Part of raising awareness about the potential problems we would have in an influenza pandemic is saying the same thing over and over again, sometimes in different ways and sometimes just repeating it. So we're going to do it again. From the Globe and Mail (Toronto):
Severe restrictions that allowed only emergency patients to be admitted to hospitals during the 2003 SARS outbreak in Toronto would not be enough to handle the flood of patients expected during even a mild flu pandemic, a new study has found.[snip]
"The [various governments' pandemic flu] plans are quite comprehensive, but the problem with many of their measures is that we don't really know how effective they are, what their limitations are," said Dr. Schull, who wrote the study with physicians from several Toronto hospitals and the Institute for Clinical and Evaluative Sciences.
[snip]
Using Ontario Ministry of Health projections, it estimated that there will be 4,819 influenza-related admissions in the first eight weeks of a mild pandemic; that figure rises to 8,032 and 11,245 in the first eight weeks of a moderate and severe pandemic, respectively.
But in the first eight weeks of SARS-related hospital admission restrictions in Toronto that would be similar to restrictions outlined in pandemic-flu plans, hospitalizations were reduced by 3,654.
Dr. Schull noted their analysis does not take into account the roughly 35 per cent of hospital workers who will likely be sick with the flu, further reducing the amount of resources.
"Even in a best-case scenario of having a mild pandemic and having only a few, if any, hospital staff affected, we still would not have sufficient capacity to deal with all of the patients who would need hospitalization," Dr. Schull said. (Unnati Gandhi, Globe and Mail)
As we and many others have pointed out, it's not just flu cases that won't get care. People will still have heart attacks, kidney stones, gall bladder attacks and deliver babies, not always on time. It won't be just ventilators that are rationed. It will be all kinds of services, for all kinds of diseases.
At some point, the wave of influenza will subside. Maybe one month, maybe two months, maybe three months, but at some point. In the same article Mt. Sinai's Alison McGeer, a veteran of the SARS wars, sounds this weary coda for health care workers:
And although it hasn't been fully discussed among health officials, Dr. McGeer said post-pandemic planning is just as important as planning for the pandemic because there will be a huge backlog of services that were deferred.
"The bad part of the pandemic is going to be two months long. Then it's going to be over . . . and what everybody is going to want to do is take a deep breath and relax but we can't do that in health care," she said. "We're going to have to play catch-up. That's a big and incredibly important challenge and one of the things we didn't do as well as we might have after SARS."
Health care has become so expensive we have tried to wring the last drop of efficiency out of it, cutting down on beds and staffing. With no reserve and no redundancy I have no doubt we will find it to be a false economy. Sometimes inefficiency and redundancy aren't wasted resources, they are common sense.
But as we have remarked here before, Common Sense isn't all that common.
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What seems to be consistently ignored is that a global pandemic may have severe consequences for an ecconomy that is now global. Where are the gloves and masks made that supply our hospitals - what if those factories (China? Vietnam? etc) are closed down and our hospitals all have just in time inventories. What if there are not enough folks to man ships that bring these supplies here. What happens if the call centers in India that are used for Visa, MC etc. can't get in enough people to man the calls. What happens in Asia affects us more than we know. We may soon find out.
"A false economy"... as similar as is the case in trade of food and beverages, medicines and the way cattle is held.
The just-in-time economy will have nothing to offer to the already weakened people, in times of pandemic waves.
Last decades we have been living in a way that has diminished our stocks and bank accounts because we think shrinking is going backwards.
The economic rules of growth and profits are ruling the world.
I am reading an interesting book (Dutch) about 1918 pandemic Spanish Flu and by then is was the war that inundated the Netherlands by as many as 900.000 refugees from the Belgian border (Dutch inhabitants by then about 6.700.000) and the German submarines indirectly and directly decimated the Dutch food supply while the Netherlands weren't even wageing war at that time.
The causes of non-existing reserves nowadays are different: we all want to be rich and consumers of a lot of rubbish while we can't afford it in a way. But the situation in our Western countries is in fact the same as it was in 1918.
About the health care situation in The Netherlands: everyone wants to be in an expensive care situation as long as possible and the government thinks the solution is IMO to burden the medical specialists, physicians and therapists with a lot of administration about the details of their medical activities, phone calls and writing reports about patients in so many minutes. And finally Big Brother Government will decide I as a psychotherapist will have to 'do' a grave depression in 8 sessions when I used to 'do' one in 10 sessions. (I understood that during a happening meant to inform us psychotherapists). And not pay me one euro more for under the flag of 'improving techniques' they force me to work 'faster, more effective' etc. in the same way all profits of multinationals have to go up every year.
