Medical

My philosophy regarding the avian flu virus is not too panic, but to be prepared. Whether it’s a H5N1 virus or some other yet unknown strain, the world is overdue for another pandemic. It’s the same as being prepared for other possible emergencies such as earthquakes. I don’t live in fear of them everyday, but I do know that they can happen (having grown up in the San Francisco Bat Area and been in Kobe when the devastating earthquake hit out here) and thus take basic precautions on the off chance that it does happen while I’m in the area.

Money magazine has a Flu doomsday scenario for the world economy article currently up on its site. Some highlights:

Estimating how many (people) another pandemic could kill is fraught with difficulty. Calculating an overall economic impact is even trickier, given the potential for panic and indirect costs from a hiatus in travel and trade…

“We cannot begin to quantify the potential damage in terms of gross domestic product, but a realistic scenario might be GDP declines in the tens of percent,” said Carnell. “In the case of slower growing economies such as Europe or Japan, a decade’s economic growth could be wiped out.”

Note that the quote says “realistic scenario” meaning that the 10% decline in economic growth wouldn’t be a worst case scenario.

But even these direct cost estimates — which look at income and production lost from loss of life as well as the cost of vaccines and health care in the United States — run at least as high as August’s devastating hurricane Katrina.

A 1999 paper from the Centers for Disease Control and Prevention in Atlanta estimated an economic impact of between $71.3 billion and $166.5 billion from U.S. deaths of up to 207,000 and hospitalization of up to 734,000, “excluding disruptions to commerce and society.”

“In considering what planning there would have to be for the next pandemic, we thought — and still do — that the 1968 scenario is adequate,” Martin Meltzer, co-author of the report and a senior health economist at the CDC, told Reuters.

These numbers are based on the 1968 flu pandemic in which approximately 1 million people died of the “swine flu,” but was the least devastating of the three pandemics that occurred in the last century. The 1958 flu pandemic killed 2 million and the 1918 outbreak killed 50 – 100 million.

The most interesting part of the article was that while loss of life and illness would cause economic decline, it is likely that the way people react will have the largest effect:

“Substantial loss of life would obviously lead to a decline in economic output but we believe fear of infection, leading to drastically altered behavior, would result in the greatest economic damage,” said Rob Carnell, economist at ING bank.

I guess I am more cautious and have been following this more closely because of a conversation I had with my best friend from college who is in the medical field. He says that lab tests have shown that the current H5N1 virus can mutate into one spread by human to human contact in less than 10 generations. That is enough for me to be prepared:

“Recent clinical, epidemiological and laboratory evidence suggests that the impact of a pandemic caused by the current H5N1 strain would be similar to that of the 1918-19 pandemic,” Michael Osterholm, director of the Center for Infectious Disease Research and Policy, said in a recent paper.

Disruption to trade and travel from efforts to contain the virus would be incalculable, he said, adding global, regional and national economies would come to “an abrupt halt.”

One big fear about the reemergence of a 1918-type flu strain is that it killed millions of people in the most productive age groups — the 20- to 40-year-old bracket — as opposed to just preying on the very old and very young.

The last part is the most troubling. I think there is an assumption that only the young, old and those with weak immune systems die in pandemics which is not true. My advice – don’t obsess on it, but keep an eye on what is happening through the news, just as you would if there was a hurricane out at sea that had the potential to head your way.

It seems that the President and Congress are finally getting the hint that the Avian Flu Virus might be something to prepare for ahead of time. Living in Japan where I’m living a lot closer to where they predict the outbreak will first occur, I’ve been thinking about how to prepare to lesson the risks of getting it. While this is for practical reasons (if several million people are going to die, I don’t want to be one of them), it also has a financial aspect to it.

For those of you who haven’t been following this story, there is a new flu virus that is currently being carried by birds in Asia. Since this is a totally new flu virus, we (as in the human race) have no immunity to it. While it isn’t a problem at this point (because it isn’t easily passed between humans at the moment – although 65 people have contracted by being close to birds and have died), many experts are saying it’s just a matter of time before it does mutate and can be passed along easily from human to human. When this happens, a pandemic will occur (as has happened in the past) and it’s likely millions will die. Not a real fun thought.

