A post at Energy Bulletin recaps a recent presentation at the
Johns Hopkins University Bloomberg School of Public Health, in
conjunction with the Centers for Disease Control and Prevention.
href="http://www.energybulletin.net/node/48895">The post is U.S.
public health community begins discussing peak oil.
The presentation was:
href="http://www.jhsph.edu/preparedness/events/eventscalendar.html">Peak
Oil: Implications for Disaster Preparedness & Response (the
link goes to the event calendar, so it probably won't be valid after a
while. The archives are
href="http://www.jhsph.edu/preparedness/events/archives/index.html">here,
although the event hasn't yet made it to the archives.) The PDF
versions of the presentation slides are
href="http://www.jhsph.edu/preparedness/events/Peak_Oil_and_Health/Peak_Oil_and_Health_Slides">here.
The Energy Bulletin post highlights some of the major
issues. The main point is that mainstream public health folks are
taking this very seriously, but still are in the early stages of
analyzing the problems and figuring out what to do. The post is
fairly terse, so there is not much point in providing excerpts
here. What I will add, is some of the highlights from the
presentation slides that got my attention.
In Daniel J. Barnett's
href="http://www.jhsph.edu/preparedness/Images/Peak_Oil_and_Health_Slides/Bednarz_Color_slides.pdf">talk
(PDF link), he reminds us that in the 1973 oil crisis, there were
shortages of ethylene and benzene. So what? These are
precursors to many of the disposable plastic items used in
hospitals. There were, in fact, shortages of syringes.
These items are used because they are disposable, therefore
sanitary. Does anyone have a stockpile of glass syringes, the
ability to sterilize them in large numbers, and even the skills to use
them efficiently? How would reversion to this old technology
impact needlestick prevention practices? How would the workflow
be affected, especially in the face of a pandemic? This reminds
us that there is a real risk of acute shortages in the near future.
Only 74% of physicians responded (in a survey) that they would be
willing to come to work if there were an avian influenza
pandemic!!! The percentages were lower for nurses, and even lower
for other workers.
I suppose the dermatologists could stay home, but that number
astonishes me. (I have nothing against dermatologists: when you
need one, you are glad they are around).
He discussed some of the obvious things, such as the potential for
transportation problems in rural areas, the problems with the lack of
surge capacity in Emergency Departments, and the already high rate of
ambulance diversion to other hospitals because of ERs that are full.
He stressed the fact that psychological preparedness would likely
suffer in the face of a crisis, even more than usual, in the face of a
shortage of petroleum products. The only thing to do about that,
is to start preparing, psychologically, right now.
He also discussed the ethical issues that will arise. Mostly,
this has to do with old problems of rationing resources. The
thing about that, is that most people are not accustomed to thinking
about it in depth. They do not realize that health care already
is rationed.
He links to the Johns
Hopkins preparedness website, which is worth noting.
There were several other presentations, that I haven't gotten through
yet. More to come on this topic.
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"I suppose the dermatologists could stay home, but that number astonishes me."
Which reminds me of a question I've been meaning to ask someone for a long time: Aren't dermatologists (or psychiatrists, or neurosurgeons, or gynecologists, or pediatricians) generic physicians as well? What I mean is, they may each have their own specific specialties but they've all studied medicine, done internship rounds and can do "general" medicine as well if need be?
So during a pandemic, could not a dermatologist still handle a lot of non-skin related medicine and could they not bring themselves up to speed on the specific crisis-related medical issues in fairly short order? Or is each specialization so far removed from any non-related field that after some years people really no longer can function as general physicians any more? Should the distress call "Is there a doctor in the house" be replaced by something more specific along the lines of "Quick, is there a geriatric emergency pulmonary cardiologist in the house? Anyone? Anyone at all? Oh wait, forget that; is there a pathologist in the house? No hurry."
An oil interruption would affect health in an immediate fundamental way. In a very short period people would get hungry. Almost every prescription drug has a hydrocarbon content. Our very bodies at this stage in time is probably supported in the flesh with 90% hydrocarbon generated food production or more. Peak oil also brings the flue to me on wings of aluminum and carbon fiber very quickly. A man died not far from me in Snohomish from the new Swine Flue. This flue was probably generated and released accidentaly in a lab that was studying flue changes.
Janne:
All doctors go through four years of medical school, and the vast majority do one year of general internship. This enables them to function as general practitioners. That does not necessarily qualify them to do specialized work. For example, people with very severe influenza might need to be placed on a ventilator (breathing machine). You definitely would want a specialist to handle that.
After the internship, most doctors do 2-3 years of residency. Some then do 1-2 years of a fellowship. In many programs, the internship and residency are somewhat integrated.