Pandemic Flu Patients Should Stay Home, U.S. Officials May Say

By John Lauerman

Oct. 24 (Bloomberg) -- Health officials may propose a plan to prevent the spread of pandemic flu in the U.S. that includes treating sick patients at home, rather than in hospitals.

The home therapy option is based on computer models showing that limiting personal contact may slow growth of a pandemic. Advisers to the U.S. Institute of Medicine are meeting tomorrow in Washington to determine if scientific estimates are strong enough to make health policy decisions affecting the lives millions of Americans in a deadly flu outbreak.

Some advisers say the so-called ``social distancing'' measures might buy critical time for officials to develop, produce and distribute drugs and vaccines. That may be enough to slow or even halt an outbreak of flu that health officials say might kill millions of people worldwide and cause as much as $2 trillion in economic losses.

``There's strong historical evidence that where it appears that aggressive social-distancing measures were used, they had an impact,'' said Ira Longini, a University of Washington epidemiologist who advises the government on flu, in an Oct. 19 telephone interview. ``It can be highly effective.''

Other government advisers say many Americans, accustomed to getting the latest treatments at well-equipped hospitals, won't be content to wait at home for doses of Roche Holding AG's Tamiflu or other therapies.

``I think we have to understand that what we recommend and what people do are two different things,'' said Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy in Minneapolis, in a telephone interview Oct. 20. ``I don't think that because we tell people stay home that they're going to do it.''

Institute

The Institute of Medicine, a branch of the Washington-based National Academy of Sciences, forms volunteer committees to study important medical questions in the U.S. The agency's panels have highlighted the dangers of medical errors and the need for Food and Drug Administration reform.

As the lethal H5N1 bird flu spreads in Asia and parts of Africa, the Middle East and Europe, U.S. health officials are grappling with how best to slow its spread. Even a mild pandemic, such as those in 1957 and 1968 that each killed less than 2 million people, is likely to overwhelm hospitals with patients, Osterholm said.

``Hospitals won't be able to care for the majority of pandemic related illness,'' he said. ``We've already gnawed hospitals down to the bone.''

`Unrealistic'

It may be unrealistic to expect that government advice will be sought or closely followed during a pandemic, said Stephen Brozak, an analyst with WBB Securities Inc. in New Jersey.

``That might have worked 100 years ago, when we were an agrarian economy,'' said Brozak, who previously worked as a military liaison to the United Nations.` `You're talking about social disruption the likes of which has never been seen.''

Many Americans, though, may see an incentive to follow social-distancing guidelines, said Richard Hatchett, a National Institutes of Health researcher who's advising the Department of Health and Human Services on pandemic response.

In a severe pandemic, similar to the 1918 Spanish flu that killed as many as 50 million people worldwide, fears of infection alone may be enough to keep the and sick and their families away from hospitals and clinics, Hatchett said in an Oct. 19 telephone interview.

One proposal that might help keep sick people at home would be to tie it with the quick delivery of Roche Holding AG's Tamiflu, GlaxoSmithKline Plc's Relenza, or other proven antiviral drugs, he said.

``I suspect that people will be very interested in getting their hands on drugs if they're available,'' Hatchett said.

Other Controversies

Other pandemic measures being considered may also be controversial. For instance, the Centers for Disease Control and Prevention, based in Atlanta, has discussed a proposal to close schools for long periods of time, a measure that is sure to draw fire from some parents, said David Bell, director of the agency's Office of Strategy and Innovation.

Parents may have to skip work or telecommute for days or weeks if pandemic concerns keep children at home, and many children get lunch regularly through school programs, he said.

``If that's planned in advance it can be dealt with,'' Bell said at a September conference on infectious disease in San Francisco.

A study by researchers at Sandia National Laboratories in Albuquerque predicted that closing schools and keeping children at home during even a mild pandemic would cut the proportion of the population infected by more than 90 percent.

``The public is intelligent and will behave in a way that it perceives to be in its own best interests,'' he said. ``You can shape that perception with information.''

To contact the reporter on this story: John Lauerman in Boston at jlauerman@bloomberg.net ;

Last Updated: October 24, 2006 12:08 EDT

    Im suprised that there no screaming about money lost should people have to stay home.

Happy C...... I hope your pumpkin feels better.  It is a bit unsettling.  I feel we over here, have preps enough to be safe away from others.  What we are hearing now is amazing compared to what has gone before...little info to the masses.  Now it's...as Cruiser says, refreshing and way overdue.

Staying home is a good idea.  With the ability to telecommute, the amount of money lost in the economy can be minimized and you probably could get better care at home than in a overcrowded hospital during a pandemic.

The part that stood out for me was

"A study by researchers at Sandia National Laboratories in Albuquerque predicted that closing schools and keeping children at home during even a mild pandemic would cut the proportion of the population infected by more than 90 percent." 

Wow, that's huge!