Carter Mecher, M.D., one of the authors of the National Strategy for Pandemic Influenza: Implementation Plan, is the clinical manager of the Veterans Integrated Service Network (VISN7) in Atlanta. He worked on the implementation plan while on assignment to the White House in 2005. Mecher spoke with the Challenge staff about pandemics and the importance of response planning.
Think of a pandemic as a fire. When smoldering in the corner of a room, it’s much easier to contain than if it has spread beyond the room and is burning down the house. And fi res move fast. This is the best metaphor for pandemics according to Carter Mecher.
If a pandemic begins elsewhere in the world and reaches the United States, Mecher says research models suggest it could spread across this country within two to four months. Numerous research facilities, including the Los Alamos National Laboratory, are working on these models that simulate flu transmission patterns. Cases could potentially double every two or three days in a pandemic, and natural immunity is not prevalent as with a regular flu virus. Early planning and being ready to act quickly will be vital to communities in the face of an approaching pandemic.
Mecher and his colleagues looked at the education system and its myriad processes (including daily instruction, nutrition, and transportation) to ensure that children and staff are well represented in national planning and well protected during an outbreak.
“Schools, compared to work and homes, are the most dense population,” Mecher said. “Kids spend the school day in close proximity to other kids, and they are a key factor in the normal exchange rates of a flu virus. Kids are among the first ones to get the flu and have higher rates of illness compared to adults.”
Dismissing students from school can be one of the most effective measures a community can take when faced with a pandemic; however, when the topic comes up, it raises a lot of concern and subsequent discussion among administrators, educators, and parents.
Because of the overwhelming speed with which a pandemic can travel, it is critical to address these concerns and discussions now. Schools, health departments, communities, and parents need to work together now so flu-mitigation processes are established, tested, and well known.
For Mecher, looking at the past is a smart way of preparing for the future. He studies the best practices used during the 1918 Spanish flu pandemic and how things have changed in the education system since then. “We’re looking at transportation, school meals, and what happens during the summer. What programs are in place?”
The 1918 pandemic is regarded as the deadliest in modern history, killing between 20 and 50 million people worldwide. Researchers and policy advisors are interested in the virus that caused this pandemic because it was so severe, and many of its victims were healthy young adults. Studying the genetic attributes and functionality of this virus helps researchers evaluate current public health interventions and refine them for the future.
Schools are a key resource for communities in terms of offering flu shots, sharing safety messages, such as hand washing and cough etiquette, and possibly serving as overflow treatment centers. They also should play a key role in community planning. Schools must have a plan and ensure everyone knows what to do should this fire spark.