Life in the Time of a Pandemic

In the event of a major pandemic, school and universities would send students home and close their doors for 12 weeks or more.

Offices would shut down, and flights would be grounded. The sick and their families would be encouraged to quarantine their households in order to contain spread of the disease.

Such would be the scenario according to a guidance document issued Thursday by the Centers for Disease Control and Prevention (CDC), which offers a glimpse into what changes might take place in day-to-day life should a major pandemic occur.

The strategies outlined in the 106-page document are not modest ones. But the authors of the guidance say that keeping people physically apart could offer the best chance of minimizing the spread of a severe pandemic -- at least in the months it would take before a well-matched vaccine became available.

Disease experts say such measures, if properly followed, could save lives.

"Properly applied, anti-viral treatments, effective social distancing, proper protocols and movement restrictions will have a major impact," said Dr. David Nabarro, senior United Nations system coordinator for avian and human influenza. "These measures could indeed lead to total containment."

But if a pandemic like the one that occurred in 1918 were to happen again, the scope of the measures that would be implemented through the proposed guidelines would have a dramatic economic and societal impact.

"There are very significant repercussions of these guidelines, and there need to be systems in place to deal with these repercussions," said Dr. Jeffrey Duchin, chief of communicable disease control at the University of Washington's Division of Allergy and Infectious Disease. Durbin is also part of the working group that devised the recommendations.

"A lot of the burden of these measures falls on individuals and communities," he said. "They would need to figure out how they can survive the cure.

"The disease is bad, but the cure in this case is no cakewalk."

Categorizing the Pandemic Threat

The extent of the response to a pandemic situation would be largely determined by how many people get sick from it, as well as what percentage of those with the disease die from it.

The CDC report categorizes future pandemics in much the same way as hurricanes are measured, on a scale of severity from Category 1 to Category 5.

"Not all pandemics are equally severe, and we can use what we know about epidemiology to create a security index," CDC Director Dr. Julie Gerberding said Thursday in a press teleconference.

Thus, the measures taken in response to a Category 1 or 2 pandemic, such as the ones that occurred in 1957 and 1968, would be correspondingly moderate. Most of the recommendations would center around commonly practiced personal hygiene measures -- washing hands, covering mouths and noses when coughing, and staying home from work when sick.

On the other end of the spectrum, a Category 5 pandemic such as the one seen in 1918 would require much more drastic efforts to separate people to limit the spread -- and thus the mortality rate -- of the disease.

"When we're talking about Category 4 and 5, we're talking about a pandemic that would have 10 to 20 times the impact as a regular flu season," Duchin said. "It would result in up to 1 million deaths."

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