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Expert: Public response determines spread

LAKEWOOD RANCH — The public will determine if swine flu becomes a pandemic, a nationally recognized expert insists.

Linda Spaulding, an infection control consultant and owner of InCo and Associates in Lakewood Ranch, says that if people follow prevention advice, the spread can be contained and the severity of the outbreak lessened.

If they don’t, we could be facing a pandemic that will greatly impact the global economy.

Controlling germs is Linda Spaulding’s business. As a certified infection control specialist, Spaulding trains staff at hospitals and health care facilities throughout the world on how to keep their facilities safe.

She returned last week from helping a hospital in the San Diego area gear up for an outbreak of swine flu. Now back home in Lakewood Ranch, she is making sure her hometown hospital is prepared should an outbreak occur here. She met late last week with a Herald reporter to discuss the situation.

Some experts have speculated that the U.S. strain of swine flu is less virulent because we have only one death so far as compared to more than two dozen in Mexico. Do you agree?

I don’t think we have had enough cases yet to know if we are going to have more deaths. Mexico had over 500 cases before people started dying. If the volume of cases grow here, so will the death toll.

Do you expect to see a rapid increase of cases?

As the volume of cases grows over the next couple of weeks, we will see if it is going to get worse or level off. It’s not going to go away anytime soon. It will spike at some point. Whether it spikes tonight or in two weeks or two months, we just don’t know.

What variables will decide what course swine flu takes?

We will know two months from now how good our prevention efforts have been. If people stay home when they are sick, if they wash their hands, if they cover their mouths with a tissue when they sneeze and then throw it away, that will make a difference. Everybody worldwide has to participate. It’s the general public that will contain it or not.

Do you think that message is getting through?

I hope so, but many people are not willing to stay home; some employers are not willing to let workers stay home when they are sick. The general public has to realize their decisions will determine how serious an outbreak we have. I hope it just burns out like the SARS epidemic did a few years ago, but experts are predicting that we could have more than 1 million people sick if this reaches the pandemic stage.

Are the numbers we are hearing a true reflection of what is happening?

Not necessarily. Some people may be sick and just staying home and treating this themselves and not getting tested. The Rapid A and B swab test used in doctors’ offices has only a 60 to 70 percent reliability rate. That test is not 100 percent. We may be missing people in initial screening.

Have you seen an uptick in patients with flu-like symptoms at Lakewood Ranch Medical Center?

No, as of Thursday we had done 17 cultures over five days, all were negative.

Should the public be wearing masks?

It may give some people some peace of mind or comfort to wear a mask, but you have to remember that even surgical masks we use in the hospital are only good until they get wet. If a mask gets wet, it is no longer effective. It must be changed.

When an infected person sneezes, how long can the influenza virus in the droplets released with the sneeze survive?

Influenza can live on counter tops for up to 24 hours. It is very easy to transmit. That’s why we are so concerned. Consider that this is a combination bird, swine and human virus never before seen in humans. There is no vaccine yet. The Centers for Disease Control are working on one and one may be available in four to five months, but I think it will take longer. And during that time we are still going to get reported cases. We are going to be getting reported cases for a long time.

What is your working relationship with public safety officials at Manatee County?

We are set up to work directly with the county’s EOC (Emergency Operations Center). We are already having briefings.

How prepared are we?

I can only speak for Lakewood Ranch Medical Center. We have brought in a lot more supplies and we have been checking with our vendors, but many are back-ordered by seven days in this area. If we were to have an outbreak that would bring in 100 people over the weekend, our stockpile of supplies would go quite fast. We have to be prepared to restock quickly, but if you have everybody trying to get supplies from the same vendors that could be a problem.

Do you think the general public understands what is happening?

People need to wrap their minds around the fact that thousands of people could be sick at the same time. That’s a hard thing for us to do. A lot of people can’t fathom that.

Is our health department doing all it can do?

They are doing as good as they can, considering their resources. People are very resourceful. We will get through this. It will work out in the end. You do what you have to do, but the people have to understand that what happens will depend on the decisions they make. The outcome is in the public’s hands.

Have you ever been through something like this before?

No, nothing like what we may be heading for if this turns into a pandemic. I don’t want to panic people, but I don’t want people to think that this is an everyday kind of event. We’ve been saying for a long time that this is coming. We know we are due for a pandemic. This may be it or it may disappear, but we have to be ready.

Donna Wright, health and social services reporter, can be reached at 745-7049.

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