May 11, 2006 The TV movie "Fatal Contact: Bird Flu in America " raised questions about the U.S. ability to handle a pandemic. C. Ed Hsu, an expert in public health emergency preparedness for disease and bioterrorism and assistant professor of public and community health looks at some of the issues the movie raised. Hsu has prepared a number of studies on public health preparedness and response and bioterrorism and surveillance databases on minority health, including Asian Americans.
How worried should Americans be about an Avian Influenza pandemic?
Hsu: Worry alone is not enough. Preparation is the key.
How prepared is the U.S. for a pandemic?
Hsu: We are not really well prepared. America is not ready even for annual seasonal flu that kills 45,000 every year.
Could what happened in the movie "Fatal Contact: Bird Flu in America" really happen?
Hsu: What happened in the movie can actually happen in real life -- the panicking, the lack of supplies and vaccines, the exponential growth of deaths, and the increased needs of medical resources. We should bring the preparedness effort in perspective, and broaden the scope of preparedness to seasonal flu, as well as Avian Flu.
Our current knowledge of existing cases/fatality attributable to H5N1 virus does not warrant worries or heightened attention, because it appears to be a virus that predominantly infects the bird population. This is based on the reported human vs. bird cases, suggesting that the case fatality in human is high, the bird infection is growing, but human infection/fatality rates are not in proportion to the increase of bird infection. This is based on the assumption that the case-reporting is correct.
Can we rely on the current case reporting?
Hsu: One exception of the world surveillance system again H5N1 is those countries that prefer "national interest" to free communication, including China . The transparency of case reporting from China will need to be strengthened. They need a lot of help on surveillance data monitoring. This is particularly important in light of the ill-reporting of SARS cases there.
Did the move make any points we should pay attention to?
Hsu: Two areas revealed in the movie in flu preparation (either Seasonal Flu or Avian Flu) warrant attention. First, the movie delivers a positive message to encourage people to prepare emergency stockpile for their own homes. The stockpiles might include, among other things, 1. daily necessities (food and clean water) 2. gloves, masks, etc. 3. medication for patients with chronic conditions (such as insulin for diabetics) 4. vaccine if available.
Second, in light of the diverse society that we are living in, it is important to know where are medical providers who can provide culturally and linguistically appropriate care to their patients, particularly in time of urgency such as a flu pandemic. The State of Texas health authorities has started to "take inventory" of their ethnic medical providers and assessing their training needs in public health emergency and response. Other states with diverse population may want to consider similar preparedness effort.
C. Ed Hsu has published in a number of journals, including Disaster Management and Response and Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. Hsu is on the editorial boards of the International Journal of Health Information Systems and Informatics and the American Journal of Health Behavior.
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