NURS 6700 Wk 11 Flu Pandemic Essay
In the history of the United States, many infectious disease breakouts have occurred, and have resulted in increased number or morbidity and mortality. Of the many, in 2009, a new strain of influenza A (H1N1) emerged quickly without any warning and became a pandemic. Also known as the swine flu, this infectious disease lasted from early 2009 to late 2010 and resulted in 18,449 confirmed laboratory tested deaths around the world (Knox, 2013). However, the actual toll may have been ten times higher and up to 203,000 deaths (Knox, 2013). NURS 6700 Wk 11 Flu Pandemic Essay
Epidemiological Considerations
The first outbreak of the swine flu was first recognized in the state of Veracruz, Mexico in March and April 2009 with many people experiencing respiratory illness and flu like symptoms. In response to this disaster, the General Directorate of Epidemiology (DGE) issued a national epidemiological alert to all influenza-monitoring units and hospitals and asked hospitals to report all patients with severe respiratory illness and recommended collection of diagnostic respiratory specimens from these patients within 72 hours of illness onset (Centers for Disease Control and Prevention [CDC], 2009). To prevent and control the spread of the disease all schools in Mexico were closed and incoming and outgoing passengers in airports were advised to use caution and go to a hospital if they experience the symptoms (fever, cough, and difficulty breathing). Other measures included disseminating educational messages regarding respiratory hygiene through mass media, distributing masks and alcohol hand-sanitizer to the public, and discouraging large public gatherings, including church services, theater events, and soccer games (CDC, 2009). On April 25, a national decree allowed for house-isolation of any person with a suspected case, and on April 27, school closures were mandated throughout the country (CDC, 2009).
National Response
In response to the swine flu pandemic measures were taken at the international, federal, state, local, and community levels that were ongoing for almost a year. After the virus emerged and cases were identified, the United States (US) notified the World Health Organization (WHO), the Pan American Health Organization (PAHO), and Canada as a security measure. The CDC worked aggressively by tracing cases of the virus, developing a vaccine, and activating its Emergency Operations Center (EOC) on April 22, 2009 (CDC, 2010). Other measures included travel health warning, education on taking antiviral drugs early, and encouragement to stay home from work or school if experiences symptoms of cough or sneezing. All of the measures taken were effective as they increased a public awareness and decreased the spread of the disease. NURS 6700 Wk 11 Flu Pandemic Essay
Nearly 100 years ago, in 1918, the world experienced the greatest tidal wave of death since the Black Death, possibly in the whole of human history. We call that tidal wave the Spanish flu, and many things changed in the wake of it. One of the most profound revolutions took place in the domain of public health.
The world was a very different place in the first decades of the 20th century. Notably, there was no real joined-up thinking when it came to healthcare. Throughout the industrialized world, most doctors either worked for themselves or were funded by charities or religious institutions, and many people had no access to them at all.
Public health policies—like immigration policies—were colored by eugenics. It was common for privileged elites to look down on workers and the poor as inferior categories of human being, whose natural degeneracy predisposed them to disease and deformity. It didn’t occur to those elites to look for the causes of illness in the often abject living conditions of the lower classes: crowded tenements, long working hours, poor diet. If they sickened and died from typhus, cholera, and other killer diseases, the eugenicists argued, then it was their own fault, because they lacked the drive to achieve a better quality of life. In the context of an epidemic, public health generally referred to a suite of measures designed to protect those elites from the contaminating influence of the disease-ridden rabble.
The first wave of the Spanish flu struck in the spring of 1918. There was nothing particularly Spanish about it. It attracted that name, unfairly, because the press in neutral Spain tracked its progress in that country, unlike newspapers in warring nations that were censored. But it was flu, and flu as we know is transmitted on the breath—by coughs and sneezes. It is highly contagious and spreads most easily when people are packed together at high densities—in favelas, for example, or trenches. Hence it is sometimes referred to as a “crowd disease.”NURS 6700 Wk 11 Flu Pandemic Essay
That first wave was relatively mild, not much worse than seasonal flu, but when the second and most deadly phase of the pandemic erupted in the autumn of 1918, people could hardly believe that it was the same disease. An alarmingly high proportion of patients died—25 times as many as in previous flu pandemics. Though initially they reported the classic symptoms of flu—fever, sore throat, headache—soon they were turning blue in the face, having difficulty breathing, even bleeding from their noses and mouths. If blue turned to black, they were unlikely to recover. Their congested lungs were simply too full of fluid to process air, and death usually followed within hours or days. The second wave receded towards the end of the year, but there was a third and final wave—intermediate in virulence between the other two—in early 1919.
Flu is caused by a virus, but virus was a novel concept in 1918, and most of the world’s doctors assumed they were dealing with a bacterial disease. This meant that they were almost completely helpless against the Spanish flu. They had no flu vaccine, no antiviral drugs, not even any antibiotics, which might have been effective against the secondary bacterial infections that killed most of its victims (in the form of pneumonia). Public health measures such as quarantine or the closing of public meeting places could be effective, but even when they were imposed this often happened too late, because influenza was not a re portable disease in 1918. This meant that doctors weren’t obliged to report cases to the authorities, which in turn meant that those authorities failed to see the pandemic coming.
The disease claimed between 50 and 100 million lives, according to current estimates, or between 2.5 and 5 percent of the global population. To put those numbers in perspective, World War I killed about 18 million people, World War II about 60 million. Rates of sickness and death varied dramatically across the globe, for a host of complex reasons that epidemiologists have been studying ever since. In general, the less well-off suffered worst—though not for the reasons eugenicists proposed—but the elites were by no means spared.NURS 6700 Wk 11 Flu Pandemic Essay
The lesson that health authorities took away from the catastrophe was that it was no longer reasonable to blame an individual for catching an infectious disease, nor to treat him or her in isolation. The 1920s saw many governments embracing the concept of socialized medicine—healthcare for all, delivered free at the point of delivery. Russia was the first country to put in place a centralized public healthcare system, which it funded via a state-run insurance scheme, and others in Western Europe followed suit. The United States took a different route, preferring employer-based insurance schemes, but it also took measures to consolidate healthcare in the post-flu years.NURS 6700 Wk 11 Flu Pandemic Essay