Pandemic Flu and who?

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The Syndicate
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Pandemic Flu and who?

Post by The Syndicate » Mon May 05, 2008 6:12 am

Who will be teated, and who is on there own. ... ing_care_2
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Post by shenkhu » Mon May 05, 2008 7:04 am

i knew it was to come out one way or another... i mean, it's like battlefields hospital, when there is too many causalities, doctors must decide who they can ill and who will recieve morphine to kill the pain, i think they call it selective approach...
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Post by TC » Mon May 05, 2008 9:36 am

shenkhu wrote:i knew it was to come out one way or another... i mean, it's like battlefields hospital, when there is too many causalities, doctors must decide who they can ill and who will recieve morphine to kill the pain, i think they call it selective approach...
It's called triage. You do the greatest good for the greatest number of casualties, using your resources in the most efficient way with the goal of getting key personnel (such as power station workers, water station workers etc. in civilian cases) working again in the shortest time possible.

I'm sure that a lot of the public would have a negative reaction to the idea of not treating the most seriously wounded (who are terminal cases anyway), since people tend to think that everyone has a right to be treated with the maximum effort possible. They do not seem to recognize that by treating a person who is pretty much a gonner anyway, they could be sacrificing the lives of two or three or more people.

It's the most sensible and rational decision, since the ultimate goal is to keep as many people alive as possible.

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Kathy in FL
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Post by Kathy in FL » Mon May 05, 2008 4:27 pm

This has been known for months on the flu boards. They've also got a plan for implementation of a vaccine once it is developed. Fluwiki will have it over there somewhere.

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Post by ironraven » Mon May 05, 2008 8:39 pm

It's called triage. It sucks. But it lets those that can't be helped efficently die without wasting resources that can keep others alive. Suck it up, this has been on the books for fifty years. In the cold war, the plan was to send the old people out to scavenge within a few days as they would die faster that way.
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Post by TC » Tue May 06, 2008 4:13 am

ironraven wrote:It's called triage. It sucks.
I disagree. Maybe I am a cold bastard, but saving 2 lives instead of maybe saving one is far more logical and, from a point of view where it makes sense to save as many lives as you can, produces a far better outcome. One grieving family is better than two.

Remember, it's not about selectively weeding out people who "don't deserve to live". We are talking about people who, even if they were given medical help at the expense of others, have a very limited potential for survival.

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Post by Ellie With An Axe » Tue May 06, 2008 7:52 am

One of the saddest, and most frustrating, things about a report like this is that if the health care system were equalized somehow, and not such a burden on the medical and financial resources to care for the poor (who can't afford care, and thus tend to get and/or stay ill more than the wealthy), a focus group might not have been assembled with such a grim task of having to think about these things. You see, it might not be such a burden to care for the poor if the poor weren't a burden because of the health system where they're not cared for.

It's truly fucking sad. I haven't had health insurance or life insurance since I was laid off of my appointed position at the university about a year ago. I've had other jobs since then, but have cobbled together the 40 hours a week to pay bills from several sources, which means nobody ended up having to give me insurance for working for them. Which means my health insurance is with Mutual of Ellie, and I have monthly medical maintenance to take care of. Which means there are probably a lot of people in my situation who probably wouldn't get the attention they need for other issues, if I'm feeling this report right.

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Post by CavemanSam » Thu May 08, 2008 2:20 pm

In pandemic situations, as long as the medical infrastructure is functionally intact, triage will most likely not resemble battlefield or disaster triage. Infectious disease care, unlike shock-trauma, can be delegated to individuals with little or no training, and can be mediated with long term, low intensity care (thus, the critical time window in which lives are saved and lost is much longer in infectious disease situations). A well organized medical supervisor can provide treatment to a greater number of affected patients in an infectious disease situation than shock trauma.

At the same time, infectious diseases can be mitigated by fast and well implemented preventative measures. SARS, for example, shares many attributes with pandemic influenza, but a swift response was able to keep the outbreak contained (thank Canada, not China for this). Another example is the MSF response to the outbreaks of Ebola, where a full scale epidemic was prevented by the introduction of proper handwashing, gloves, and BSI barriers. The myth that Ebola burns itself out by killing it's victims too fast is false: the time between onset of symptoms to death, 7-14 days, is plenty of time to spread the highly transmittable disease, especially since early symptoms are difficult to distinguish from malaria.

The article talks about susceptible populations during a pandemic, not specifically pandemic flu. Pandemic flu throws a wrench in the plans of this article because of its atypical target population of young people, rather than the usual young children under 2 years, and the elderly over 65. Approx 99% of deaths from the Spanish flu were under 65 years of age, and about half were between the ages of 20 to 40. If normal triage methodologies are followed, post pandemic society and economy will be devastated by the loss of society's most productive members.

One final point about triage in a pandemic scenario is that whatever the condition or situation of a patient, they absolutely must be attended to, in one way or another. When faced with highly infectious pathogens, every affected individual that is ignored becomes another potential source of disease outbreak, and that goes for any infectious disease, not just pan flu. I think ZSers should be more aware of the implications of this than anyone else.

[edited for typo purge]
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