Even if you don’t die, if you contract the virus, you’re going to be sick in bed for awhile. If that does happen, you’re not going to really be thinking about lost productivity (because at that point, you’ll be feeling really, really lousy and probably won’t care about anything beyond getting well), but since I’m in the preparation stage, I can.

The likelihood is you’ll be out not for a few days, but a few weeks. Depending on your source of income, that could mess up your finances quite a bit. So here are some tips I have for preparing for when it does arrive and preventing from getting it. Yes, the preparation will cost a bit of money, but it will be well worth it and you’ll thank me that you did.

1. Buy a good supply of surgical masks: You can get these at your local drug store or home improvement store. Once the outbreak happens, there will be a run on these at your local stores and they soon won’t be available. Supply and demand will cause their prices to rise quite a bit in second hand markets like ebay. How do I know? That is exactly what happened in Japan when the SARS outbreak occurred.

The masks are not so much for preventing people from coughing directly in your face as keeping your hands away from your nose and mouth. The virus is much more likely to be transmitted as follows than you getting coughed on directly in the face:

— Someone with the virus touches his nose getting the virus on his hand

— He opens a door leaving the virus on the door knob

— You opened the same door after him getting the virus on your hand

— you unconsciously touch your nose contracting the virus

Which brings us to number

2. Get in the habit of washing your hands regularly: As a former teacher with lots of kids running around with runny noses, you learn to wash your hands constantly to make it through the school year without getting sick. If you have kids, get them in the habit of washing their hands several times a day (the more the better). Once the flu comes, if they aren’t in the habit of washing their hands often already, you aren’t going to be able to teach them in that short period of time.

3. Wash thoroughly: From what I’ve read, bacterial soap in itself won’t kill the flu virus, but the main reason to wash you hands isn’t to kill it.

“The soap isn’t meant to kill the bug, its purpose is to make your hands slippery, so the virus slides off under water.”

That means taking the time to wash hands thoroughly so all the virus slips off.

4. When the outbreak occurs, change your habits: You’re not going to be able to lock yourself inside when the outbreak occurs since it will last a full season (several months), but avoiding crowds will be a good habit to get into. Crowds are always an easy place for the flu to spread. If you have kids with play groups or other activities, you’ll want to consider cancelling them for a season.

5. Get the vaccine immunization when available: I doubt the government will have enough medication to go around when the flu outbreak occurs and the limited supplies they have will go to high risk patients (elderly, children, those with compromised immune systems, etc). The fact is, antibiotics don’t work on the flu virus (they work on bacteria), so there is little the doctor can do once you get sick. Since the virus will be totally new, even the drugs that doctors think may help in reality may or may not, so you don’t want to count on these (thus prepare not to get it in the first place). Once the virus is identified, however, they will culture it to make a vaccine. As soon as that vaccine is ready and available, get immunized with it.

As with many things, taking the time to prepare and spending a little money upfront can save you a lot down the road. This is certainly one time it’s worth preparing for an even that is sure to come in our lifetime.

The Federal Drug Administration has an extensive article on how to save money on prescription drugs in their latest issue of FDA Consumer magazine. The article has a number of good points that can save you a significant amount of money and suggests these basic tips:

Tell your doctor whether paying for prescription drugs is a problem.

Ask your doctor about generics, another brand of the drug that may cost less, and nonprescription options.

Find out whether Medicare Prescription Drug Coverage can benefit you and your family members.

Check to see whether you are eligible for drug assistance programs in your state.

Check with the pharmaceutical companies that manufacture your medicines to find out whether you qualify for assistance programs.

Shop around your neighborhood or legitimate online pharmacies for the best prices on prescription drugs.

One point that I found interesting was area of the report that shows that people buying brand name prescription drugs through Canadian pharmacies could actually save more money much of the time by purchasing the equivalent generic drug in the US.

When I last talked to my best friend from college, one of the issues we talked about was whether generic drugs were as effective as their brand name counterparts. Both he and his wife (also a doctor) said that the generics are just as effective and that they themselves take generics.