Geoscience Reference
In-Depth Information
a list). Practical and ethical issues are certain to arise. For example, should those in
failing health (unrelated to the influenza) be administered the vaccine rather than
those who are younger and more vital? Should “key” staff be administered a vac-
cine before those deemed less critical for operations? Government and health care
officials would be expected to resolve these endless issues. Other issues also would
need to be considered, including topics such as use and efficacy of prepandemic
vaccines (ones that might be available before a pandemic but not perfect matches
to the circulating virus).
Antivirals do not function like vaccines. Antivirals do not provide immunity,
but they may make the illness less severe or shorten the course of the illness. They
are not specific to a virus in circulation (although considerable differences exist in
effectiveness and the like for each variation of antiviral), and large stockpiles (e.g.,
tens of millions of regimens in the United States alone) already have been developed
and stored. Antivirals have demonstrated some effectiveness in prophylactic use,
but they are not intended to immunize a recipient to a virus.
However, antivirals also have shortcomings. Because they can be used prophy-
lactically, there is fear that they will be overused or cause the virus strain to develop
resistance. Resistance, whether a result of overuse or not, can be significant. For
the 2008 and 2009 seasonal flu, virtually all flu cases have shown resistance to
Oseltamivir,
*
a popular antiviral. Furthermore, although large quantities of anti-
virals are stockpiled, there still might be a need to prioritize who gets them and when.
Another tool is infection control. Many control measures are commonplace and
intuitive, but others are less so. Encouraging standard hygiene processes (e.g., hand
washing, covering coughs and sneezes) has a strong impact on limiting the trans-
mission of an influenza virus. Other personal protective equipment (PPE) such as
surgical masks and other respiratory devices (e.g., N95 masks, respirators) has been
shown to be effective, although such equipment can be burdensome, expensive,
possibly misused, and effective only in certain situations. The key issue for all these
techniques is compliance; without constant and vigilant use, these tools are ineffec-
tive. As discussed earlier, training is a key element in developing compliance; the
more communities are trained, the more likely that they will comply with these
infection control approaches.
Finally, community mitigation techniques are an important part of pandemic
preparedness planning. A key mitigation approach is social distancing, requiring
that people maintain a minimum distance between one another to “reduce the
duration and/or intimacy of social contacts and thereby limit the transmission of
*
L.A. Times
, “Tamiflu No Longer Works for Dominant Flu Strain,” February 4, 2009, http://
articles.latimes.com/2009/feb/07/science/sci-flu7. Although this news report states specifically
that only the H1N1 virus is showing this resistance (thus avoiding such resistance from the
H5N1 Avian Flu variant), this caused further concern over the H1N1 Influenza A (Swine Flu)
variant that posed a global threat in 2009.
