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by FT Resident and Flu Wiki Founder DemfromCT:
Pandemic Influenza: 2009 H1N1 And The Peak of The Second Wave?
From the Free Dictionary:
Well, besides the fact that I'm interested in the topic, it happens that pandemics affect a lot of people in a lot of ways great and small, and any such topic is worth spending time on. But it's not that folks don't know about it. There's just a certain amount of complacency about flu and vaccinations.
That would be a good thing, though we don't know if we are yet, and we can't predict whether there'll be a third wave in a few months. But health authorities are only now coming to grips with vaccine resistance from the public, and a report here or there from a death really won't make a dent in that (but more would, and the death of a child is a variable different than the death of a senior.) What to expect, therefore, is a varying demand for vaccine, which will start to become available in most states over the next two weeks (and be more readily available by end October.)
From the WaPo:
Now, in addition to that being a reason for a major on-going vaccination program, the logistics of which will consume public health folks for the next few weeks (public health infrastructure!!!), the other two aspects of flu news have to to do with two major reports released this week, one by Brookings on the cost of school closures and the other by Trust For America's Health on the capacity of states to handle illness in 35% of the population.
Both topics have been discussed here before (see H1N1: Why Do Schools Close, And When Do They Open? from May, 2009, and Hospital Surge, Exercises and Pandemics from April 2008.) The issues covered in those posts are good background for the reports issued this week.
More below the fold
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It remains a tool in the toolbox, albeit an expensive one to use. You'll see spot closures when things get intense locally:
For example:
You can find more information here at flu.gov and at cdc.gov.
No black helicopters here. Just advice you need to hear.
by FT Resident and Flu Wiki Founder DemfromCT:
Pandemic Influenza: 2009 H1N1 And The Peak of The Second Wave?
From the Free Dictionary:
pan·dem·ic (pn-dmk) adj.
June 11, 2009, Margaret Chan, Director General of the World Health Organization: - Widespread; general.
- Medicine Epidemic over a wide geographic area and affecting a large proportion of the population: pandemic influenza.
On the basis of available evidence, and these expert assessments of the evidence, the scientific criteria for an influenza pandemic have been met.
I have therefore decided to raise the level of influenza pandemic alert from phase 5 to phase 6.
The world is now at the start of the 2009 influenza pandemic.
When we write about flu here, there are still a remarkable number of comments to the tune of "it's not a pandemic, why are you scaring people?" or "why do you spend so much time on this?"I have therefore decided to raise the level of influenza pandemic alert from phase 5 to phase 6.
The world is now at the start of the 2009 influenza pandemic.
Well, besides the fact that I'm interested in the topic, it happens that pandemics affect a lot of people in a lot of ways great and small, and any such topic is worth spending time on. But it's not that folks don't know about it. There's just a certain amount of complacency about flu and vaccinations.
In a new survey, Harvard School of Public Health (HSPH) researchers found that just 40% of adults are "absolutely certain" they will get the H1N1 vaccine for themselves, and 51% of parents are "absolutely certain" that they will get the vaccine for their children. The survey examined the reasoning among those who said they would not get the vaccine or might not.
But none of that is written in stone.
If there were people in their community who were sick or dying from H1N1, roughly six in ten adults (59%) who say they do not think they'll get the vaccine would change their mind and get it for themselves. About the same percentage of parents (60%) who say they do not think they'll get the vaccine for their children would change their minds if H1N1 was causing sickness or death in their community.
"These findings suggest that public health officials need to be prepared for a surge in demand for the H1N1 vaccine if the H1N1 flu becomes more severe," said Robert J. Blendon, Professor of Health Policy and Political Analysis at HSPH.
It's not hard to find stories of people getting sick or dying of flu, though as of now it's not that widespread in every community. We don't have specific data on whether vaccine rates are higher in Dallas or Atlanta, which have higher rates of influenza-like illness than New England or the mid-Atlantic states. The good news on that, at least for the second wave of illness we may be peaking."These findings suggest that public health officials need to be prepared for a surge in demand for the H1N1 vaccine if the H1N1 flu becomes more severe," said Robert J. Blendon, Professor of Health Policy and Political Analysis at HSPH.
That would be a good thing, though we don't know if we are yet, and we can't predict whether there'll be a third wave in a few months. But health authorities are only now coming to grips with vaccine resistance from the public, and a report here or there from a death really won't make a dent in that (but more would, and the death of a child is a variable different than the death of a senior.) What to expect, therefore, is a varying demand for vaccine, which will start to become available in most states over the next two weeks (and be more readily available by end October.)
From the WaPo:
Part of the reason for the tepid enthusiasm may be that the vaccine campaign is being buffeted by political and social currents: wariness of mainstream medicine combined with suspicion of big government and a general unease and complacency about vaccines. Together, these trends have sparked a flood of misconceptions about the vaccine's safety and effectiveness, as well as about supposed plans to make the vaccine mandatory.
"There's a lot of misinformation out there," said Gregory Poland, a flu vaccine expert at the Mayo Clinic. "Then you mix into that people's concerns about conspiracy theories and government misbehavior and conflicts of interest and all of that, and the average layperson has a difficult time discerning what to do."...
