augigi, thanks for the correction! I apprecicate it, sorry for my error.
and I admit- I am a bit jealous :)
Tulip, the pandemic in the 60's wasnt H5N1 it was another strain, H3N2, and that was about the first it circulated widely, and was believed to be created by antigenic drift from the human circulating H2N2 that it replaced. Because it was antigenically related to an already circulating human virus the impact was less than a virus which jumps rapidly into humans. Part of the reason anyway, but virulance seems to be a combination of factors, some genetic in the virus itself (like receptor site amino acid sequences), and some related to host susceptability.
Steroids are no longer recommended for ARDS, and have been shown to increase mortality. They had no beneficial effect on recent H5N1 victims. No help there.
The flu is such a promiscuous virus and mutates so rapdly, that you can have a strain one year, and still catch the same named strain the following- it may have changed just enough to outwit your immune system. Thats why flu vaccine is reformulated every year, to include the most current and likely to be circulating strains.
Anitbiotics- yes, that's a definite plus! It should help reduce the deaths caused by secondary pneumonia.
But H5N1 is currently killing via primary bacterial influenza pneumonia not secondary. Antivirals like oseltamivir have shown some benefit, but need to be started within a day or two of infection to be most effective-by the time the cytokine storm hits, they apparently have little beneft.
So yes, we do have lots of good things now- we know a lot more about infection control and how to avoid getting sick. We have PPE. We have antibiotics. We have ventilators.
And nowhere near enough of any of them. Estimates by some planners are they current stcoks are good for about 2 weeks if we are lucky. Waves last 60-12 weeks or longer and can recur two or more times, with a few months in between. After those supplies go, we are back to pretty close to what they could do in 1918-supportive care, and hope for the best.
It doesnt have to be 1918 again- it could be much worse. Theres no guarantee that 1918 was the worst pandemic and things cant be worse, and soem researchers feel older pandemics have had even higher mortality rates than 1918. I sure hope it isnt worse, dont get me wrong , I am hoping for the best while preparing for the worst! if we get very very lucky, maybe it will be mild like 1968 or 57.
The longer I watch and learn about this, the more convinced I am that we need ot be proactive and prepare. Its not going to be business as usual evening a mild pandemic, health care has changed so much since the mild one in 68 that it will have huge impacts on HCW.
A serious or severe pandemic could be devastating. We cant stop it, if it does jump but we can prepare and mitigate the impacts on our communities, facilites and our families.