By By JOHN EBY / Dowagiac Daily News
CASSOPOLIS – What would a flu pandemic look like in Cass County?
Jason Tompkins, M.D., deputy medical director of the Van Buren-Cass District Health Department, crunched the numbers Thursday for the Cass County Board of Commissioners.
If a moderate influenza strain struck Cass County, comparable to 1957 or 1968 and less severe than 1918, when a global epidemic canceled the Dowagiac Chieftains football season, based on data from the Michigan Department of Community Health, 10.1 million people in the state and 52,000 county inhabitants:
17,504 citizens would fall sick.
12,871 would be sick enough to seek outpatient care from a physician.
262 patients would require hospitalization.
77 would die.
As for the resources available to cope with such a scenario, "We have Dowagiac's Borgess-Lee Memorial Hospital, which is licensed for 30 beds," Dr. Tompkins said. "We have two ventilators and two anesthesia machines that in a pinch you could use as ventilators. And we have three old ventilators we could try to bang the dust off and get them going. That puts it in perspective of what a moderate influenza outbreak would look like."
Dr. Tompkins just returned from Toronto and the Infectious Disease Society of America national annual meeting.
"A lot of talk was had about social distancing," he related. "If you tell the public you're going to quarantine them," movies condition a response of "you're going to stick me in a room with a bunch of people with something nasty, and then blood is going to squirt out all of my body orifices and I'm going to die? Quarantining is pretty much a bad word. Social distancing is a much better way to look at it" because it taps "people's preservation instinct of running for the hills."
The World Health Organization recognizes six stages leading up to a pandemic.
"We're in phase three," Dr. Tompkins said. Phase three "is defined as human infection with a new subtype, which is avian influenza, but no human-to-human spread or, at most, rare instances of spread in close contact. That's two steps away from a pandemic. In order for us to get to a pandemic with avian strain or a non-avian strain, only God knows if it's going to happen and when it will happen."
Phase four involves small clusters of limited human-to-human transmission. Phase five means large clusters.
Dr. Tompkins said the last two flu seasons "have hit us late, in February and March and on into early spring. We haven't seen any significant flu activity yet. It's not yet upon us. We kind of know within a week or two because there are sentinel physicians who report when seeing so many people for flu-like illness to regional epidemiologists."
Commissioner Gordon Bickel, R-Porter Township, who had a flu shot Wednesday, asked Dr. Tompkins about the wisdom of getting immunized later in the season.
"Injectable shots have a maximum detection about two months after they're given," Dr. Tompkins said. "After that, it declines. Four to five months after it's given, it's pretty much gone. So, if you got it right now it would start kicking in the middle of November and you'd be okay through December and January. February and March it'd start coming down. What we do with vulnerable patients in the nursing homes is we give them shots in October and another shot in late January or February to keep their immunity level up. It's not as critical for the general population."
Dr. Tompkins told Commissioner Minnie Warren, D-Pokagon Township, that flu shots and pneumonia shots are not the same thing.
"Pneumonia shots are recommended once before age 65 – usually at age 50 or later – and once after 65," he said.