Your job is to be a politician making decisions about policy as regards to the pandemic. Stopping the pandemic is not necessarily your first priority! People sick and dying are bad for re-election—but so is unnecessary economic disruption. Some questions you may need to answer might be:

What disruptions to trade/tourism/business will the pandemic cause? What disruptions would panic over the pandemic cause? What is the trade-off you would make? What policies will you set to try to keep the disease and/or panic under control. Scapegoats are common in these situations—will you try to prevent blame, or will you try to encourage it (often very useful for gaining political power)?

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(This disease is very similar to Ebola)

Based on the facts in this scenario and the answers to the questions at the end of this scenario write down your political strategies regarding how to solve the problems of the outbreak.

SCENARIO:

In northern Alaska, five members of an oil-drilling crew develop symptoms of a severe flu. The company infirmary attempts treatment but when one of the crew begins vomiting blood the decision is made for them to be evacuated to a hospital in Anchorage. One person dies on the airplane; two others die in the hospital. All of the patients show signs of internal bleeding, and most show bleeding in the eyes. The dead patients also bled copious amounts from the eyes, nose, mouth, and rectum. The remaining two recover and are sent back to their homes; one in Seattle and the other in Samoa.

A sixth member of the crew left on vacation two days before the symptoms developed. He went to Manila to visit his grandparents. While there, he decided to get a tattoo at a spot popular with sailors, tourists, and other international visitors. The tattoo parlor is busy—so busy that the tattoo artist doesn’t have time to sterilize the needles between clients.

Soon outbreaks of this disease, dubbed “Alaskan Hemorrhagic Fever” or AHF, are seen in the Philippines, Samoa, Hong Kong, and the United States. Currently, 200 people have fallen ill and 96 have died.

STATS:

R0 of AHF = 1.2

Average serial interval = 5-7 days

Mortality rate = 60%

Treatment availability = None

MONKEY WRENCH:

Two months into the outbreak, Harborview hospital in Seattle reports to the CDC that they have identified five patients with AHF that apparently have had no direct contact with any other AHF patient. They don’t know how these patients caught the disease, but suspect that either the virus has mutated to become airborne, or else the virus can live outside the body for much longer, and can be spread by fomites much easier, than previously known. Based on this, the CDC is tentatively revising their R0 estimate to 3.

Questions and Answers:

• Did 6th member of crew spread disease to his grandparents?

His grandparents were among the dead in the Philippines outbreak.

• Why were two members well enough to recover at home?

Because the mortality rate is 60%–those were the two lucky ones.

• Have the people who treated them shown symptoms?

Yes, one of the nurses and one orderly in Anchorage fell sick. In addition, two people that helped wash and sterilize hospital equipment were among the ill.

• Were they on a private plane coming home?

No, they flew commercial. However, they were not released until they were fully symptom-free, and no one on the flight has reported symptoms. However, the Samoa cluster began with the girlfriend of the crewmember.

• Where else in the US has shown outbreaks?

Seattle had 25 cases (before the recent development), though none were traced to the original crew. This outbreak seems to have been started by a traveler recently returned from Samoa. It has also been seen in Dallas (3 cases), San Francisco (12 cases), and Chicago (5 cases). There was also a reported case in rural Arkansas, but so far has not caused a cluster. All of these so far have been traced back to Seattle.

• What are the symptoms that occur early in the disease?

The early symptoms include a mild fever, headache, fatigue, and occasionally nausea though vomiting is rare until day 5-7. Red eyes are commonly seen as soon as 3 days post exposure, and some patients report seeing traces of blood when they blow their nose.

• Have any other oil crews in Alaska fallen ill?

No, no other crews have reported symptoms. This crew had actually been sent out to a new location where they dug test wells in the permafrost to check for possible new drilling locations.

• How are other pandemics treated?

Depends on the disease. This one should remind you of something…looking at the response to that may give you some ideas.