Modern quarantine... (experts' version)

[Guest Guest]

What would a modern quarantine look like?

 

Experts: Isolating bird flu patients could be accomplished in several ways

 

Associated Press

Updated: 5:34 p.m. ET Oct. 10, 2005

 

WASHINGTON - Quarantine — or some version of it — in a 21st-century flu pandemic would look very different from the medieval stereotype of diseased outcasts locked in a do-not-enter zone.

 

President Bush’s specter of a military-enforced mass quarantine is prompting debate of the Q-word as health officials update the nation’s plan for battling a pandemic — a plan expected to define who decides when and how to separate the contagious from everyone else.

 

“All the options need to be on the table,” said Dr. Marty Cetron, head of quarantine at the Centers for Disease Control and Prevention.

 

Bush’s comments recall how quarantines were enforced in parts of this country in the 1890s, when armed guards patrolled streets to keep victims of smallpox and other dread diseases confined to their homes.

 

'A whole range of options'

 

“The image that perhaps was inadvertently conveyed is really a setting in extreme that’s less likely,” Cetron cautioned. “There’s a whole range of options in the public-health toolbox for ways to achieve this goal of social distancing.”

 

For three years the CDC has been helping states plan how they would enact quarantines in case of a bioterrorism attack. The instructions stress using the least restrictive means necessary to stem an infection’s spread.

 

And public health officials expect a U.S. quarantine today to almost always be voluntary, with incentives to cooperate. In case of a horrific outbreak, quarantined areas would get first shipments of scarce medicines.

 

“I don’t think either the Tennessee National Guard or the U.S. Army and Marines will try to establish a cordon sanitaire around Nashville,” said Dr. William Schaffner of Vanderbilt University, an influenza expert who advises the federal government. “That’s not going to happen.”

 

Actually, “we practice in this country quarantine every day,” said Health and Human Services Secretary Mike Leavitt. “If a child gets the measles, their mothers are expected to keep them at home.”

 

Vaccination is the cornerstone of fighting a pandemic, and quarantine-like steps are supposed to be brief, “designed to buy time until we have an adequate supply of countermeasures,” CDC’s Cetron said.

 

Voluntary measures?

 

The SARS epidemic of 2003 illustrated that “the public will voluntarily comply with measures to both protect themselves and their loved ones” — if doctors make the case that the steps are for their own good, he added.

 

Legally, “isolation” is the term for separating people who already are sick from others. That happens routinely in hospitals, as they limit access to patients being treated for certain infections.

 

“Quarantine” means restricting the movement of still healthy people who may have been exposed to an infectious disease, in case they’re carrying it. It’s almost always for a brief time; during SARS, for instance, hospital workers exposed to suspect cases were asked to stay home from work during the respiratory disease’s 10-day incubation period.

 

States have the primary legal authority to enact quarantines during outbreaks within their borders. Federal quarantine authority involves preventing infectious diseases from entering the country and stopping interstate spread. Expanding that authority to encompass a military role might entail legislation, something lawmakers’ staffs have begun mulling as public health experts downplay the need.

 

With SARS, CDC used its existing authority to stop that virus from spreading here like it did in Asia: Over three months, CDC workers delayed on the tarmac 12,000 airplanes carrying 3 million passengers arriving from SARS-affected countries. Anyone with SARS symptoms was isolated. Anyone possibly exposed was told what symptoms to watch for in the next 10 days and how to seek help without exposing entire emergency rooms if symptoms arose.

 

SARS showed that tracking down patients and people they may have exposed — allowing individuals, not large areas, to be contained — can work, Cetron said.

 

Flu would spread more easily than SARS

 

At the same time, a super-flu would demand more intense measures because it would spread more easily, perhaps even before symptoms appeared. Drafts of the pandemic plan make clear that affected communities would probably close schools, shut down large gatherings and restrict travel.

 

Ramping up gradually is crucial to minimize social and economic fallout, Schaffner cautioned.

 

He offered his home city of Nashville as an example: Authorities first might urge people to watch the Titans play football on TV instead of at the stadium, and to avoid shopping malls. Then schools might close for a while. Then people might be told to postpone holidays or business trips to Nashville, all steps to stem transmission by minimizing contact — but well short of compulsory quarantine.

 

“We’re going to have to permit ourselves a graduated, intelligent response to the magnitude of the threat,” he concluded.

 

http://www.msnbc.msn.com/id/9653037/

[gardnmom]

If they close the schools and allow those who are quarantined to postpone most bills while the quarantine is in effect, so at least one parent is home with the children, voluntary quarantine would work for most of us that understand the risk. However we do have to eat and keep warm.

[kaseyb (Supermom!)]

Ah! At last, an encouraging news story on Avian Flu!

[Guest Guest]

Tea,

 

This is what they are saying about the flu in the post I placed over in Are You Really Ready:

 

How Influenza Spreads

 

It is easily transmitted by inhaling exhaled or sneezed out particles from a sick person. When a host coughs, sneezes or exhales, large amounts of the virus are released into the environment. It can also be shed in stool and other body fluids. A person can be transmitting flu 1 to 3 days before they feel any symptoms . Most people start feeling sick in about 2 days. You pass on the virus for up to a week after you stop feeling symptoms. Children under 12 are contagious up to 21 days after symptoms stop. It is not normally necessary to see your doctor about colds and flu. During a pandemic, it may be difficult to reach your doctor. Remember that antibiotics only kill bacteria and can do nothing to stop a cold or the flu which are caused by viruses. Bed rest and

liquids are usually enough, acetaminophen or ibuprofen can lessen fever and body aches. Aspirin and other aspirin containing products should never be given to children or teenagers. Call your doctor if you have persistent fever or pain.

