HEALTH: Questions to Consider

If such an outbreak started and spread throughout the world, there are few options that the U.S. government can try.  These include things such as using some medications that seem to have some effectiveness against the avian influenza and taking steps to slow the spread of the disease. Other options would be to try and quickly develop a vaccine that would protect the population against the infection.  If these steps do not work, then decisions about how to use limited medical supplies to care for as many people as possible.

Developing a new vaccine against a disease is difficult and takes time.  It is unlikely that enough vaccine could be made to protect the entire U.S. population, at least in the first year. This might mean that decisions would have to be made about who should receive the vaccine first. The very young and very old are usually the people most at risk to die from the "flu" that we see every year.  These same people are likely to be most at risk from an outbreak of severe avian influenza.  However, these groups are not the ones that keep things running in society. For example, they are not the police officers, the nurses, or the people who keep your electricity running.  So the government might be asked to decide who should get the limited vaccine - the most vulnerable, or the people who help take care of the sick people and keep order in society?

A similar question could come up as the hospitals and intensive care units fill up.  As more and more people come to hospitals which are already completely filled up, how do you decide who will get to use the remaining limited resources that are available? Should we begin to withdraw care from people who are unlikely to get better so that we can help people that have a better chance of surviving?  Who do you think should be making these types of decisions? You should also consider how you might protect some of the supplies or treatments that are required during the outbreak.  Some people might try to steal these limited supplies from others.

Another question to consider is how antidotes should be used if one is available.  We are concerned about what to do if there is a shortage of some treatments, but we are also concerned with how to use some antidotes if some people do not want to take them.  Almost all medications or vaccinations have the potential for side effects. Treatments that are made quickly may have a greater risk of some of these types of side effects.  Therefore some people may not want to take a vaccination even if it might save their lives.  If these people get sick because they refused to take the vaccine, they may spread their infection to others. The question is whether or not people should be forced to take vaccinations if they are unwilling to do so.

Sometimes the spread of disease can be slowed by limiting the ways in which people gather together.  Examples of this are closing schools, canceling public gatherings, and closing stores.  This helps keep people who might be sick and contagious from coming into contact with other health people.  However, this causes some problems that you should try to think about.

If no treatments are available, one of the last available, and most dramatic, options is to try and prevent the spread of the infection by quarantining sick people, or people who might get sick, from the rest of the population. This usually means restricting the movements of these people either through voluntary or forced means. If a community forcefully restricts the movements of some people because they are sick or might get sick, there are some things that the community must do for those people.  There are also questions about whether it is ethical to quarantine people.  You should think about some of these issues and also whether you would be willing to be quarantined.

Conclusion....