Battling the bird flu: HMEs on the frontline

WASHINGTON - If the deadly bird flu breaks out in the United States, the $64,000 question is: What role, if any, will HMEs and other homecare providers play? U.S. Health and Human Services Secretary Mike Leavitt believes the role will be a large one. At a National Press Club Forum in April, Leavitt said "home health care providers will provide critical services during an influenza pandemic." The secretary specifically mentioned the need for ventilators. But if the bird flu hits the United States, the thought of HMEs delivering equipment also conjures up the possibility of technicians spreading the illness as they go from house to house. "It's a concern," said Sam Clay, president of Clay Home Medical in Petersburg, Va. "The main thing is not to spread it, and there is some limit to what you can do. If you have a lot of staff out sick, it will affect everything." Having a lot of staff out sick is not out of the question. If a pandemic the scale of the 1918 Spanish flu were to break out now, Leavitt said, "45 million Americans would become sick enough that they would require some kind of serious medical attention, whether that was a clinic visit or a hospital stay. Regrettably, roughly 2 million people would die." If the bird flu strikes to the degree Leavitt predicts, hospitals will be overflowing with those sick with the flu. In that case, it's likely that some patients will be discharged to the home early to make room for the afflicted. If that happens, said industry consultant Wallace Weeks, homecare providers will have to choose between helping out or quarantining themselves at home out of harm's way. Most, he predicted, will feel obligated to help. "That is their life, to help others, and sometimes to their own detriment," he said. Given a doomsday scenario, another provider, who asked not to be identified, said: "I'm going to wear good expensive masks--my whole family will be in those things--and I'm not coming out the door until I know it is safe."