In the Case
of an Outbreak of Pandemic Flu, Large Majority of Americans Willing to Make Major
Changes in Their Lives
Survey
Also Finds Many People Would Face Critical Work-Related Problems
Thursday,
October 26, 2006
Boston,
MA -- The latest national survey conducted by the Harvard School of Public
Health (HSPH) Project on the Public and Biological Security finds that when
faced with a serious outbreak of pandemic flu, a large majority of Americans are
willing to make major changes in their lives and cooperate with public health
officials' recommendations.
However,
the survey also finds that a substantial share of Americans would have no one
to care for them if they become ill or would face serious financial problems if
they had to stay home from work for a week or more.
Pandemic
flu is a term used to describe a virulent human flu that causes a global outbreak,
or pandemic, of serious illness. Because there is little natural immunity, the
disease can spread easily from person to person.
Currently,
there is no pandemic flu, but health officials are concerned that the H5N1 avian
flu which has caused about 250 illnesses and deaths among people in Asia, Africa,
and Europe could become a pandemic flu. No humans or poultry in the Americas have
been infected with this avian flu virus.
This
HSPH survey was conducted to help public health officials in planning for a possible
outbreak of pandemic flu and was presented Thursday, Oct. 26 in Washington, D.C.
at an Institute of Medicine workshop: Modeling Community Containment for Pandemic
Influenza. HSPH Professor Marc Lipsitch also presented historical analyses
of interventions in the 1918 pandemic, comparing cities that intervened early
and those that intervened late, to assess the difference in epidemic curves in
these groups of cities.
This
is the first report to attempt to tap the public's intentions when faced with
the specific circumstances of an outbreak. The people interviewed were first read
the following scenario about an outbreak of flu that spreads rapidly among humans
and causes severe illness:
Now
I want to ask you some questions about a possible outbreak in the U.S. of pandemic
flu, a new type of flu that spreads rapidly among humans and causes severe illness.
Currently there have not been any cases of pandemic flu in the U.S. However, imagine
that there was a severe outbreak in the U.S. and possibly in your community and
a lot of people were getting very sick from the flu and the flu was spreading
rapidly from person to person.
They were then asked how they would respond to and be affected by the circumstances
that would arise from such an outbreak.
Willingness
to Cooperate with Public Health Recommendations
More
than three-fourths of Americans say they would cooperate if public health officials
recommended that for one month they curtail various activities of their daily
lives, such as using public transportation, going to the mall, and going to church.
More than nine in ten (94%) say they would stay at home away from other people
for seven to ten days if they had pandemic flu. In addition, 85% say they and
all members of their household would stay at home for that period if another member
of their household was sick.
Nine
in ten Americans (90%) say that if public health officials recommended that they
and the other members of their household stay in their town or city, they were
likely to stay.
These
findings speak to the resilience of the American public in the face of a potential
health crisis, said Robert J. Blendon, Professor of Health Policy and Political
Analysis at the Harvard School of Public Health.
The
area where anticipated cooperation is lowest involved the workplace. While
a majority (57%) of employed adults say they would stay home from work if public
officials said they should, even if their employers told them to come to work,
about one-third (35%) say they would go to work.
More
than eight in ten Americans (85%) say they would be able to take care of sick
household members at home for 7 to 10 days, if public health officials recommended
it. However, about three-fourths (76%) say they would be worried that if they
stayed at home with a household member who was sick from pandemic flu, they themselves
would get sick from the disease.
Nearly
three-fourths (73%) say they would have someone to take care of them at home if
they became sick with pandemic flu and had to remain at home for seven to ten
days. However, about one in four (24%) say they would not have someone to take
care of them. More than four in ten people living in one-adult households (45%)
and about one third of low-income (36%), African-American (34%), disabled (33%),
and chronically ill (32%) adults say they would not have anyone to take care of
them if they were sick and had to remain at home that long.
A
substantial proportion of the public believes that they or a household member
would be likely to experience various problems, such as losing pay, being unable
to get the health care or prescription drugs they need, or being unable to get
care for an older or disabled person, if they stayed at home for seven to ten
days and avoided contact with anyone outside their household.
