By David J. Skorton
As the president of a university with more than 21,000 students, and as a physician, the thought of handling the still-worrisome H1N1 virus with a sense of avoidance deeply concerns me.
A recent Washington Post-ABC News poll showed that nearly seven out of 10 people ages 18 to 29 do not plan to get vaccinated against the H1N1 virus.
The pandemic attributed to this virus has been surprisingly moderate, but we do not know what lies ahead. The main weapon in our defenses is a vaccine that is safe and effective.
Students and other young people should remember that H1N1, also known as swine flu, has reached 207 countries where it has been responsible for nearly 9,000 deaths. In the U.S. alone, an estimated 3,900 died from April through mid-October. That's not huge when compared with seasonal flu, which every year results in about 36,000 U.S. deaths. But we may be in for another wave of H1N1.
Think about community
My message to college students to get vaccinated is not simply so that they don't get the flu, but also so that the rest of us in the community don't get the flu.
My university, Cornell, is dealing with the second wave of H1N1 influenza. The first began in the spring and early summer, after students had departed U.S. campuses. Even so, Cornell had one of the earliest and largest university outbreaks in the country. Starting in August, we became home for the age group at greatest risk for contracting swine flu: Those younger than 25, who have illness rates three to five times higher than among the general population (and the median age for H1N1 hospitalization is 21). For nearly three months, we have seen a constant round of students seeking medical help, with 100 a week being diagnosed with flu-like symptoms.
Some students with underlying medical conditions have had secondary bacterial infections, and, tragically, one student died in September.Since the H1N1 vaccine arrived on campus, we have inoculated fewer than 2,000 students and are awaiting delivery of a large number of injections and nasal mists on back order.
When you also consider the social pattern of students – everything from studying and eating together to more intimate activities – it is obvious why vaccination is so critical. Are our students any different from those surveyed in that poll? Probably not. But they, like most students on large campuses, are susceptible to the pull and closeness of community.
Because we know how rapidly this virus can spread, community response has become a powerful ally of vaccination. Our close campus community has allowed us to deploy two effective weapons ahead of the availability of the vaccine – separation and education. By separation, I mean asking our faculty to encourage students to stay home during their illness; supplying drivers and vehicles for ill students during the outbreak; offering students flexibility in class assignments and exams; and waiving class requirements for medical excuses.
Education has reduced fear and encouraged sensible behaviors that helped mitigate the spread, particularly during those weeks when the H1N1 vaccine was not available. That has meant a student-organized moratorium on parties. Particularly effective was a 24-hour "flu line" students could call to provide essential information and to quell anxieties.
As a physician at the center of just one vulnerable population among which H1N1 can breed, I would say that universities have become critical agents in the national response. We dealt with the virus first on a large scale, and other communities and health authorities have much to learn from us. But first, listen to your doctor: Get vaccinated.
David J. Skorton, a cardiologist, is president of Cornell University.