a pandemic with a high CFR? We are now in a pandemic. So the question still remains, will you work during a pandemic?

The CFR for confirmed H5N1 cases is currently around 60% and for a hypothetical H5N1 pandemic it could still be that high. The CFR for the current H1N1 pandemic is unknown because of the opacity in the reporting of health officials, but seems to be under .01% right now. That could change for the next wave which is expected in the northern hemisphere in a few months.

Goju hasn't checked in for a while, but I imagine he is interested in your response to working during the current, apparently low CFR H1N1 pandemic and if you will work in a high CFR H1N1 pandemic if this virus changes or recombines in the next several months.

When Goju first posted his question, it was a mental exercise for members of allnurse.com. Now, today, Since June 11, 2009, when WHO declared the first pandemic of the 21st century, it becomes a much more relevant question for each and everyone of us: Will you work during a pandemic or not?

[lamazeteacher]

• be as informed as possible before deciding (from reliable sources)
  
• take approporiate precautions (have your n95 mask fitting properly)
  
• stay home at the first sign of your own illness (usually sore throat)
  
• isolate possibly infected patients with their companions who came with them, "at the front door" (a stand with masks and a sign saying
  
• "please wear this if you have a sore throat, cough, or other signs of flu, and be sure it fits closely to your face" that saves money!
  
• do not take your child(ren) to their regular childcare setting, if they have s/s of flu, or expose anyone who has an existing healthcare problem, to them.
  
• opinion: the who's askew flu fears
  
  
  
• swine flu: complete coverage
  
  
  

• swine flu declaration will speed work on vaccine
  
• swine flu is a pandemic, who says
  

if a large-scale outbreak of the virus recurs this fall, a similar infection rate could cause significant problems -- not only because it would limit the number of workers available to care for the sick, but also because the infected nurses, doctors and others could transmit the virus to debilitated patients before their own symptoms become apparent. already-ill patients would be more likely to develop life-threatening side effects from the flu.

the report in the morbidity and mortality weekly report studied 48 cases that occurred from the beginning of april to may 13, and concluded that "probably half were related to the healthcare setting," said dr. michael bell of the cdc's center for preparedness, detection and control of infectious diseases. an additional 33 cases have been observed since then, but not studied in depth.

one of the key findings of the study, he said, is that potential patients with so-called swine flu "need to be identified at the front door" of the hospital so that personnel will know they need to take preventive measures, such as wearing masks, isolating the patients and paying particular attention to hand hygiene.

it is also "absolutely essential that healthcare personnel be vaccinated annually, for their own protection and to protect patients in hospitals," he added.

the agency is not recommending that all hospital personnel receive the antiviral drug tamiflu, but that it be used prophylactically in personnel who have been exposed to the virus.

agency officials are mildly surprised that the new flu virus is continuing its spread in the summer months, well after the normal end of the flu season.

to date, there have been more than 17,800 laboratory-confirmed cases in the u.s., with 1,600 patients hospitalized and 44 deaths, according to dr. daniel jernigan, an epidemiologist in the cdc's influenza division.

worldwide, there have been nearly 40,000 confirmed cases in 88 countries, with 167 deaths.

in the u.s., the spread appears to be tapering off throughout most of the country but is continuing at relatively high levels in new england and new york state. and the confirmed cases may be the tip of the iceberg, jernigan said. in areas such as new england and new york, an estimated 7% of the population has been infected, suggesting that hundreds of thousands of americans have contracted the virus to date.

note: those people are not necessarily hcws, so hospitals aren't a great source of infection.(by lamazeteacher)

"the fact that we are seeing ongoing transmission now indicates that there is something different with the virus," jernigan said. "it may also have to do with the complete lack of immunity among the younger population."

the spread in the northeast may be because of cooler weather there, which favors transmission of the virus.

note: good air conditioning may be helpful in lessening transmission. (by lamazeteacher)

as schools have closed for the summer, the focus of transmission has shifted to summer camps, another place where children congregate. a boy scout camp in asheville, n.c., for example, sent 19 scouts from florida and georgia home after they got sick and 10 tested positive for novel h1n1. other students were quarantined.

bell said the cdc had the same recommendations for camps as it did for schools: sick children should be sent home and not allowed to return for a week or for 24 hours after the last symptoms disappeared.

in the week that ended june 6, the most recent period for which figures were available, 89% of laboratory tests for influenza viruses revealed the presence of h1n1. only 1.8% of the tests revealed seasonal viruses. the rest were not sub-typed, which generally means that they were also novel h1n1.

