08 May IT may take a back seat in fighting avian flu
Madison, Wis. — Household planning will accomplish more in preparing for the eventual spread of a virulent strain of avian flu than will any reliance on information technology, attendees of WTN Media’s Digital Healthcare Conference were told.
Panelists talked about being three years late in developing IT systems to help detect and mitigate the effects of a flu pandemic, which would cause significant social and economic disruptions before running its course.
For health professionals, one challenge will be preparing for the methodical erosion of their ability to maintain services as they become overtaxed. But panelist Dr. Barry Chaiken suggested that preparing a six-week stockpile of food, making sure your home’s water supply is secure in the event of an electrical failure, and establishing a common rendezvous point for loved ones and co-workers could do more in the way of prevention than Tamiflu or leveraging IT.
In other words, emergency mobilization begins at home. As disturbing as the avian flu doomsday scenarios sound, the reality is that the nation will survive it, Chaiken stated. “It will be a temporary event when it comes, but you need to prepare for it,” he said. “And if you prepare for it, you will mitigate its effects.”
How temporary? Dr. Chaiken cited estimates that human-to-human transmission of the potentially lethal H5N1 or avian flu virus would result in an outbreak that lasts 4 to 6 weeks. The incubation period in humans is about two days, plenty of time for travelers to contract the virus abroad and unknowingly bring it home, and the average person will transmit it to two other people, Chaiken said.
Still, by the time a severe pandemic runs its course, it will have wreaked havoc. Citing information from BearingPoint, where he is associate chief medical officer, Chaiken said a severe pandemic would result in between 50 million and 180 million deaths worldwide, and cause an estimated $4.4 trillion in economic losses. In the United States, a severe pandemic would cause two million deaths, mostly among people with existing chronic diseases. It could also cause the American economy to contract by 2.5 percent, largely because fear of contracting avian flu would convince people not to leave their homes.
“There will be significant social disruption,” he added. “The only way to mitigate that is to plan for it.”
Mild or moderate Avian flu outbreaks obviously would be less severe, but damaging nonetheless.
IT to the rescue?
In addition to Dr. Chaiken, panelists included: Dr. Edward Barthell, executive vice president of strategy and clinical affairs for Infinity Healthcare; Bevan Baker, commissioner of health for the City of Milwaukee; and Dr. Seth Foldy, principal investigator for the Wisconsin Health Information Exchange.
Conference attendess were shown an alarming video in which health experts issued a number of dire warnings. Among the assertions made in the video were:
• The H5N1 virus has only one or more mutations to make before it spreads from human to human, and then the world is in dire difficulty.
• If this virus learns to transmit from human to human, it will be the worst act if bioterrorism ever known.
• A pandemic of this rapidly spreading virus would be twice as devastating as small pox or the explosion of a “dirty bomb” in New York City.
While IT may be a distant second to meticulous planning, health surveillance technology can play a role in detecting an outbreak and preventing a widespread problem. If the public trusts the information it is getting, telecommunications and text messaging, the Internet, and the news media are theoretically capable of successfully disseminating public health information, even to a public that may be in the throes of hysteria. “After [Hurricane] Katrina, we found that people did not believe the information that was given to them,” Baker said. “That’s why we have to work on communication now.”
To assist with early detection, the Centers for Disease Control has invested in a public health surveillance tool called BioSense, which Baker characterized as an interface platform that can rapidly disseminate fresh information whenever a seminal event occurs. The technology has been deployed in 34 cities and 49 states, and while 159 million health-related records have been delivered to local, state, and national health officials, BioSense has yet to be thoroughly vetted in hospitals.
Dr. Barthell said in the event of a pandemic, there are systems in place to monitor activity at hospitals and ambulance services, including a Web-based EMS that has been deployed in a number of states. However, it’s more of a way to assess the impact on a given area, not a preventive tool. “The term that people use is situational awareness,” Barthell said. “I still think it will be detected by an alert clinician, or CNN.”
Vaccine development for the H5N1 virus is ongoing. The drug Tamiflu has shown promise against viruses of a certain class, but it is unclear how effective Tamiflu would be once mutations occur. In the absence of a vaccine, existing anti-viral drugs, which interrupt viral replication in cells, also would be used to lesson the impact of avian flu.
More on avian flu:
• Barry Chaiken: Preparing for avian flu with information technology
• Interview: Dr. Barry Chaiken on changing healthcare, AI and pandemic flu
• IT critical in pandemic response, but many are not paying attention