Friday, June 19, 2009

Pandemic Severity Index

Since the "stages" of pandemic do not appear to be terribly useful in describing novel H1N1, CDC has created a Pandemic Severity Index. It mirrors the hurricane severity index, with a Category 1 being mild, like seasonal flu, versus Category 5 as the most severe. Disease control activities are then based on the severity of the illness, although I would think you would still be concerned with the stage -- ie the levels of transmission within the area -- in conjunction.

I just returned from a table top exercise on what I suppose would be a Category 4 or 5 pandemic. Bad case scenario, where lots of people die, the grocery stores run out of food, people have heart attacks on the street because the hospitals are too full to accept them, etc. One of the big worries the responders expressed was about how the public will react next time -- "See there they go again, the government over-reacting!" and then ignoring prudent advice.

One of the big problems is that for the last few years (decades?) we have lived in a culture of fear. Fear is the primary motivation for people. Scare the crap out of people to get them to do things. Check your breasts monthly so you don't die of breast cancer. Put your kids in car seats so they don't die in car wrecks. Everything is dangerous. Nothing is safe. Parents won't let their kids play outside because of a fear that they might be abducted.

Not long ago I had a conversation with a friend about the use of fear as a tool to control people in religion, and how there has been a shift away from that. As a kid, I was scared to death that I would burn in a lake of fire. Terrified, terrorized really, of going to hell (why yes, I was a Catholic. What do you ask?). A lot of churches (Western, Christian) have gotten away from that message, and now promote spirituality and having a relationship with God for the sake of the relationship, rather than blindly following church doctrine out of fear of hell. It seems to me that this is something we should consider moving towards as a society -- acting because something is the right thing to do, rationally, rather than being driven by fear and anxiety. I am not sure how to accomplish that, but it makes sense to me.

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