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.
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.
Let's see. This thread was about a hypothetical pandemic. One that is impossible in exaggeration of extremes. How having one extreme, such as no ppe's and still having the government require skilled nursing is just one of the ways that the scenario is at best ludicrous.
Ludicrous in what way? You say that it is impossible yet which is historically valid, i.e. we have seen it before.
Notice that still fully two-thirds of the people polled, will work during a ludicrously exaggerated worst case pandemic. If you want to link it to the real world pandemic, I think you'll notice that 98% of us are working.
The current pandemic is little akin to the historical pandemic of the late 19-teens, i.e. people are not dieing in droves and the overall acuity of the infection remains low, and whether you'd care to admit it or not the values of today's population in general are a far cry from those of nearly 100 years ago. A significant percentage of those who proudly proclaim themselves self-sacrificing and unafraid to report for work in the face of a deadly pandemic strain may find themselves having to eat their words before all is said and done.
Let's see. This thread was about a hypothetical pandemic. One that is impossible in exaggeration of extremes. How having one extreme, such as no ppe's and still having the government require skilled nursing is just one of the ways that the scenario is at best ludicrous.
Then linking this to a real world pandemic. Stretching that to somehow make the original post plausible. Well O.K. Still, why not discuss a possible worst case scenario? Why is it so important to exaggerate an already serious situation?
Notice that still fully two-thirds of the people polled, will work during a ludicrously exaggerated worst case pandemic. If you want to link it to the real world pandemic, I think you'll notice that 98% of us are working.
I really wonder why fear mongering is so important.
I guess having an opinion of my own and the ability to differentiate between reality and fiction, makes my post off topic?
When Goju posted this question, it indeed was hypothetical. The pandemic is now here. Predictions vary but a CFR of 2% in the next wave is well within the range of probability, it could happen soon.
Based on your comments, I assume you will be willing to continue working into the next wave of H1N1. But I don't want to over presume about your choices and actions.
So tell us, Woodenpug, are you going continue working and treating patients if the CFR climbs to 2% in the next H1N1 wave and you don't have access to PPE? Will you turn down an offer to have an H1N1 vaccination if it is offered to you? Will you stay at your post even though you have a sick family member or a dear friend that desperately needs your help and attention? Since these are hypothetical questions in what you believe is a hypothetical thread, I am sure you will have no trouble responding to them, hypothetically, of course.
When Goju posted this question, it indeed was hypothetical. The pandemic is now here. Predictions vary but a CFR of 2% in the next wave is well within the range of probability, it could happen soon.
Based on your comments, I assume you will be willing to continue working into the next wave of H1N1. But I don't want to over presume about your choices and actions.
So tell us, Woodenpug, are you going continue working and treating patients if the CFR climbs to 2% in the next H1N1 wave and you don't have access to PPE? Will you turn down an offer to have an H1N1 vaccination if it is offered to you? Will you stay at your post even though you have a sick family member or a dear friend that desperately needs your help and attention? Since these are hypothetical questions in what you believe is a hypothetical thread, I am sure you will have no trouble responding to them, hypothetically, of course.
Yes, and thank you for asking. Let's note the current pandemic is a novel H1N1, not H5N1.
Since I believe you are not continuing the hijacking of this thread, as initiated by the OP. (I guess hijacking one's own thread is not off topic.) There are some logical contradictions, which should be clarified to create a possible "worst case scenario."
Now, in what universe do we run out of ppe's and have food shortages, yet still have other supplies such as syringes, IV lines, medications, briefs, linen, etc.?
If there was a general population quarantine, wouldn't you have an advantage if you were "ordered to work?" That would mean that you are part of the essential people who are allowed to travel.
If there was a quarantine placed on your household wouldn't you have already been exposed? and why would the government order you to work and a chance to further spread the H5N1? Unless you were wearing your ppe's from one day before the onset of symptoms, every time you came into contact with your household members. (Oh yeah, no ppe's are available.)
The above is just a starter, I think we could develop a fun and possible "worst case scenario." Oh and by the way in the original scenario, a plausible (for H5N1) CFR of 60% was given. Though the use of ORT and other forbidden counter measures would likely reduce that.
Why would I want a h1n1 vaccination during an H5N1 pandemic? Interesting thought though, seasonal flu on top of an avian flu pandemic is possible and would make for an interesting addition to the hypothetical.
Yes, and thank you for asking. Let's note the current pandemic is a novel H1N1, not H5N1. . . . Why would I want a h1n1 vaccination during an H5N1 pandemic? Interesting thought though, seasonal flu on top of an avian flu pandemic is possible and would make for an interesting addition to the hypothetical.
