Sunday, January 08, 2006

Time to get ready for quarantine

Before I get started, I hope you enjoyed the ranch photos. I have many more that I will share as we go along.

For the last several months, we have been hearing about avian flu and how bad it is, the deaths that are attributed to this disease and of couse the media questioning the country's preparedness (it is like the government is supposed to make sure everyone is safe from everything, all the time-by the way we aren't prepared and maybe we can just try the best that we can). Before Avian Flu, it was SARS, Smallpox, and I still worry about Ebola more than most, but the point of this posting is to prepare you for what will happen if something like Avian Flu or Ebola shows up here in the states.

Quarantine is what will happen. People who are exposed or infected may face seclusion some where based on public health laws that exist or will be legislated into existence. People held against their will based on the threat to the general public.

Let me give you a likely scenario:
A flight comes in from Asia or Africa to a major airport like LAX or JFK. Someone becomes ill during the flight and when the land EMS or Public Health officials are called. They suspect a virus like ebola or avian flu. Do you think that everyone else on the flight gets to go along their merry way? Not likely. The rest of the passengers, say 300-400 of them have been in a recycling air environment for several hours with a person stricken with a highly contagious disease. Everyone else on the plane including the crew and maybe the responders(if they weren't in level A or B suits) are now going into quarantine.

Now lets take it a step further, the plane lands and the passengers disembark to the international terminal where they mingle with the many other international flights that have arrived. In a place like JFK or LAX, you might have several thousand people in the terminal at one time. During the inspection process an alert Officer suspects that someone might be ill and refers them to public health. PH suspects Avian Flu or Ebola and quarantines the person and who else? Think about the airport environment, once again a recirculating air environment. How many open windows do you see there? So now what, who gets quarantined? Certainly everyone on the plane, and now how about the several thousand in the international terminal and the hundreds of people that work there.

Now one step further, the plane lands at LAX, the infected passenger goes through the inspection process without notice and hops a flight to Salt Lake City, then another flight to Green Bay, WI. In a few days, the passenger's illness becomes worse and they are hospitalized. The medical personnel suspect Avian Flu or Ebola. Now what? Contact the CDC in Atlanta, who contacts Customs and Border Protection. CBP reviews the manifests for all people who flew in with the patient, then all the people who came in on all the other international flights at the same time and were in the international terminal, plus all the passengers on the flight to SLC who might be infected, plus all the flights that they might have got on there plus all the people they might have contacted. Now all the people that were on the flight from SLC to Green Bay and others that might have had contact with the patient or those exposed to the patient. So Now, Who goes to quarantine???? How many thousands have been possibly exposed, do we quarantine them all, where do we quaratine them, how do we move them, do we have enough hospital beds? Maybe we can use old military bases.

By now, you should have identified many of the logistical problems with keeping everyone safe all the time, with the use of quarantine, and the overwhelming task it is to prepare for the inevitable. In todays day and age of fast international travel and faster domestic travel, it is only a matter of time when we have a terrible outbreak of something, whether it is Avian Flu or Ebola.

Don't be to hard on the civil servants when it happens, because now you know some of the challenges. There are action plans set up throughout the country with feds, state, and locals all working together, but it is a very daunting task.

On a positive not(from an enforcement perspective), CBP reports seizures of fake tamiflu, which is the drug thought to be effective against Avian Flu. There have been seizures in New York and San Francisco of the fake drug in over 300 packages. See, there are some folks looking out for you, but having fake tamiflu on the market during an outbreak would certainly be a mess.

BT