Flu

Were civil defense to receive as much attention as the threatened Asian flu epidemic in this country, there would probably be fewer gray hairs and ulcers in the Civil Defense Administration. Yet Americans are preparing for a disease, whose fatal effects will be negligible, with more Boy-Scout-brand energy than they have ever devoted to the nuclear peril.

Nineteen states have already established flu advisory councils; the Red Cross is advertising home nursing courses especially for the feared onslaught; confused priority and quota systems for vaccine distribution are being mulled over by local and national health authorities; and a small vaccine black market is in operation.

Judging by these somewhat frantic goings-on, an observer would think that a major catastrophe was about to occur. Asian flu, however, need not be a disaster at all. Scientifically, its symptoms are runny noses, back and head aches, sneezing and muscular pains. A Harvard medical official described it a little more poetically, as "a feeling that the world has left you behind."

The fatality rate among those who contract it, and one authority predicts that one out of four Americans will, will be only about .005 per cent. In Asia the highest incidence of deaths was reported in the extreme age groups--young children and old people. In America deaths are expected to range between two and twenty thousand, and only one in a hundred cases will require hospitalization.

The feverish preparations, were they better coordinated, might be able to improve the outlook even more. The Department of Health, Education, and Welfare and the Surgeon General's Office, however, show little desire to control the situation nationally. The latest pronouncement of the Public Health Service asks that vaccine production be geared to state and local quotas, rather than to a centralized distribution system. In effect, distribution will be governed not by a manufacturer's ability to produce but by the limited demand in his area. Thus, heavily populated areas with too few vaccine producers will not have access to the facilities of medical suppliers in areas where demand falls below production capacity.

Even the priority systems in adjacent areas will probably not be co-ordinated. Consequently, one town may provide vaccine for all its municipal employees and another only for medical people who are liable to come into close contact with the disease. No system has been set up to exchange the crucial services of such groups between towns.

Vaccine production, itself, shows no signs of direction or control. Estimates vary from 60 million shots ready by Feb. 1 to 85 million by Dec. 31, but there is so little collaborative effort in this field, too, that only 6.9 million have been made available to date. Furthermore, the possibility that children may need special types of vaccination has been largely ignored.

The vaccine, even if produced in large enough quantity, will be largely ineffective unless distributed soon in the most vulnerable areas. As a dosage requires seven to ten days to provide immunity, it is useless in an area where numbers of cases have already appeared. Most logically, the vaccine would be distributed in seaboard areas, where the flu hits first, but there seems to be little or no central logic governing flu preparations.

So far in the United States the majority of the flu cases have been reported in coastal or port areas--California had 25,000 cases by August 17, Houston, Dallas, and New York City have both reported what are still minor outbreaks, Louisiana and Mississippi have a total of 45,000. No cohesive attempt, however, has or can be made to distribute vaccine on a geographical basis, starting at the oceans and working inland.

Another difficulty in stemming the disease is the difficulty in diagnosing it rapidly before it has spread. If every case of the sniffles were isolated for the three days required for accurate analysis, most American businesses, schools, and federal agencies would have to shut down.