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Opinion: Carlson: With bird flu looming, a cough in the face is bad idea

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  • Opinion: Carlson: With bird flu looming, a cough in the face is bad idea

    Carlson: With bird flu looming, a cough in the face is bad idea

    JOHN CARLSON
    REGISTER COLUMNIST


    March 12, 2006
    The Des Moines Register is the number one source for Des Moines and Iowa breaking, politics, business, agriculture, Iowa sports and entertainment news.



    So I'm walking out of Starbucks with a tasty cup of pricey coffee, and a guy does a full-lung blast of a cough straight into my face.

    I let it pass. No sense calling him a jerk and starting something ugly on a fine March morning.

    Six months or a year from now it might be cause for a punch in his drippy nose. Or maybe strangulation.

    Why suggest the need for violence?

    Something ugly is on the way.

    It's not a question of whether the bird flu will hit North America, scientists say. It's a matter of when. It might be brought from Asia to Hawaii or the West Coast by infected people on airliners. Then to places like Iowa, which may or may not be prepared.

    If travelers don't bring it our way, it's likely to arrive in infected migratory waterfowl.

    Either way, the experts look for it to be in North America within six months. A year tops.

    Still, lots of people are scoffing at what may well become a global nightmare. Probably because the horror is impossible to imagine and we have come to expect science to protect us from this sort of thing.

    I just remember what a doctor told me a few weeks ago. He said people in Iowa's medical community are sweating big time. Not enough respirators, hospital beds or space in intensive care units.

    "We're going to have to look at some very tough decisions," he said. "As in, who gets the respirator and who doesn't, who we treat and who we don't treat."

    It's a medical disaster in the making, he said. Then a legal one. First, the bodies of patients left to die in hospital parking lots. Then the lawsuits.

    Public health officials are telling people to calm down, that it won't happen like that and they shouldn't panic. And at the same time, this thing is being compared to the so-called "Spanish flu" pandemic that swept the globe in 1918 and 1919. It killed 40 million to 50 million people and is believed to be the most deadly illness in history.

    It cost an estimated 10,000 Iowans their lives ? one of them my grandfather ? with some dying within a day or two of showing the first symptoms. Public gatherings were prohibited. Streetcar conductors in Des Moines wore protective gauze masks. Some communities posted armed guards to keep the infected from entering.

    Humans had no natural immunity to that strain of influenza. There is no such immunity to the new type of flu that is already killing people in Asia.

    Convinced a repeat of the calamity is headed our way, I called Dr. Patricia Quinlisk, Iowa's state epidemiologist, for reassurance.

    She told me to calm down.

    But what about not enough respirators and hospital beds?

    "We've developed models and looked at how many beds would be needed, how respirators would be needed, all those things," she said. "Obviously, it would be more than typically needed. But if it would occur over a three-month period of time, which is what most people are predicting because not everybody gets sick all at the same time, we would have a reasonable ability to deal with it. We probably won't have to go down the road of not being able to treat everybody. At least not very far down that road."


    OK, what about not having enough vaccine?

    "Nobody is saying we're going to have enough vaccine for everybody," she said. "So the question we have looked at is, how do we decide who gets the vaccine? We don't know if it's going to hit old people, young people, healthy people. But we know how we're going to do it once we know what's happening."

    What if some guy in seat 17B on an airliner brings it here?

    "Say we've identified somebody (who was infected) and flew in from Asia to the Cedar Rapids airport. We'd give anti-virals to all of the people who might have been exposed to keep the thing from getting started in Iowa. Or at least, hopefully, slowing it down."

    Quinlisk doesn't think it will be a repeat of 1918-19.

    Antibiotics, improved communication, lots of things make for a much better scenario.

    "I'm not kidding myself," she said. "It could be pretty bad, but I don't think it's going to be like it was then. I believe, even worst case, we'll be able to care for sick people."

    Quinlisk's words helped. Some. I'm slightly calmer.

    Just not entirely convinced. A cough in the face continues to be a very bad idea.
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