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Doctors Might Abandon Nation in Pandemic, Study Warns

July 27, 2009 06:00 PM
by Jill Marcellus
As swine flu preparations reach fever pitch, a new study warns that health worker defections might undermine pandemic response plans.

Doctors with Borders

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Roughly one in six public health professionals would not answer the nation’s call during a pandemic flu crisis, according to researchers from the Johns Hopkins Bloomberg School of Public Health.

The study, which determined that 16 percent of workers would be unwilling to “respond to a pandemic flu emergency regardless of its severity,” represents an improvement over the research team’s 2005 findings. In their previous study, they found that a flu pandemic would deter 40 percent of public health employees from showing up to work, ScienceDaily reported.

Despite the two studies’ vastly different results, the researchers conclude in both that willingness to work in a pandemic relates to the importance of a particular job. According to the Johns Hopkins team, “public health workers who were both ‘concerned’ about the threat posed by a pandemic, and who were ‘confident’ that they could fulfill their response roles and that their roles would have a meaningful impact on the situation, were 31 times more likely to respond to work in an emergency than those who perceived the threat low and had low levels of confidence.” The 2005 survey correspondingly found that technical and support staff were the least likely to report to work during an outbreak.

Dr. Jonathan Links, a professor at the Bloomberg School, emphasized the study’s importance to emergency planning. According to Dr. Links, it “points the way towards specific interventions—those that increase both concern and confidence—to increase willingness to respond.”

Both studies, it should be noted, were limited in scope. In 2005, the researchers surveyed just 308 public health workers in Maryland, while the recent study used an online survey to gather under 2,000 responses from Minnesota, Ohio and West Virginia.

Mixed Precedents

Similar concerns have arisen before. The SARS outbreak revealed the vulnerability of Canada’s emergency response system, and focused global attention on the ethical dilemma faced by front-line responders, who have to weigh their own and their family’s health against the public good.  According to a report in the journal Critical Care, poor communication contributed to the low morale among health care workers in Canada, and “some refused to even enter wards containing SARS patients.”

American emergency response plans have also undergone severe scrutiny in the past decade, particularly in light of the government’s handling of the Sept. 11 attacks and Hurricane Katrina. Although health care workers and volunteers from other states assisted in the New Orleans relief effort, nearly 250 police officers failed to report for work, as the BBC reported.

Still, some experts believe that alarm is overblown. Jane Kushma writes in the Natural Hazards Observer, published by the University of Colorado at Boulder, that there is little historical support for the “role abandonment myth.” She insists that with the exception of the New Orleans police defection, which may have been partly due to transportation issues, “there have been no documented reports of widespread role abandonment during disasters in the United States.”

NEXT: British Strategies Against Swine Flu Instructive for a U.S. Outbreak
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