 

Antiviral medications may be effective if taken by the second day of symptoms. If you are sick, cover your nose and mouth with a tissue every time you cough or sneeze. Also maintain a distance of several feet from people. Always cough or sneeze into a tissue and do not reuse it. Complications from the flu can lead to deadly secondary infections like bronchitis, pneumonia, encephalitis, or meningitis. Presence of blood or thick yellow/green mucus may be a sign of a secondary infection. Another complication that may occur is a cytokine storm (the body’s immune response fills the lungs with liquid).

 

[Guest Guest]

heard yesterday that if a pandemic hit it would last about a year and a half.

 

what does that mean to me.... not sure.

[kaseyb (Supermom!)]

Very good information. Not happy news, but important to know.

 

Well, the Spanish Flu went through 3 phases, each lasting roughly 3 months.

 

West, I'm with you.....what does it mean for us?

[Guest Guest]

The biggest variable seems to be our mobility. No one knows how that will affect a pandemic. People fly all over the world in a very short time, which means it would be very difficult to control a fast-acting virus.

 

I've read that WW1 was probably shortened primarily by the Spanish Flu and it's effects on the young fighting men.

 

 

[kaseyb (Supermom!)]

Yes, Cat, the mobility issue concerns me too. We all know the authorities would question anyone who gets this flu, asking every place they've been within the past ten days and so forth. And depending on how quickly the flu spreads, tracking everyone down who visited certain places could be tricky. Someone else here posted a piece saying that with the SARS case most people cooperated well with authorities regarding quarantine, so that's good news. Perhaps the increased communication channels we have today would offset the negatives imposed by the rapid mobility.

[Guest Guest]

I have been listening to the Glenn Beck show today (no errands!

[redhenfarm]

Hmmmm. Wonder if the state of "do your own thing" Oregon is cooperating with that.

[Guest Guest]

This is all very interesting information. There is a lot of food that can be grown in MN, but not during the winter months! It is disturbing to say the least. Cold and hungry, not a good combinations for sure. I'm still praying and talking with my husband about what extra messures to take for this if any.

 

Regardless of how the quarantine takes effect, it will still take effect, and we need to be prepared for that. Hopefully there will still be internet to come and say hi to you!

[Guest Guest]

Well, I'm sure the government can't quarantine people without food. (Another lesson from Katrina.)

 

I'm guessing that people would be issued MREs if nothing else, and also that every effort would be made to keep the utilities like water, sewer, and electricity running.

 

I think that's why President Bush suggests using the military. They would be given the first vaccines and be ready to actually go *work* in the affected areas wherever it is. They can drop off food & supplies, run power stations, man airports, and control panic.

 

No other agency would have the mobility and resources of the military available at short notice.

 

If the power went off for long, it would send all quarantined people out searching for a safe haven, thus spreading the flu, which is exactly what they *DON'T* want. They'll try to keep people happy at home.

 

 

[Freetobeme]

I don't know about the MRE production, but we have a good supply of them. I would suggest that those in cold regions look into container gardening in the house or having an attached greenhouse/sunroom for growing some fresh veggies. Lettuce and other greens, maybe some tomatoes and peppers, herbs, and so on. These will all grow in containers inside the house if you have a sunny spot for them. Because of lack of pollinating insects, you might have to hand pollinate tomatoes and peppers. We have grown tomatoes through the winter in Payson in a window box that is built out from the kitchen sink.

[Guest Guest]

Just 3 days ago I started lettuce and spinach seeds. I thought with the price of lettuce last year, $1.99 a head, I'd try growing leaf lettuce and spinach and see what I get. It took 2 days to come up. I don't know how fast it'll keep growing but it'll need to be thinned and when it is we'll have "sprouts" to eat. This is fun!!!

 

I've brought tomatoes in to over winter and it's seldom we get a tomato of any size to ripen BUT never fear I'm trying something new this year. I found tiny little tomatoes at Park Seed so I ordered the seed and started them 3 days ago too. I start seeds every spring for the garden so I'm going to see what I can get this winter.

 

I'll let you know how it all works HappyGirl.

 

Don't you just love this experimenting Goatherder???

[Darlene]

For a 'basic idea' of how the gov't/military MIGHT act, get a copy of the movie "Outbreak" with Dustin Hoffman. Granted, the primise is out of control military guys trying to keep their secret weapon secret, but the images of a whole town under quarantine with military personnel all over the placed is frightening.

 

Not saying this is how it would be, but it COULD be.

[Freetobeme]

The best tomatoes for indoor growing are the small ones like Patio or Sweet 100. They need a warm, sunny spot, and as I said before, you may have to hand pollinate. I haven't tried Romas, but I think they might also do well in pots. Make sure you give them a nice big pot and fertilize them. Miracle Grow works well.