Bird Flu

How to Protect Yourself and Your Family

Reproduced with the exceptionally kind permission of the New Scientist

Prepare In Advance:

The antiviral question

We're not going to tell you not to get antiviral drugs such as Tamiflu or Relenza - we know of too many flu experts who have their own stash.

But governments are against private stockpiles, and you can see their point. If individuals buy up all the available supplies, health authorities might not have enough for the most seriously ill in the event of a pandemic. And if you panic and pop the pills when you are not sick, they will be wasted.

On the other hand, the distribution of official stocks could be a problem. It might be too late for the drug to work by the time you get it. You might have to wait in a huge queue of infected people or try to penetrate an angry mob. And you could be mugged on the way out of a dispensary by people desperate for the drug.

If you do decide to get antivirals, beware fakes. Don't order drugs on the internet unless it is from a reputable pharmacy in a well-regulated country. You will need two courses per person, as standard doses might not be enough. And don't be taken in by any of the companies peddling quack remedies.

Ask your doctor for a pneumococcus vaccination

This vaccine protects you from a kind of bacterium that can cause pneumonia when it infects lungs damaged by the flu virus. The protection lasts for five years.

You could also stock up on antibiotics for treating other kinds of bacterial pneumonia. Half the victims of 1918 died of such secondary infections. Ask your doctor which antibiotics work against the most common infections in your area.

Consider statins

Yes, we know, these drugs are for lowering your cholesterol. But there is very preliminary evidence that they might protect against the general inflammatory reaction caused by flu, which can trigger heart attacks or strokes. A Dutch study of several thousand people aged 60 or more found there was no surge in deaths during the flu season among those on statins.

Become indispensable

Some countries are creating lists of "priority" people who will be the first to get drugs, or a vaccine if one is available. Now might be a good time to realise those childhood dreams of becoming a nurse, a firefighter or head of state.

Stock up emergency supplies

If the pandemic is far worse than feared, or if you plan to isolate yourself during a pandemic (see right), you will need emergency supplies of food, water and fuel. Each person needs 2 to 3 litres of water a day just for drinking, more for keeping clean.

Companies should prepare for many workers being absent and, where possible, set up systems that allow people to work from home.

A healthy lifestyle will increase your chances of surviving pandemic flu. Eat plenty of fruit and vegetables, exercise and get enough sleep.

Get rich quick

The wealthy will fare better in a pandemic than the poor for many reasons: they are generally healthier and less likely to succumb to a virus, and they can afford to take measures to protect themselves and to pay for medical care. Far more poor people died in 1918, many for lack of simple nursing care. Needless to say, poor countries are definitely not the place to be.

If A Flu Pandemic Starts:

Wash your hands - often

Flu can be airborne, but it is mainly spread by touch. Someone sneezes on their hand and then touches a railing or an elevator button. Touch it after them and then touch your mouth, nose or eyes, and you could be infected by the virus.

We all touch our faces far more frequently than we think we do: just try not doing it. And the H5N1 in Asia can lurk for up to six days on surfaces, longer than most flu viruses.

So don't kiss or shake hands. If you have to touch public surfaces, wash thoroughly afterwards. Use a nail brush and carry little bottles of alcohol-based cleaning gel for when you don't have soap and water. You could use a clean tissue to touch things, or wear latex gloves, but discard them before touching your face. And if you do cough and sneeze, do it into a tissue, and dispose of it carefully to avoid infecting others.

Masks will do little to protect you from inhaling any airborne viruses unless they fit snugly and meet US standard N-95 or the equivalent - and such masks make it very hard to breathe. However, any mask will at least help remind you not to touch your mouth, nose and eyes.

Avoid people if you can

People carry pandemic flu. Staying away from other people will reduce your chances of getting it. Most countries' pandemic plans call for "social distancing", such as cancelling big public events, but this will make little difference if people still travel on buses, trains or aeroplanes, and go to shops and offices.

The most effective way to avoid infection would be to isolate yourself and your family at home with a lot of books and canned food, assuming you've stocked up in advance. If not, get groceries delivered if possible. In 1918, some institutions in the US successfully protected themselves in this way.

Isolating young children is particularly important, as they are not only more likely to get infected, thanks to their unhygienic habits, but also more vulnerable when they do fall ill.

The trouble with isolating yourself is that you could be in for a long wait. With 1918's flu, the first wave in spring lasted three months and was followed by a far more deadly wave in the autumn and another wave in early 1919. So if you have do go out, take precautions such as leaving your shoes and outer clothes at the door when you return, and washing your hands.

And as with antivirals, what's best for individuals could be bad for society. If too many workers stay at home, essential services such as water and electricity could be disrupted. In fact, fear of a pandemic might be worse than the virus itself, both for its effects on the economy and for the social breakdown that could result - children orphaned by flu in 1918 starved when people refused to care for them. Don't make things worse by taking extreme measures if a pandemic virus turns out to be only slightly worse than normal flu.

But there is no doubt that if you think you might be infected, you should go to bed and stay there. Don't risk infecting others. Remain in bed for a week or two after recovery to avoid post-flu complications.

Don't flee the city

Unless you are lucky enough to have an isolated, self-sufficient country house, fleeing the city will not help. A mass movement of people will carry the virus with it, and you will be far worse off if you end up in a crowded shelter.

In any case, even remote places are unlikely to escape. Studies suggest that 98 per cent of people alive in 1918 were exposed to the pandemic virus. A few small islands managed to keep the virus out by shutting their borders, but hardly anywhere else avoided infection.

The high-risk strategy

Trying to avoid infection makes sense if you assume the pandemic will be over in a month or two, or that a vaccine will soon become available, so you'll be safe when you emerge. But the virus could circulate for many months, and the second or third waves might be worse than the first, as happened in 1918.

An alternative strategy is to get infected early on, before the healthcare system is overwhelmed and antivirals run out. If you survive, you'll be immune. But you'll be gambling with your life.