Jamaica's already fragile public-health system could be severely burdened if there is an outbreak of the bird flu, which some health experts predict could occur by next year.

"The nature of the impact will depend on the severity of the pandemic," said Allan Wright of the Department of Management Studies at the University of the West Indies.

He was one of several persons speaking at a recently concluded Caribbean Community Pandemic Influenza Workshop, held in Kingston.

Wright told participants that an outbreak will result in excessive demand for health services, which invariably will lead to the overcrowding of health institutions.

He said an anticipated 10 per hospitalisation rate among infected workers would be very high. Also of concern is the potential hospitalisation rate among the young (0-14 years) and the elderly (65+ years) - totalling about one million persons - which would be considered high-risk cases.

According to Wright, the island's hospitals have a combined bed capacity of 4,846, with just over 50 per cent being occupied under normal circumstances.

"With 34 hospitals and 348 health centres spread across the country, and the highest concentration of facilities in the Kingston Metropolitan Area, the critical issue is whether the sector has enough capacity to cope with the huge inflow of persons that will require care," he continued.

Workforce worries

He said a study, which was conducted jointly with Diaram Ramjee Singh of the UWI, estimates a 17 per cent infection rate among the island's workforce, which means 189,000 members of the labour force would become ill.

"If five per cent of them require hospitalisation within our public health-care services, we will not have enough bed capacity within the system to accommodate those 9,000 persons," he stated.

Wright said the estimates will become larger if more members of the population are infected.

"Our resources will not be enough to accommodate these numbers, even with the use of private facilities islandwide," he revealed.

He said the Government needs to develop a disaster plan to help marshal additional resources, both locally and internationally, towards assisting in the hospitalisation and care of sick individuals as a result of an influenza pandemic.

Major flu pandemics have occurred three times over the last century, beginning with the Spanish flu in 1918, then the Asian flu in 1957 and the Honk Kong flu in 1968. Scientific experts suggest that major pandemics have a 10-40-year cycle.

While vaccination can limit the number of persons who are likely to become infected with the flu virus, it is expected that a significant number of persons will become ill and require hospitalisation if an outbreak occurs.

The recently concluded Caribbean Community Pandemic Influenza Workshop brought together more than 100 persons from several countries in the region to examine gaps in pandemic influenza preparedness among CARICOM nations and discuss potential solutions.

Public-health concern

The availability of safe drinking water during an outbreak is also a major public-health concern which governments in the region are being urged to address.

Dr Thomas Costa of the National Defence University's Center for Hemispheric Defence Studies says it is worrisome that the national water supply of most Caribbean countries are electricity-operated.

With predictions that a significant portion of the region's labour force will be absent from work for prolonged periods due to illness during an outbreak, Costa said regional governments should be using water supply and treatment plants that are able to operate without electricity and without manpower.

He says Grenada is probably the only Caribbean island that has a national water supply system which uses gravity instead of electricity. In addition, he said countries need to have a reserve capacity for storing water in the event the main water system is unable to functional for extended periods or if the water supply becomes contaminated.