Who Gets to Decide Between Essential and Nonessential?

Some day soon a US president will have to decide whose lives are the most important to save, and whose lives are “nonessential.”

Photo Caption: Influenza victims crowd into an emergency hospital near Fort Riley, KS in this 1918 file photo. The 1918 Spanish flu pandemic killed at least 20 million people worldwide. Officials say that if the next pandemic resembles the 1918 Spanish flu up to 1.9 million Americans could die.

I’m talking about the next pandemic and one study from Harvard University estimates that the next pandemic will kill somewhere between 51 million and 81 million people – mostly in developing countries.

Organizations and institutions around the world are developing plans for dealing with this expected pandemic. Some people will be more important than others when fighting the disease and many will be left to fend for themselves.

WHO IS ‘ESSENTIAL’?

Doctors and nurses will be vital. Others essential to public health and safety will also be vital…but after that it gets tough.

We need to consider that the secondary effects of a severe pandemic influenza could be greater than deaths and illness from influenza itself. A pandemic could create a societal collapse on many levels.

So it is important to consider that people who might have been thought of as nonessential will be extremely essential if society is to keep functioning. Truck drivers fall into this category.

THE TRICKLE-DOWN EFFECT

There will likely be a presidential decree to designate broadly who gets preferential treatment in response to the disaster. Who will make the decision on a community level?

People will likely be told to stay home from nonessential jobs because a pandemic is marked by the ease and speed that a misunderstood virus can spread from one person to another. Isolation reduces the chance of exposure. How will families survive without a paycheck, though?

Also of note…all of this would be occurring at a time of great confusion.

THE MOST VULNERABLE

Young children and older adults are the most vulnerable in an influenza pandemic. However, records show that healthy young adults were most likely to die during an epidemic.

A study out of Johns Hopkins recently showed that half of the public health employees in Maryland stated they would stay away from work instead of risking their families to the virus. Physicians and nurses were more likely to show up than support personnel. Two-thirds of the public health employees in that study said their role was not important in combating a pandemic so they were less likely to report to work.

If essential workers fail to work, the entire structure of a society will begin to fall apart. So you can see why the aftermath of a pandemic could claim more lives than the virus itself.

So many people underestimate the seriousness of an influenza pandemic. We all struggle with the flu from time to time…how can this really be life threatening? In the US an average of 36,000 people die every year from influenza and 200,000 are hospitalized.

Big numbers… but they dwarfed by comparisons to projections for a global pandemic. The Harvard University study did something interesting. They extrapolated the number of deaths during the 1918-20 pandemic to the worldwide population in 2004. It’s estimated that 62 million people would die each year from the pandemic (96 % in developing countries).

Don’t be tempted to rest on the assurances of technology and advancement…for time is on the side of any virus.

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