Friday, May 1, 2009

Containment is no longer a feasible option

In the 1918 Spanish flu, American cities that reacted quickly had fewer deaths than those that acted slowly and used fewer precautions, according to a 2007 study of 43 cities by researchers from the University of Michigan and the Centers for Disease Control. The most common combination was school closings and bans on public gatherings, which in 34 cities lasted for a median of four weeks. All those cities except New York, Chicago, and New Haven closed their schools; the median time was six weeks.

Deaths per 100,000 population ranged from 210 for Grand Rapids, Mich., to 807 for Pittsburgh.

Although some scientists and historians have argued that those measures just delayed deaths that later happened anyway, Dr. Cetron, one of the authors of the 2007 study, denied it.

“There’s no evidence of that,” he said. “Cities that acted early and layered on different interventions did well.”

Many people do not realize how long measures take to work. A child can shed flu virus for 10 days, Dr. Imperato said, an adult for 5.

Some experts are cautiously optimistic. A computer simulation of this outbreak released Wednesday by a team from Northwestern University projected a worst-case scenario, meaning no measures have been taken to combat the spread. It predicted a mere 1,700 cases in the United States four weeks from now.

-Containing Flu Is Not Feasible, Specialists Say

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