Re: CDC: "U.S. Bracing for 1.8 Million Flu Hospitalizations"
STATE OF THE UNION WITH JOHN KING (CNN)
Interview with CDC Director Dr. Thomas Frieden
Aired September 6, 2009 - 20:00 ET
http://transcripts.cnn.com/TRANSCRIPTS/0909/06/sotu.05.html
KING: Dr. Frieden, thank you for joining us. Let me just start with your threshold. Much of the nation is back to school. The rest will be heading back to school in the week ahead.
Based on what you've seen so far, what is your expectation for the number of cases in the United States and the number of deaths we are looking for as we address the H1N1?
DR. THOMAS FRIEDEN, DIR., CENTER FOR DISEASE CONTROL & PREVENTION: Only the future will tell what the future brings. What we do know is that with schools back in session, particularly in the southeast of the U.S. but also in many parts of the country, we're seeing a fair amount of influenza and that's very unusual for this time of the year.
KING: If it's a fair amount, I'm going to get up and go over to our wall. As you say, if it's a fair amount already, sir, now we have a heat map here that shows some of the cases here. The brighter the state, the higher number of cases.
If it's a fair amount already in September and generally it's mid- October or a bit later in the season, what does that tell you? Does that make you more worried?
FRIEDEN: We generally expect that flu will continue to go up after it starts, but this is really something we haven't seen before. It's very unusual to see flu continue to occur over the summer. It's very unusual to see it start to increase this rapidly in August and September.
So only time will tell what the future holds. We do know that two things are essential. One is to intensively monitor so we understand what's happening, where flu is occurring and whether it becomes more deadly and so far, it hasn't.
And second, to be ready to adapt, to be ready to change when things develop. But the fact that flu is here now means that we need to do things now, to address it. That means, on the one hand, simple things, like not going to school or work if you have a fever, covering your cough and sneeze, and washing your hands frequently, and for people who are sick, there are special measures as well which we can get into.
KING: We will get into those. I want to first pop in, Wisconsin is one of the states with the highest incidence of cases so far. And I wanted to pull up this from the President's Council of Advisers on Science and Technology.
Now this has many Americans alarmed, that report to the president said 30 to 50 percent of the U.S. population this fall and winter could become infected, 30,000 to 90,000 deaths possible in the United States, concentrated among children and young adults. And perhaps as many as 1.8 million hospital admissions because of H1N1.
Are you in sync with these numbers, sir, or do you think that is too alarming a presentation?
FRIEDEN: What the President's Council reported and what we completely agree with is that there are a range of scenarios and it's really important that we prepare for scenarios that are severe, and they outline one such scenario and we are in fact preparing for that.
KING: Let me ask you a bit more then. Let me just show the high risk chart then. People 65 and older, children under 5, pregnant women, people with chronic medical conditions and people taking immune- suppressing medications.
For people on this list, should they be doing something different than the everyday population?
FRIEDEN: Yes. If you're at higher risk of having influenza or more importantly of getting severely ill, if you get it, then you need to do a couple of things. First is, if flu is in your community, and you develop a fever, see your doctor right away. Treatment within the first 48 hours makes a big difference. And when vaccine becomes available, get vaccinated.
KING: Well, you mentioned when vaccine becomes available. That's one of the questions people have in the sense that this first surfaced in the spring. They're being told now by the government the vaccine should be ready, should be ready sometime mid-October. Why does it take so long?
FRIEDEN: We wish we had more modern methods of making vaccine, quicker methods of making vaccine. We wish we could turn on a dime and make vaccine to a new strain. The fact is that growing vaccine currently, growing the virus up, growing it then in eggs, a time- honored way of making flu vaccine, which we're confident in the safety and efficacy of, that takes nearly six months.
KING: And as you know, many people get very suspicious and anxious when it comes to this. A new vaccine, rushed into production, what do we know about possible site effects and what do you say to a parent out there who says wait a minute, if this is not such a deadly strain, I'm not going to do this, I'm not going to take this risk with my child.
FRIEDEN: Well it's not a new vaccine. This is a flu vaccine that's made in the same way the flu vaccine is made every year, it's a new strain. Every year we add new strains into the flu vaccine. So the way it's being made, the content of it is similar to the flu vaccine that literally hundreds of millions of doses have been given of.
My kids are going to get this vaccine when it becomes available. We have a very high confidence in the safety of influenza vaccination.
KING: Is there anything you need, when you -- now you're in your new job in Atlanta, is there anything when you get on the phone to Washington, saying you know what, I need this now?
FRIEDEN: Well, I think the challenges are really significant. On the one hand, we have a public health infrastructure, health departments at states and localities that have had literally decades of underinvestment.
And on top of that now, fiscal crisis, so we've had layoffs and hiring freezes and furloughs, and these are the individuals, these are the programs which are really essential to our response, and essential to public safety that are going to have to step up and do the vaccination and coordination and treatment, the communication in the coming weeks and months.
And the health care system, which is going to have to deal with an influx of people who are mostly not severely ill but large numbers, but may have to deal with people who are severely ill, in some parts, may have to deal with vaccinating people in large numbers, and our health care system is not well set up to coordinate.
It's not well set up to have an information system that allows us to manage the population's health, wealth and frankly, it's not set up to prioritize prevention, and those are things that make addressing H1N1 more difficult.
KING: And when this vaccine is ready in mid-October, sir, how many doses do you expect to have at your disposal?
FRIEDEN: Each year, we vaccinate about 100 million people for influenza and the current projections are that we'll have 40 to 50 million doses in mid-October or by mid-October. I think although we might wish we had more, it's actually not going to be so easy to get out large numbers and what we're going to try to ensure is that everyone who wants to get vaccinated can be vaccinated but to prioritize those of highest risk.
KING: Dr. Frieden, thank you very much for your time.
FRIEDEN: Thank you.
(END VIDEOTAPE)