Although the new H1N1 virus generally causes mild illness, most people have no immunity against it, meaning far more people will probably become infected, sick, end up in the hospital and possibly die than during a usual flu season. Most disturbingly, children, young adults and pregnant women appear to be especially vulnerable.
There's room on line for anyone and everyone, but high risk people (pregnant women, under 24, 25-64 with chronic health conditions and health care workers) need to be at the head of the line."There's a lot of misinformation out there," said Gregory Poland, a flu vaccine expert at the Mayo Clinic. "Then you mix into that people's concerns about conspiracy theories and government misbehavior and conflicts of interest and all of that, and the average layperson has a difficult time discerning what to do."...
Although the new H1N1 virus generally causes mild illness, most people have no immunity against it, meaning far more people will probably become infected, sick, end up in the hospital and possibly die than during a usual flu season. Most disturbingly, children, young adults and pregnant women appear to be especially vulnerable.
Now, in addition to that being a reason for a major on-going vaccination program, the logistics of which will consume public health folks for the next few weeks (public health infrastructure!!!), the other two aspects of flu news have to to do with two major reports released this week, one by Brookings on the cost of school closures and the other by Trust For America's Health on the capacity of states to handle illness in 35% of the population.
Both topics have been discussed here before (see H1N1: Why Do Schools Close, And When Do They Open? from May, 2009, and Hospital Surge, Exercises and Pandemics from April 2008.) The issues covered in those posts are good background for the reports issued this week.
More below the fold
<!-- polls come after this -->
- ::
We give estimates of both the direct economic and health care impacts for school closure durations of 2, 4, 8, and 12 weeks under a range of assumptions. We find that closing all schools in the U.S. for four weeks could cost between $10 and $47 billion dollars (0.1-0.3% of GDP) and lead to a reduction of 6% to 19% in key health care personnel. These should be considered conservative (i.e., low) economic estimates in that earnings rather than total compensation are used to calculate costs. We also provide per student costs, so regionally heterogeneous policies can be evaluated. These estimates permit the epidemiological benefits of school closure to be compared to the costs at multiple scales and over many durations.
Back in May we wrote: The more severe the pandemic, the longer the schools will stay closed.
It remains a tool in the toolbox, albeit an expensive one to use. You'll see spot closures when things get intense locally:
After a two-day closure due to an increase in flu-related absences among its students and staff, Huntsville Independent School District [Texas] opened its doors Thursday to a significant decrease in absences.
If the widespread flu seen in Texas hits elsewhere, the same scenarios may also play out elsewhere:
Swine Flu Hot Spots
Southern U.S. First to Battle Deadly Flu
As the nation braces for flu season and a potential outbreak of swine flu, the South already appears to be dealing with a wave of H1N1 cases, setting up tents to deal with hundreds of possibly infected children each day.
As TFAH notes: Southern U.S. First to Battle Deadly Flu
As the nation braces for flu season and a potential outbreak of swine flu, the South already appears to be dealing with a wave of H1N1 cases, setting up tents to deal with hundreds of possibly infected children each day.
15 states could run out of available hospital beds during the peak of the outbreak, if 35 percent of Americans were to get sick from the H1N1 flu virus. Twelve additional states could reach or exceed 75 percent of their hospital bed capacity, based on estimates from the FluSurge model developed by the U.S. Centers for Disease Control and Prevention (CDC). The report, H1N1 Challenges Ahead, estimates that the number of people hospitalized could range from a high of 168,025 in California to a low of 2,485 in Wyoming, and many states may face shortages of beds or may need to reduce the number of non-flu related discretionary hospitalizations due to limited hospital bed availability. The numbers of people who get sick could range from a high of 12.9 million in California to a low of 186,434 in Wyoming, if 35 percent of Americans were to get H1N1.
It's for that reason that surge exercises have been run, and surge planning has taken place for several years now, dating back to 2005 when the National Strategy for Pandemic Influenza was released. And quoting myself from 2008,
"This isn’t just about us, it’s about our neighborhoods and where we live."
None of the above is about fear, it's about planning (much of which you don't have to do, and some of which you do.) And for right now, the planning you most need to consider is whether you will participate in a voluntary flu vaccine program designed to mitigate further waves of illness, and protect the vulnerable you come in contact with.
For example:
Health officials say that pregnant women should be among the first to get the new vaccine.
But they know it will be an uphill battle persuading some people -- even those who are at high risk -- to take it.
"With vaccines, you're asking a currently healthy person to do something to prevent a future harm," said Dr. Greg Poland, a Mayo Clinic expert in pandemic flu and infectious diseases. "To me, it's an easy decision. But I recognize not everybody would feel that way."
Recognize that the baseline is 8% vaccination for pregnant women (6 million pregnancies and half a million vaccinated.) Tripling that gets us up to 24%, still pretty low.But they know it will be an uphill battle persuading some people -- even those who are at high risk -- to take it.
"With vaccines, you're asking a currently healthy person to do something to prevent a future harm," said Dr. Greg Poland, a Mayo Clinic expert in pandemic flu and infectious diseases. "To me, it's an easy decision. But I recognize not everybody would feel that way."
You can find more information here at flu.gov and at cdc.gov.
No black helicopters here. Just advice you need to hear.
