Tweet
On Swine Flu in California
Pandemic has taken hold
Jorge R. Mancillas
Wednesday, August 5, 2009
While state officials haggled over a solution to the state's budget deficit, the swine flu virus continued to spread unabated, the number of fatalities in California has doubled in a few days and, yet, we are still in the early days of a public health crisis that has escaped the grasp of the state's public institutions.
Our country and our state failed to take the measures necessary to contain the pandemic while we still had a chance, and we are now left with mitigation and keeping the fatalities down as the only option.
We are now facing a virus that is highly contagious, has spread more rapidly than in any previous flu pandemic and is reaching every corner of the world. We have no immunity against this new strain, a vaccine will not be ready and distributed until this fall, antiviral medications have limited effectiveness and there are already reports of three cases of mutation rendering the virus immune to the antiviral drug Tamiflu.
Nowhere has complacency had worst effects than in the United States, which, despite our wealth and technological advantages, has now surpassed all countries in the number of cases - with around 35 percent of the world total - as well as in the number of deaths.
Absorbed by its budget woes and distracted by implementing cuts in its public services just when we most need them, California leads all states in the number of H1N1 infections and fatalities. As of July 16, it reported 3,168 cases, 55 deaths and a whopping fatality rate of 1.73 percent, almost four times higher than the global rate of 0.45 percent, or 4.5 deaths per 1,000 persons, and almost three times the U.S. rate of 0.64 percent. By July 30, the California death toll had risen to 80.
This dire performance has taken place when we are facing a "mild" strain of the virus in summer, when Californians are spending more times outdoors and are not concentrated so heavily indoors, thus reducing transmission of the virus. There was a marked increase in the spread of infections in July, a spike attributable to the geometric increase in the number of cases.
The H1N1 virus has an attack rate of 30 percent, meaning 1 in 3 of those exposed becomes infected. Only a small fraction of infections result in death. But when millions become infected, that small fraction rises to thousands. If current trends continue, up to 11 million Californians could become infected and 176,000 could die in our state before the pandemic is over.
The severity of the consequences of this pandemic has varied significantly in the states and countries affected to date. The determining factor has been their level of medical preparedness. Yet, even as we witness a spike in fatalities in California, the governor and legislative leaders have decided to implement cuts that will further weaken our health system, just when we should be strengthening it. The state workers who should be in the front lines of the response to the pandemic are being sent on furlough, their ranks will be cut and those remaining will be demoralized.
What this reveals is a warped sense of priorities. We may not face higher taxes, but will pay a higher toll in lost lives, medical costs and disruption of economic activities as millions in the state fall ill.
Dr. Jorge R. Mancillas is the health services officer for Public Services International, a global federation that includes 231 organizations representing 7 million frontline health workers in 154 countries.
This article appeared on page A - 15 of the San Francisco Chronicle
Source: http://www.sfgate.com/cgi-bin/articl...#ixzz0NMo8SvUw
Pandemic has taken hold
Jorge R. Mancillas
Wednesday, August 5, 2009
While state officials haggled over a solution to the state's budget deficit, the swine flu virus continued to spread unabated, the number of fatalities in California has doubled in a few days and, yet, we are still in the early days of a public health crisis that has escaped the grasp of the state's public institutions.
Our country and our state failed to take the measures necessary to contain the pandemic while we still had a chance, and we are now left with mitigation and keeping the fatalities down as the only option.
We are now facing a virus that is highly contagious, has spread more rapidly than in any previous flu pandemic and is reaching every corner of the world. We have no immunity against this new strain, a vaccine will not be ready and distributed until this fall, antiviral medications have limited effectiveness and there are already reports of three cases of mutation rendering the virus immune to the antiviral drug Tamiflu.
Nowhere has complacency had worst effects than in the United States, which, despite our wealth and technological advantages, has now surpassed all countries in the number of cases - with around 35 percent of the world total - as well as in the number of deaths.
Absorbed by its budget woes and distracted by implementing cuts in its public services just when we most need them, California leads all states in the number of H1N1 infections and fatalities. As of July 16, it reported 3,168 cases, 55 deaths and a whopping fatality rate of 1.73 percent, almost four times higher than the global rate of 0.45 percent, or 4.5 deaths per 1,000 persons, and almost three times the U.S. rate of 0.64 percent. By July 30, the California death toll had risen to 80.
This dire performance has taken place when we are facing a "mild" strain of the virus in summer, when Californians are spending more times outdoors and are not concentrated so heavily indoors, thus reducing transmission of the virus. There was a marked increase in the spread of infections in July, a spike attributable to the geometric increase in the number of cases.
The H1N1 virus has an attack rate of 30 percent, meaning 1 in 3 of those exposed becomes infected. Only a small fraction of infections result in death. But when millions become infected, that small fraction rises to thousands. If current trends continue, up to 11 million Californians could become infected and 176,000 could die in our state before the pandemic is over.
The severity of the consequences of this pandemic has varied significantly in the states and countries affected to date. The determining factor has been their level of medical preparedness. Yet, even as we witness a spike in fatalities in California, the governor and legislative leaders have decided to implement cuts that will further weaken our health system, just when we should be strengthening it. The state workers who should be in the front lines of the response to the pandemic are being sent on furlough, their ranks will be cut and those remaining will be demoralized.
What this reveals is a warped sense of priorities. We may not face higher taxes, but will pay a higher toll in lost lives, medical costs and disruption of economic activities as millions in the state fall ill.
Dr. Jorge R. Mancillas is the health services officer for Public Services International, a global federation that includes 231 organizations representing 7 million frontline health workers in 154 countries.
This article appeared on page A - 15 of the San Francisco Chronicle
Source: http://www.sfgate.com/cgi-bin/articl...#ixzz0NMo8SvUw
Comment