You are right, I can't speak for Goju. I think, based on reading and following his posts since 2005, that he is more interested in the here and now, especially since a pandemic is upon us, rather than a hypothetical future. Whether it is H5N1 or H1N1 is immaterial. The key factors that will affect the worldwide population during a pandemic are the Attack Rate (AR), the Case Fatality Ratio (CFR) and the Reproductive Number (R0).
For the current H1N1 pandemic, the latest figures form New Zealand suggest a R0 of about 1.96, that is, each H1N1 infected person infects almost 2 other people. This scale of infections can lead to exponential growth in a very short time. Similarly, the CDC has recently suggested that the AR may reach 30% compared to the 6-8% that has been reported so far by public health officials outside of the flu season. That means that as many as 30% of the total population will become infected and possibly ill from H1N1.
What is not yet clear is the CFR for this pandemic which seems to be less than 1% for this wave. Given these numbers, what might the future hold for us with an H1N1 pandemic? The answer is an awful lot of people getting sick in a very short period of time. How prepared is your hospital or medical facility for this onslaught of patients?
You can continue to dismiss this thread as relating to a hypothetical H5N1 scenario, but I think most thread readers can recognize the immediacy of the current H1N1 pandemic in the general question "Will you work during a pandemic?"
"...You can continue to dismiss this thread as relating to a hypothetical H5N1 scenario, but I think most thread readers can recognize the immediacy of the current H1N1 pandemic in the general question “Will you work during a pandemic?”
That's why 2/3'ds of the respondents choose to work in the ridiculous scenario? Or is it based upon the idea that to date, no one has chosen to stop work due to the current pandemic?
While many of us will continue to work, H1N1 has for us in the ER been very telling of how people would react in a truly heinous pandemic. It is coming back and truthfully I am not looking forward to the BS media that will accompany it and stir up the population!
Any pandemic will be dangerous if not from the infectious agent but from the United States frenzied media that drives people to bring their whole families to the ER! They need to get a grip and stay home. People get the flu, only TRULY SICK people should ever be coming to the ER! That's not what happened this spring, and I will assume the worst for the fall.
If medical personnel can't get it together, God help John Q Public-they are already clueless!
If we have a major pandemic, all we as nurses will really be able to do is provide some comfort to the dying. Whether or not one wishes to do this will depend on the individual. No one can judge another for the decision they make in this regard. It's all well and good to say that we MUST, it's our job, but trust me on this, the ones who will be in charge will not have our best interests at heart!
If things get really bad, the structure for dealing with it will fall apart very quickly. Those with children to care for, or other issues must use their own judgement. As nurses, we did not sign up for martyrdom.
Any pandemic will be dangerous if not from the infectious agent but from the United States frenzied media that drives people to bring their whole families to the ER! They need to get a grip and stay home. People get the flu, only TRULY SICK people should ever be coming to the ER! That's not what happened this spring, and I will assume the worst for the fall.
If medical personnel can't get it together, God help John Q Public-they are already clueless!
M
See this post for how they are dealing with patients with H1N1 influenza in the United Kingdom.
"People get the flu, only TRULY SICK people should ever be coming to the ER!"
This is so true, but of course this won't happen...The media attention will cause people to show up there as soon as they get a sniffle. Once it happens, it will be the "story du jour".
To be honest, I think the LAST place I'd want to be during a real pandemic is an ER! You'd be better off taking your chances and staying at home. If you are going to die, then at least be where you are comfortable. Why die on a gurney in an overcrowded emergency room listening to all the chaos around you? Hell NO!
I'll take a couple of Percocet, wash 'em down with a cold beer, and say goodbye with my loved ones around me in my own bed, thank you very much.
I'm a PCA. I'm not going to the ER when/if this surges in the Fall/Winter. If I'm working, I'll work until I can't, then I'm staying home unless I'm dreadfully ill.
"...You can continue to dismiss this thread as relating to a hypothetical H5N1 scenario, but I think most thread readers can recognize the immediacy of the current H1N1 pandemic in the general question "Will you work during a pandemic?"
That's why 2/3'ds of the respondents choose to work in the ridiculous scenario? Or is it based upon the idea that to date, no one has chosen to stop work due to the current pandemic?
It would be interesting to add, "Would you work during the A/H1N1 pandemic, once you have the 2 shots that would protect you against it?"
That would bring out all the anti-vaccine folks in healthcare........
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Ayrman
83 Posts
Ludicrous in what way? You say that it is impossible yet which is historically valid, i.e. we have seen it before.
The current pandemic is little akin to the historical pandemic of the late 19-teens, i.e. people are not dieing in droves and the overall acuity of the infection remains low, and whether you'd care to admit it or not the values of today's population in general are a far cry from those of nearly 100 years ago. A significant percentage of those who proudly proclaim themselves self-sacrificing and unafraid to report for work in the face of a deadly pandemic strain may find themselves having to eat their words before all is said and done.Ayrman