Bracing for the inevitable

Monday, December 10
NORTH ADAMS — Among health experts, the question is not if — but when — an influenza pandemic will happen, and officials are assembling a regional plan to handle a future outbreak.

In case all this sounds scary, Berkshire County officials — looking back on history — say it is smart to plan ahead.

The inevitability factor is based on three worldwide flu outbreaks in the 20th century: the so-called Spanish flu in 1918-19, the Asian flu of 1957-58 and the Hong Kong flu of 1968-69. Each of the outbreaks accounted for at least tens of thousands of deaths worldwide.

Similar planning efforts are under way across the country: setting up a system to react quickly to an outbreak, ensuring that enough hospital beds are available for those who need them, having enough volunteers ready to help with the sick, and delivering medicine and supplies to the homebound.

Planning efforts here are based on projections that a virus would infect 2 million Massachusetts residents and require the hospitalization of 80,000 over the course of two or three months. In addition, planning will take into account that 30 to 40 percent of the working-age population would be ill, creating a massive vacuum in services.

Next spring, local civic and medical officials plan to convene a meeting with various service sectors of the community to identify essential services and to devise ways to keep them running.

"Because a pandemic flu will affect every sector of the community, it makes sense to have many sectors of the community involved in the planning process," said Amy Carey, the public health emergency response coordinator with the Berkshire County Boards of Health Association.

A pandemic typically consists of three waves, according to Carey. The first wave is the deadliest, and the subsequent waves arrive three weeks to a month or more after the preceding one.

"Each wave is less virulent, so the first wave is going to be the most difficult to deal with," she said.

Today, the prevalence of air travel makes an outbreak difficult to contain, and viruses spread to regions faster, according to Kathy Arabia, vice president of guest services at North Adams Regional Hospital. Arabia meets regularly with a group of Western Massachusetts hospital officials to plan for a pandemic.

It is possible that those needing hospitalization after an outbreak could "exceed the capacity of hospitals in Massachusetts on a day-to-day basis, but with planning, we can meet that targeted need," Arabia said.

One effort is to identify additional emergency hospital space that can provide 50 more beds at each hospital. North Adams Regional Hospital's backup medical ward facility is St. Anthony's Parish Center in North Adams. For Berkshire Medical Center, it is the Hillcrest Campus.

In each city and town, one central location will be used as an information and communications center.

Volunteers who can answer phones or deliver food and supplies to the sick will be critical, Arabia said. "It's important that we get people signed up before any outbreak, so we can have their contact information and have the training done so we can respond more quickly," she said.

Businesses, schools and government agencies are being asked to review, or devise, emergency strategies to keep essential operations running and to shut down those that are not essential.

"Gas stations, banks and grocery stores will still need to function, as will the utilities," Carey said. "And in some cases, some companies should be prepared to allow their employees to work from home, if they have a loved one to care for or if they want to help curtail the spread of the virus in the workplace."

With a more than 30 percent infection rate, a significant portion of workers in any given sector would be incapacitated, requiring some entities to cross-train employees to keep essential services running.

Depending on the outbreak's severity, schools — a major hub in the spread of contagion — could be asked to close.

"Closing the schools can cut the rate of infection in half," Carey said. "That's going to be a really important piece of dealing with a pandemic."

One of the toughest challenges will be educating the public, Arabia said.

"There will be a large number of people seeking care," she said. "So we need plans for a systemized approach and to communicate consistent information on a variety of media. We'll try to link everyone together so that, in the event of a pandemic, we can take care of each other in the community."

Families can prepare by stocking an emergency supply of water, medicine and nonperishable foods.

"The more people that are prepared, the fewer that will be a burden on the system," Carey said.

"It's a given that we'll have a pandemic flu outbreak — we just don't know when it will happen or how severe it will be," Carey continued. "We're certainly not entirely prepared yet, but we are better off than we've been."

Lucy Britton, emergency management coordinator at Berkshire Medical Center in Pittsfield, said it is important to have a local effort prepared because the federal government would not be able to handle such a widespread crisis.


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