outbreak

Photo by Jen Siska

[MakeShift was a column and competition, by MacGyver creator Lee Zlotoff, that ran in Make: magazine for its first five years. This challenge appeared in Make: Volume 15, 2008. Read past installments of MakeShift here.]

The Scenario

Imagine you’re a world-renowned epidemiologist (yeah, we know, its a stretch, but roll with it). You’re on your way home to Northern California after a pandemics conference in Tokyo, with your 5-year-old child and significant other, cruising over the Pacific at 37,000 feet, with at least six more hours from home or any airport.

You’ve had your second meal, watched the movie, and you’re dozing peacefully in business class when your child wakes you to say he really needs to use the bathroom. So you get up to escort him to the nearest lav, only to run into the longest lines of passengers you’ve ever seen waiting to get to all of the plane’s restrooms, from first class to coach.

An anxious flight attendant tries to push past you carrying numerous loaded barf bags as you stop her to ask what’s going on. Trying to remain calm, she says that, unless you’re a doctor, could you please return to your seat. Well, as fate would have it…

The Challenge

Clearly there’s an outbreak of unknown origin spreading through the plane, and a sense of panic is starting to build among the passengers and crew. Given your credentials, you might be the only person that everyone, including the captain, will listen to. So, putting aside all your years of medical school and practice for the moment, since a snap diagnosis might do as much harm as good, what are you going to do to manage the crisis?

What You Have

In addition to the airliner’s basic emergency medical supplies, you have whatever any of the passengers might be carrying on a commercial aircraft capable of trans-oceanic flight. And, for the purposes of this challenge, you can assume the flight crew and passengers will follow your instructions without argument, be they very old, very young, or anyone who had significant health issues prior to boarding the plane. So what now, Doc?

Analysis and Commentary

This was undoubtedly one of our trickier challenges since it assumed you were a medical specialist — which most of us aren’t — and because there were lots of potential variables: the possible cause of the outbreak itself, the reactions of the passengers and crew, and the options of what you could actually do to manage the situation.

Still, you once again rose to the challenge and gave Dr. House a run for his money with lots of interesting and creative suggestions. It’s fair to say not even all the doctors who entered came up with a complete solution to a situation with so many unknowns, but most of you managed to cover the basics with admirable thinking.

Step 1: Do what you can to prevent panic and reassure everyone, since hysteria would only complicate the situation and make it worse. On a plane that size, odds are there are other medical folks on-board: other doctors or nurses, etc. So those of you who suggested starting by rounding up all those with medical training and organizing them to manage the crisis were on the right track. With a team of people in action it’s much easier to maintain calm, help those who are most in need, and gather as much information as possible to try and pinpoint the cause.

Your medical team would also facilitate the collection and distribution of any medications — both prescription and over-the-counter drugs — that might be available. Most people come on-board with a store of drugs for various aliments, particularly if they’re traveling overseas. Your team could collect these from the passengers and also determine who among the afflicted should be given medication. They would also be able to instruct crew members on the correct method to keep people hydrated — all of which would go a long way to not only mitigating some of the symptoms but instilling calm and preventing panic.

Some of you also wisely considered the possibility of the pilots becoming ill and being unable to continue flying the plane. Here again, your medical team could discreetly survey the passengers as they questioned them about their conditions to see if there were any FAA-certified pilots among them in case the cockpit needed backup.

Many of you also suggested the excellent idea of instructing the pilots to activate the plane’s oxygen masks to isolate all the passengers’ breathing and avoid spreading potential airborne disease vectors — provided, of course, that the passengers understood why this was being done and that the plane itself was not in any jeopardy. In truth, this would probably just be another way to calm the passengers and reassure them that things were being done to contain the problem. Which brings up the question of isolation in general.

A lot of you thought to try isolating all the sick passengers into one section of the plane, but, as sensible as that sounds, by the time the outbreak has started, isolation would most likely not do much to prevent the spread of the disease in the closed confines of a pressurized aircraft. And splitting up families or friends, not to mention trying to rearrange all the seating, might only create unnecessary anxiety and chaos.

However, creating additional, makeshift bathrooms to alleviate the strain on the plane’s existing lavs was another good thought.

And those who suggested establishing communications with experts on the ground were again on the right track. Such experts might provide invaluable advice in identifying the cause and controlling the spread of the outbreak, and be ready to assist when the aircraft arrives at the nearest possible airport.

While most of you understandably speculated that food poisoning was the probable cause of the outbreak, one entrant suggested that a gradual loss of cabin pressure at altitude might create a form of the bends, thereby resulting in sickness among the passengers. He suggested dropping the plane’s elevation down below 8,000 feet and manufacturing a small smoker to see if the smoke was drawn toward a leak. Since aircraft have sensors that detect loss in cabin pressure, this scenario was not particularly plausible, but it was certainly creative and earned points for looking beyond the obvious.

So, while we earnestly hope none of you ever has to contend with a situation like this, it was comforting to know that, with or without specific medical training, most of you had a pretty good sense of how to cope with the crisis … even though it was indeed a doctor who took the top prize. Then again, he had to pay for medical school and you didn’t.

Thanks once more for all of the sharp brain work and we look forward to seeing your entries on the next challenge.

Winners

The winners of the MakeShift Volume 15 Challenge are:

MakeShift Master – Most Plausible: Dr. Robert Baker
MakeShift Master – Most Creative: Nate Gatfield