Bird flu victims may be forced to fend for themselves

When the next pandemic of killer influenza finally strikes, hospitals are expected to be so stretched they will handle relatively few cases of the feared disease.

Likewise general practitioners expect to be short-staffed and do not anticipate routinely handling cases at their clinics.

"There will be mass home treatment," Dr Jonathan Fox, president of the College of General Practitioners, said yesterday.

"Self-management and self-reliance will be the cornerstone."

Medical Association GP council chairman Dr Peter Foley said it was likely doctors would make every effort to work during a pandemic, but their first obligation was to their own health.

A 2003 Health Ministry report on the Sars outbreak suggested that if a patient died after a doctor failed to provide care, he or she could be charged with homicide. But the ministry also states that health workers cannot be required to work during a pandemic.

To handle pandemic flu patients, the ministry and district health boards are considering setting up community-based assessment centres in many areas, possibly in schools or other community facilities closed for the duration of a pandemic.

The ministry's National Health Emergency Plan: Infectious Diseases estimates New Zealand has sufficient capacity, including in hospital morgues, to handle the deaths resulting from an infection rate of 35 per cent. Incidence rates of 15 to 35 per cent have been used in modelling of future pandemic scenarios.

Virus experts say the world is overdue for a pandemic of a new strain of influenza. It could arise from the current H5N1 bird flu that has led to the deaths of millions of birds in Asia.

- additional reporting: Moana Burt