the cdc is closely monitoring outbreaks in the southern hemisphere, which is now at the beginning of its flu season. outbreaks are becoming more widespread in several places, such as australia and chile. preliminary results suggest that most laboratory tests in the southern hemisphere are revealing the novel virus, implying that seasonal flu is being displaced.

such findings suggest that seasonal flu may not be a significant problem during the coming winter flu season, but that the novel virus will. but jernigan cautioned that the labs might not be looking for the seasonal virus, biasing the findings.

virologists received a bit of a scare this week when researchers at the adolfo lutz bacteriological institute in sao paulo, brazil, reported that they had isolated a mutated h1n1 virus from a patient who had recovered.

but academic researchers and scientists at the cdc discounted the report, noting that there were no changes in the portions of the virus that would alter its ability to spread or its pathogenicity.

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[Kabin]

Unless already laid off, we're all working during this global pandemic.

[indigo girl]

Unless already laid off, we're all working during this global pandemic.

Exactly, we are already working.

Those of us who have not been asleep at the wheel have had some time to get used to some of the new normals of this pandemic.

Those new normals?

Influenza in hot weather! Who would have thought to see people dying of flu in June?

Lots of young people getting sick, but the seniors not so much. Flu hitting summer camps and cruise ships! Rows of patients on vents in community hospitals in northern Canada. Families in shock, grieving the loss of their previously healthy young people before us in the news in Milwaukee, Chicago, NYC, Salt Lake City, Miami, El Paso, San Diego...

We have learned much about the types of conditions that make us more vulnerable to a a bad outcome. And, that they were a lot more common than we would have thought. Surprisingly including more conditions than we would have thought. For example, there are many of us with mild asthma that do not take medication routinely, and would consider ourselves relatively healthy. But, we now know that having any kind of reactive airway disease is a hugh risk factor. Know anyone with sleep apnea or anyone who is 20 to 30 pounds overweight? Diabetics, likewise.

We have learned that a negative rapid flu test does not mean that the person you are seeing in the ER with c/o flu symptoms is not actually going to die of flu. Most won't, but some will. Some are only going to be diagnosed later when they are critical or at autopsy.

We know that we have no vaccine yet, and that supplies of just about everything that we will need in a surge are going to be limited.

It's been an education. This flu snuck up on us when we were already busy at work.

This is only the first wave.

[Goju]

Hi all,

Havent checked in here for a while. My original post was for H5N1 but i am fascinated by the challenge H1N1 posses. While not as deadly as a potential H5N1 Pandemic, H1N1 is still pretty bad. People getting very sick and many dying. A real Pandemic virus. I do believe that health care facilities will run out of PPE soon. Certainly when a surge hits. Enough of those and no supplies will be left leaving you all totally exposed. I fear for your and your family's health and lives come this Fall.

When Goju first posed his question in 2007 the mostly likely influenza virus to cause a pandemic was H5N1. His hypothetical question really had two questions rolled into one. Will you work during a pandemic and will you worked during a pandemic with a high CFR? We are now in a pandemic. So the question still remains, will you work during a pandemic?

The CFR for confirmed H5N1 cases is currently around 60% and for a hypothetical H5N1 pandemic it could still be that high. The CFR for the current H1N1 pandemic is unknown because of the opacity in the reporting of health officials, but seems to be under .01% right now. That could change for the next wave which is expected in the northern hemisphere in a few months.

Goju hasn't checked in for a while, but I imagine he is interested in your response to working during the current, apparently low CFR H1N1 pandemic and if you will work in a high CFR H1N1 pandemic if this virus changes or recombines in the next several months.

When Goju first posted his question, it was a mental exercise for members of allnurse.com. Now, today, Since June 11, 2009, when WHO declared the first pandemic of the 21st century, it becomes a much more relevant question for each and everyone of us: Will you work during a pandemic or not?

[Woodenpug, BSN]

Yup, the sky is falling. No ppe. OMG, will you help me foxy loxy? serious, how many threads do we need before someone decides that ..... wow, we are actually addressing the situation adequately. So solly, tough to get people to overact. Let's just try harder.

[Laidback Al]

Yup, the sky is falling. No ppe. OMG, will you help me foxy loxy? serious, how many threads do we need before someone decides that ..... wow, we are actually addressing the situation adequately. So solly, tough to get people to overact. Let's just try harder.

I am sorry, Woodenpug, your sarcasm is so thick that I don't understand your post. What is your point?