In the Midst of a Flu Pandemic, Would You Work or Stay Home?

Vol. 19 •Issue 10 • Page 10
Speaking My Mind

In the Midst of a Flu Pandemic, Would You Work or Stay Home?

Here’s a good hypothetical question for you. If a flu pandemic were to erupt in your neck of the woods, would you show up for work or would you elect to stay home?

That was a question recently posed to caregivers in three health care centers in Maryland. Results were not all that surprising. More than 40 percent indicated they would probably not report for work. Two thirds of the caregivers argued they would be putting themselves at risk if they did report for duty.

This is a question typically not asked when caregivers participate in mock emergency drills. In those experiments, caregivers are generally pulled from their normal duties to treat pretend patients exposed to hazardous industrial spills or to tend pseudo victims of airline crashes.

Training for emergencies helps community medical officials assess the effectiveness of their ability to handle crisis situations should they occur. But as recent catastrophes have shown, no amount of training can truly prepare individuals for worst case scenarios. Think of Hurricane Katrina ravaging the Gulf Coast. We all harbor images of the confusion resulting when New Orleans policemen did not show up at their posts in the midst of flooding and looting.

We remember the television reports showing hospital patients and staff trying to evacuate from rising flood waters. We shudder at the horror of patients being left to die in medical facilities when caregivers abandoned their posts. We do not need to point fingers of blame here. We need to look at the purely human emotions governing our actions in fight or flight situations.

Surrounded as we are by media presentations of courage under duress, we need to reflect that staged images are merely recreations, not reality. We ponder the unconfirmed account of musicians playing “Nearer My God to Thee” as the Titanic sank beneath the waves in an iceberg-strewn sea.

Perhaps we also need to recall Scarlett O’Hara abandoning dead and dying soldiers flooding a make-shift hospital in Atlanta during the Civil War in the movie version of Gone With the Wind. Outside the partially bombed out structure, the untended wounded stretched for blocks in all directions. It was a hopeless situation. We should not condemn Miz Scarlett for her actions. She was, after all, simply a volunteer forced to choose between self-preservation and philanthropic actions amidst the ravages of a war far beyond her control. In literature, she has been branded a true rational pragmatist.

Health care officials were quick to call for more training, better equipment and caregiver counseling when the Maryland survey results were released. “In the face of a pandemic influenza threat, local health department employees’ unwillingness to report to duty may pose a threat to the nation’s emergency response infrastructure,” according to Dr. Ran Balicer in a report in the online journal BMC Public Health.

While this particular survey was designed around a scenario of run-away cases of H5N1 avian virus, aka bird flu, the results provided some important insights into potential actions.

Technical and support staff were the least likely to participate in a crisis, according to the survey. Less than a third who participated in the survey believed they would play an important role in the response to a crisis. Importantly, direct-care clinicians typically indicated they would be willing to help, particularly if they knew what their role would be.

Emergency trainers keep stressing the importance of hospitals being able to provide stand-alone care for 72 hours. Perhaps they need to equally emphasize the reality that few caregivers will be available to minister to a surging tide of critically ill patients seeking help in the aftermath of something like a biological weapons attack or a dirty bomb.

At the very least, members of every community should be forewarned not to expect the full support of existing medical facilities in a crisis. It might be advantageous for health care communities to stress the need for people to take basic First Aid classes as an alternative.

As a nation, we have come to rely on our health care communities to handle all our health needs. But there is a major point to be made for self-reliance. We need to prepare ourselves.

Individuals cannot guarantee how they will react until they enter the real battle zone. They might not stand up to the test. And we must take that truth into account in our planning.

You can reach Vern Enge at [email protected].