This containing policy asks for a lot of bookkeepers and controllers and that's where our money is going to, not to really productive activities like producing food or clothes.
This decentralization from central activities paid from the taxes of every citizen (and you know we pay a lot of tax in this country) means the money is kept at the large ministries of the government and meanwhile the financial burdens and activities are shoveled to the regional and local authorities who have to be very creative and invent their own taxes in order to survive. One guess who's the victim of this policy. It's the individual inhabitants and the people on the working level. We're going to pay double taxes but it's labeled differently.
The same financial robbery goes for school budgets: the big money planned for Education is in the central government and the schools haven't had a significant rise in budget in the last 30 years. In the mean time schools have been ordered to incorporate a lot of courses, subjects and managers to reorganize, making everything more efficient and accepting troubled children who need a lot of extra attention for their mental health who should be able to go to special schools and it's only going to be worse.
Political nerds are stating one should do one's best (as if that's not happening now) and creative solutions to survive are damned as fraud. A not so fine relation between politicians and teachers, psychotherapists and the like!
And I am not expecting much change even when we are getting a red government instead of the purple or blue government we had last years. Ouf, I had to say that once.
What is a vote, what is democracy? Is this what the wise people of the state want for all?
This must be the weakening of my immune system during last very rainy days over here!
Well I guess Tan06 pretty much coverered "Universal Health Care" and how its managed in the Low Countries..........
They cant afford it anymore than we can. Retirements are being cut there too and sure you could sock the multinationals but then you have no jobs. Fastest way to kill and economy is to have high taxes and high interest rates. Its an automatic death sentence to it.
Add the cost of a single pandemic into the fray and it will bankrupt the existing system completely for everyone. Pandemic starts, pull your money out of the market because it will have the same effect of the WTC's going down only times 5000. Not that I think that paper money will be worth anything.
Hey remember that Gold Standard that we were on until a few years ago?
Oh, please, keep repeating. No matter how much we hear or learn about a pandemic some of the instructions and thoughts arent caught the first time around. Effective learning requires repetition.
tan06, always a treat to read first hand what another country is facing, although it doesnt sound too much different than the U.S. Your comment: The just-in-time economy will have nothing to offer to the already weakened people, in times of pandemic waves. A simple yet profound statement. And, The economic rules of growth and profits are ruling the world. Yes, well said, and it has basically been this way for as long as humans have been on Earth. Theres a saying in the U.S., the bigger they are, the harder they fall. From this comes a certain amount of satisfaction for those who utter these words; only thing being is, it isnt happening fast enough as for the most part we are an impatient bunch.
Democracy? I often wonder the say thing, what is a vote? what is democracy? The wise people of the state? For me that would be the common people, not the politicans.
And I know this is a little off the topic however, my husband and I were considering retiring to Denmark, my Great Grandparents migrated to America from Odense. It would most likely make no difference to our financial situation as we would be low income. We used to be middle class but not any more. A shame for a man, my husband, who served 22 years in the U.S. Navy, 15 of those years were on a ship at sea or riding through the waterway jungles of Vietnam.
Lea: I've been in Odense. It's quite lovely and as I'm sure you know, the birthplace of Hans Christian Andersen. Unfortunately the exchange rate is very unfavorable for those paid in dollars.
Revere: Do you think "the bad part of the pandemic will [only] be two months long"?
To me that sounds like one wave, and my impression was that the three flu pandemics of the 20th century each had two or three waves, with the second being the worst.
If they're planning for a single wave, and start doing semi-elective gallbladder removals once that's past, they may be in for a nasty shock. Or are they [wrongly] assuming a vaccine will thwart a second wave?
caia: It wasn't very well said in the post, I'm afraid. I was talking about one wave. In 1918 there were three waves but excess mortality continued well into 1920 or beyond. How many waves there will be and which will be the worst (it has differed in the various pandemics) no one knows. I don't think we can count on one or that it will be two months. I was just using those numbers as backdrop to the other issues, which was what the post was about. But I could have said it better.
I do get it now why the Reveres will not be preparing. 3 adaptive mutation waves would finish this country and all of the planet for that matter if it took even 20%. One would be staggering and the government would likely collapse except in places. Those that would be euthanized with morphine when all of the facilities and capabilities cease to exist might be the lucky ones.
On the other hand, I dont throw my rifle down under any circumstances. Get me and family it might but it wont take me without one for the Gipper.
Revere thanks for the clarification... I was actually wondering about the quote from Dr. McGeer. (Psst... the Globe and Mail link leads back to this post.)
caia: My error. Fixed link. Thanks.