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article imageOp-Ed: Flu Plans Must Urgently Address History and Demographics

By Carol Forsloff     Apr 27, 2009 in Health
The flu is neither a new phenomena nor just one of the 20th century and modern times. It has been around since the time of Hippocrates. For that reason we need to address both history and demographics as communities and individuals.
Governments have a responsibility to provide help and support during epidemics, but individuals have responsibilities as well. To minimize personal risk as well as global risk, one needs to have some perspective about what could happen. That’s because we are no longer families for the most part; we are separate individuals that don’t have the same supports as folks had in earlier times.
In 1918 the Spanish influenza affected 20% of the world’s population at the time. The origin is debatable; some believe it was China. Over the period 1918 it moved rather quickly because it came on the heels of the declining months of World War I when people had contact with one another. Therefore its movement had much to do with the state of interaction that was taking place in global areas. Yet it spread worldwide. It infected millions in France and the British isles and other areas of Europe, the United States and other parts of the world. Historians have labeled it as the worst pandemic in world history. More people died of the flu during that single year than four years of the Bubonic plague.
The connections we have to one another now, especially because of modern transport, heighten concerns about any new disease that has mutated to humans. The Department of Homeland Security through spokesperson Janet Neapolitino declares that her office learned of the flu in Mexico last week, although the CDC was advised earlier. Now there are scattered reports in different areas of the world. The movement of the outbreak can be viewed through the lens of history to determine population and individual risks. 1918 was a case in point, which is why it is so often mentioned..
These were some of the restrictions and risks during the 1918 epidemic. Public health offices became overwhelmed and in some places ineffective against the flu of 1918. Health and human services could not support all of the cases. People were buried quickly; no funeral could last more than minutes. People had to have certificates to enter towns. There were severe restrictions on any type of assembly. Shops and transport centers were closed. Consider the effect on getting food and supplies during that scenario.
The 1957 flu came in two separate waves, emanating originally from China, which is why it was called the Asian flu. During the first wave mostly young people were infected; the second time it hit the elderly. Two million people died. So far many of the reported cases of swine flu have been youth. Knowing this reveals that one outbreak may follow another with different age groups involved. I had the flu that year. I was out of school for three weeks. My mother had to change my sheets several times daily. I remember at the age of 15 being unable to do almost anything.
I got it again during the epidemic of 1968. This time I was married with a young child. I was ill for two weeks. My young sister, age 14, lived with us at the time and didn’t become ill. She helped with meals and our 2 ½ year old son because neither my husband nor I could function well. Neither of them became ill; we kept them away from us for the most part. Like many people, we couldn’t even get to the doctor because neither one of us could drive. My husband’s adult brother lived 10 miles away and was sick as well. Those were the complications in a mild epidemic. It made the slightest physical movement to care for oneself extremely difficult. What John Keys in the 16th century called the “Sweating Sickness” certainly describes what I remember. At the time when Keys wrote about it, his recommendation was complete bed rest and avoidance of strenuous activities.
I can say that one won’t be able to do anything strenuous if one gets even a moderate form of influenza.
Because the recession has inhibited the movement of people, specifically family members to areas where they can be close to one another, an outbreak of the swine flu could be different and more complicated in some respects. This time around people often don’t have many family members to help care for them as they did in previous times. The problems my husband and I faced during the 1960’s have become more serious. Now people can’t move because of the recession’s consequences, having been unable to sell homes or lacking funds to leave an area. The modern world has meant separation of individuals from families. Simply put, many people will have to take care of themselves in an emergency or time of catastrophe like an outbreak of swine flu or a major hurricane like Hurricane Katrina. That’s why demographics must play a part in planning. When officials didn’t do that in the case of New Orleans, great tragedy occurred. So let’s examine two cities to take a look at those issues.
More than 10% of the population of Houston depends upon public transportation. 21.8% of the population is below the poverty line. 32.2% are single and live alone. 6.7% of the elderly live alone. 15.7% of households are headed up by women with children under the age of 18. In Minneapolis 40.3% live alone, 8.03% are elderly and alone. Female householders constitute 7.9% of the population. Approximately 10 to 15% are below the poverty line. These demographics reveal that emphasis will have to be placed on reaching individuals, so police and fire departments and security agencies will have to do what families cannot—get people to the doctor and see that other needs are addressed. It will be particularly true for Houston where there are more poor people than Minneapolis and more living alone. That’s because very sick people by themselves may have no transportation to get to medical care or to buy the things they need to care for themselves that families could do in an emergency. These are just some of the examples of how demographics must be considered very early on, in cities and in small towns.
The mission for the individual in the modern world is to recognize one’s individual and collective situation and plan accordingly during any catastrophe, including an epidemic of swine flu. Officials are watchful as the future is unknown. But knowing demographics and history as well as one’s personal support system would seem important even if it means enough groceries in the house.
This opinion article was written by an independent writer. The opinions and views expressed herein are those of the author and are not necessarily intended to reflect those of
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