Thursday, November 23, 2006

Article from the Irish Medical Times released on 27 October 2006

When it comes to who does and who does not receive treatment, doctors and policy makers would have to make hard decisions in the event of flu pandemic. This is according to Prof. Frederick Burkle who is a Senior Fellow with the Harvard Humanitarian Initiative at Harvard University’s School of Public Health.

Exploring the populations who have the greatest chance of getting the virus, shows that the metropolitan areas are going to be the ones where epidemics can take off. According to Prof. Burkle “…that is exactly where the virus will want to go if it wants to stay alive. If you are living in a rural area where people aren’t living close to each other, the disease is not going to spread.”

The way doctors currently treat patients will fundamentally change to take on a population-based health care approach. He says: “The individual is really not important. My goal is to make sure that every patient will not transmit it to somebody else. In a normal ICU situation, you have a special nurse, two or three other nurses, and a whole team of doctors. In (a pandemic) it will be like Africa. The definition of intensive care of a hospital in Africa is that you might have a nurse that day.”

A shortage of ventilators in Ireland poses a tough question to doctors in deciding who gets to live or die – just as ventilator shortages elsewhere in the world, including the US. Prof. Burkle adds that exclusion criteria must be agreed upon before the event. He adds: “Someone may come in with a cardiac arrest or respiratory arrest because of the disease. Resuscitation is high maintenance. We use a lot of medication and equipment. Chances are, resources will not allow (resuscitation) to happen”.






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