Would people stay home with flu?

WASHINGTON — Ask Americans if they would hole up at home to keep from spreading a super-strain of flu, and at first they pledge to cooperate.

But probe deeper, and here come the doubts. One in four adults says there is no one to care for them at home if they got sick, raising the specter of Grandma gasping alone in bed or a single mom passed out while her children wail.

Another one in four could not afford to miss work for even a week. Would they heed doctors' calls to stay home or go sneeze on co-workers?

And one in five fears the boss would insist they come to work even if they were sick and contagious.

So concludes a survey by Harvard researchers that will bring the concerns of average people into government deliberations on how to fight the next worldwide outbreak of a super-flu.

"If you want to contain the flu, you have to make it livable for people" to comply with infection-control steps, said Robert Blendon, a health policy specialist at the Harvard School of Public Health. He planned to present the survey today at a meeting of public health officials.

"This is really a Catch-22 here. If you can't help the people make it at home, then the epidemic's going to get much more severe."

Pandemics can strike when the easy-to-mutate flu virus shifts to a strain that people have never experienced. This has happened three times in the past century. Concern is rising that the Asian bird flu might trigger a pandemic if it starts spreading easily from person to person.

Old-fashioned infection control is one strategy to try to slow a pandemic's spread until vaccines become available: staying home if you are sick or may have been exposed; closing schools; avoiding crowded gatherings such as church services, sports events and shopping malls.

It is far from clear how well such measures would work, or if some could cause more harm than good. So the government asked the Institute of Medicine to bring together health specialists, state and local officials and industry this week to debate that issue.

Harvard's Blendon was pleasantly surprised that his survey of 1,697 adults suggests people are paying attention to pandemic discussions and are open to public health advice.