I wonder if this is the answer to the desire for early warning: Google Flu Trends.

Jesselp- Got something like this when I was still nursing and sips of water wouldn't stay down so taking an OTC anti-diarrheal was out. ER admitted for IV fluids and a Compazine suppository.

As you noted, this can hit and debilitate very quickly. We all need to think about what to have on hand to deal with this.

Realistically speaking I don't see any way for preparing against such a pandemic. Regardless of all the technology and communication possibilities of our age there simply won't be enough advance warning for most people, especially those in urban areas.

Also, don't forget the incubation period. Most infections only manifest themselves some time (usually a few days at least) after you've been infected. Which means that you may well be carrying and spreading a highly contagious disease right now without even knowing!

I can easily relate to the first post - for a few days now I have had to care for my family because everybody's caught a bad flu. It is pretty tough having to go to work every day, then take care of all the chores, eventually drive a sick kid to the hospital in the middle of the night... Repeat several times over the past four days and you'll know how I feel. It's only a matter of time before I get sick, too - only I can't afford to as I have some very important obligations at work next week. Really a crapshoot at its finest.

What I've learned over the years is that there is not much you can do about it. Everyone can get sick. You can however take a few precautions which might not prevent infections or diseases per se but at least they will make the recovery that much faster and easier:
- eat well, avoid junk food, strive for a balanced, natural diet
- avoid excessive coffee, alcohol or tobacco consumption
- work out! very important - good physical fitness is extremely important as it makes you more resistant to infections and if you get sick anyway, it probably won't last as long
- get enough sleep and rest, goes for your mental state, too (stress is bad)
- don't take pharmaceutic products, especially antibiotics or painkillers, unless absolutely necessary; your body may get used to them if you overdo it and they won't work when you'll really need it.

I couldn't emphasize the fitness part too much. This year I had Lyme disease. The first round of treatment was ineffective so the symptoms got worse and I had to take IV antibiotics. That treatment itself was tough. If I weren't in a decent shape before it all began I'm sure it would've taken even longer to get back up on my feet again.

you beat me to it

Great post, and very sobering. A pandemic is definitely a poop sandwich: no matter how you take a bite, it's going to be unpleasant.

Another factor to consider is how easily our healthcare system can be overwhelmed by a large scale public health disaster. It doesn't take long to run out of beds, and I can tell you with certainty that a non-trivial percentage of healthcare workers are not going to show up for work during a pandemic.

These are good thoughts - annual flu vaccine is the best bet you have against a possible pandemic. But remember, the very definition of a pandemic is a strain of influenza to which you have no resistance, and in the even the dice roll and the wrong strain of flu comes up, whatever immunizations were available that year are unlikely to provide very much protection. There is a period after detecting the actual strain while they are preparing a new vaccine, when everyone will be entirely exposed. Once the vaccine is prepared, the question will be how much, and who will get it. Current plans are to give it first to those who are caring for the sick, medical staffs etc, then also the target populations, those who are dying most from it. This seems to vary, sometimes it is the young, sometimes the old.

Pandemic always makes me think of panic, of which there is plenty during the actual pandemic. The better prepared you are for what may come, maybe the less panic you'll feel. I recommend reading up on it, the CDC has some good info too, and the Canadian health services has some especially good materials. Barry's book on the 1917 Great Influenza is pretty good, it even puts the pandemic in the context of the development of modern American medicine, which in point of fact hadn't actually happened by 1917.

Thanks for sharing your personal scenario, Jesselp. Many aspects of interest (and maybe a little alarm) here. Definitely makes me think differently about equipping for sickness, let alone a widespread pandemic.

The Google Flu Trends site is a good tip, Doug. (It's also a reminder of Google's ability to mine data and to collaborate with third parties.)

Unfortunately, a pandemic is like trying to call the start of a recession--you really don't know for sure except in hindsight. I appreciate your comments.

I was going to say that your comments also apply to bioterrorism (another legitimate concern in NYC), but in some ways, it's even harder to identify a pandemic early. With bioterror, you could be dealing with specific, identifiable diseases or agents, like "weaponized" anthrax, which you normally wouldn't find in nature. A real bioterror weapon would likely quickly kill many people. There may also be public announcements from terror groups related to the attack.

In contrast, a pandemic is more like rising floodwaters. Sure, it may be obvious that water is lapping at the bottom of your front steps now while you sit there watching it, but at what point do you say, "Yikes, it's really a flood!" The death rate from Spanish Flu was "only" estimated around 2-5% so the resulting deaths may only seem sporadic in the early stages and even when those reports come out, it may not be obvious to people that this outbreak is truly a problem for a while longer.

Public health officials have a tough job on their hands. Unlike hurricane forecasters, who have this realtime picture of a hurricane on a computer screen, the biggest problem is just knowing about various illnesses happening in their jurisdiction. Hard to get a bird's eye view when you're dealing with hospitals, clinics, and private doctors' offices which don't necessarily share any data with you, especially on a timely basis. Then there's the delicate balancing act of not crying wolf and unnecessarily causing panic. Of course, they get skewered if something bad happens and they don't warn the public early.

Even on a personal level, how does one really know when they or their family is stricken? Say the pandemic is some deadly strain of influenza. Flu season usually involves multiple flu strains. You feel that scratchy feeling in the back of the throat, that slight headache, that midnight bout of the runs--is this it? Or is it just a normal bug that you picked up at work? Or is it another innocuous illness? Do you blow your limited supply of antiviral meds that you somehow obtained in preparation? Do you immediately take some vacation time and head to the vacation cabin? Hard to know for sure at that stage.

Although we like to think that we are modern and smart and have all this technology, a pandemic is just one of those situations that is very difficult to identify until you're in the thick of it. If we're "lucky", it causes a big problem in another part of the world first, giving us time to evaluate and prepare.

One last thing--although I can certainly understand the bug-in/bunker mentality, in general, I think we are usually far better off trying to help one another in various calamities than just disappearing in a dark hole until the smoke clears. But that's more of a moral/philosophical point than a survival strategy.

Theoretically, you can prepare for a pandemic. Realisitically, unless you are already practicing isolation from public contact, you are not going to prevent infection.

Give it another 50 years or so, when nanite technology advances enough to where we can receive an innoculation of bug-killer robots that will last a lifetime and go after viruses and bacteria inside the host.

Good topic.

I had a bout with some Norwalk-like virus a couple of months ago. It knocked me down and put the boots to me in less than two hours.

With a pandemic, we may get some early warning from hotspots in Asia. No guarantees, but people are watching for this very closely.

For me, that would be the cue to limit public exposure and use all reasonable infection control measures. Commercial air travel can bring the pandemic just about everywhere within days.

My big worry in a pandemic is that other family members (esp. elderly parents) will be deathly ill. I'd have to go out and help despite the risk. There's really no other option I'd be willing to live with.