School
Closings
If
schools and daycare were closed for one month, 93% of adults who have major responsibility
for children under age 5 in daycare or age 5 to 17 and have at least one employed
adult in the household think they would be able to arrange care so that at least
one employed adult in the household could go to work. Almost as many (86%) would
be able to do so if schools were closed for three months. However, six in ten
(60%) say that at least one employed person would have to stay home if schools
were closed for a month.
Only
one-fourth (25%) of employed people who have major responsibility for children
under age 5 in daycare or age 5-17 in their household say that if schools and
daycare closed for one month, they would be able to work from home and take care
of the children.
More
than nine in ten (95%) adults with major responsibility for children age 5 to
17 report that they would be willing to give school lessons at home if schools
were closed for three months.
More
than eight in ten (85%) of these adults also think that if schools were closed
for three months and public health officials recommended it, they would be able
to keep their children and teenagers from taking public transportation, going
to public events, and gathering outside home while schools were closed.
"A
surprisingly large number of people would be able to keep their children home
and away from others if schools closed during a severe pandemic," said Blendon.
About
six in ten (64%) of these adults would need only a little or no help at all in
order to deal with the problems of having to stay home and keep children at home
for a long period of time. Of those who say they would need a lot or some help,
half (50%) would rely most on help from family, 11% on friends or neighbors, and
34% on outside agencies.
The
survey asked employed Americans about the problems they might have if they were
asked to stay out of work for seven to ten days, a month, and three months because
of an outbreak of pandemic flu in their community.
The
longer people are out of work, the greater the number of people who will face
financial problems. While most employed people (74%) believe they could miss seven
to ten days of work without having serious financial problems, one in four (25%)
said they would face such problems. A majority (57%) think they would have serious
financial problems if they had to miss work for one month, and a total of three-fourths
(76%) think they would have such problems if they were away from work for three
months.
Only
about three in ten (29%) say that if they had to stay away from the workplace
for one month, they would be able to work from home for that long.
Employed
Americans were also asked about their current employers plans and policies for
dealing with an outbreak of pandemic flu. Few working people (19%) are aware of
any plan at their workplace to respond to a serious outbreak of pandemic flu.
About one in five employed adults (22%) are very or somewhat worried that their
employer would make them go to work even if they were sick. Half (50%) believe
that their workplace would stay open if public health officials recommended that
some businesses in their community should shut down. Only about one-third (35%)
of employed Americans think that if they stayed home from work, they would still
get paid; 42% think they would not get paid, and 22% do not know whether they
would get paid or not.
"These
findings are a wake-up call for business, that employees have serious financial
concerns and are unclear about the workplace plans and policies for dealing with
pandemic flu," said Blendon.
Methodology
This
is the 25th in a series of studies by the Harvard School of Public Health Project
on the Public and Biological Security. The study was designed and analyzed by
researchers at the Harvard School of Public Health (HSPH). The project director
is Robert J. Blendon of the Harvard School of Public Health. The research team
also includes John M. Benson and Kathleen J. Weldon of the Harvard School of Public
Health, and Melissa J. Herrmann of ICR/International Communications Research.
Fieldwork was conducted via telephone for the Project by ICR/International Communications
Research of Media (PA) between September 28 and October 5, 2006
The
survey was conducted with a representative national sample of 1,697 adults age
18 and over, including an oversample of adults who had children under age 18 in
their households. Altogether 821 such adults with children were interviewed. In
the overall results, this group was weighted to its actual proportion (38%) of
the total adult population.
The
margin of error for the total sample is plus or minus 2.4 percentage points.
Possible
sources of non-sampling error include non-response bias, as well as question wording
and ordering effects. Non-response in telephone surveys produces some known biases
in survey-derived estimates because participation tends to vary for different
subgroups of the population. To compensate for these known biases, sample data
are weighted to the most recent Census data available from the Current Population
Survey for gender, age, race, region, and education. Other techniques, including
random-digit dialing, replicate subsamples, callbacks staggered over times of
day and days of the week, and systematic respondent selection within households,
are used to ensure that the sample is representative.
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