H1N1 projected impact is all guesswork
Unpredictable flu leaves local health officials to plan for the worst
BY JONA ISON ? Gazette Staff Writer ? August 16, 2009
Helen Ricketts remembers the first time she had to use a vaccination gun.
It was 1976, and public health officials warned the swine flu could be as virulent as the 1918 strain that killed more than 1,000 people locally at Camp Sherman.
"I remember everybody had kind of pushed their panic button. There was supposed to be a lot (of illness). It didn't turn out to be as bad as we thought it was going to be, thank goodness," said Ricketts, who has worked locally in public health since 1970.
As summer winds down, health districts are busy preparing for the cold and flu season. Although taking precautions to stay healthy always is a good idea, health officials this year are pushing those precautions even harder as they anticipate H1N1 flu infections ramping up as students head back to school.
At this point, scientists and health officials only can speculate about the impact H1N1 will have, but they are hoping today's threat ends up like the 1976 story. Regardless of how the flu returns, however, people are being encouraged to wash their hands and take other precautions.
"Until there's a vaccine, it's really all about public education and awareness, letting people know how to protect themselves and avoid it," said Rami Yoakum, Ross County Health District communications director.
Ohio is receiving $9.8 million in one-time pandemic preparedness funds for states and communities to use in their continued planning and preparations in the event a more severe form of H1N1 flu develops in the coming months. Ohio's share is part of a $260 million national program.
This week, the health district has been handing out information at the Ross County Fair and already has met with school superintendents, the hospital, prisons and the Chillicothe Veterans Affairs Medical Center. Letters also have been sent out to child care providers, churches, nursing homes, grocery stores and the library on best practices to limit the spread of the flu.
PLANNING FOR THE WORST
Although no one really knows how H1N1 will act when it returns for flu season, or how widespread infection will become, Yoakum said officials always prepare for the worst case scenario - the Spanish influenza outbreak of 1918.
"We plan for the worst, but pray for the best," he said.
Of course, no flu has been as bad as the 1918 outbreak which has been credited with killing 675,000 Americans. Yoakum feels part of the reason no subsequent flus have been as deadly is advances in science and the creation of a flu vaccine in the 1930s.
"In 1918, we didn't know it was caused by a virus, not bacteria. Treatment probably weakened people because it killed off the good bacteria," said Yoakum, who wrote a book in 2007 about the 1918 flu.
DAMNED IF YOU DO
During the 1976 swine flu scare, public health officials and President Gerald Ford were accused of overreacting, especially when the flu didn't really make many waves. Ford asked for $135 million to provide vaccinations for 213 million Americans.
"Unless we take effective counteraction, there could be an epidemic of this dangerous disease next fall and winter here in the United States," he said.
The concern was widespread as was evidenced in a March 1976 photo of Patty Hearst wearing a surgical mask after being diagnosed with the flu. Hearst was on trial for bank robbery at the time. Officials predicted there could be 4 million deaths.
Ricketts recalls being happy she was in a position to help people. The 1976 scare also was one of the first times there had been a mass clinic. People waited in long lines in Central Center where the clinic was conducted at the old Bargain City building that was located at the site of the current Community Markets. Thousands in the area received the vaccination.
Whether the lower incidence was a result of vaccinations or the swine flu just not returning en force is hard to say, Ricketts said. The vaccination program was stopped after 10 weeks when a rare side effect - Guillain-Barre syndrome - was attributed to the vaccinations. The syndrome is a disorder in which the body's immune system attacks part of the peripheral nervous system.
"The vaccine has been cleaned up a lot since then. It's not as hard on a person as it was back then," Ricketts said.
VACCINATION IMPROVEMENTS
The new H1N1 vaccination, which is expected to be provided free to states from the federal government this autumn, is currently in testing before gaining approval for mass production and distribution. Cincinnati Children's Hospital Medical Center this month began administering experimental swine flu vaccine to adult volunteers for a national clinical trial.
Although health officials still are focused on H1N1 preparation, many have appeared to stop worrying about it as a result of the media hype in the spring and minimum casualty impact since.
"There are people who approach it historically and they know (the flu) can be serious. But there are people young enough who don't worry about the flu," Yoakum said. "I hope we're overreacting. I hope nothing happens, but we have to take it seriously."
Reporting of H1N1 changed earlier this month and the state no longer is tracking it as a novel virus, said Ohio Department of Health spokesman Kris Weiss. Currently, the virus is being tracked along with seasonal flu because it is considered more widespread.
"This virus is now part of the influenza that is circulating," Weiss said.
Even though there had been more than 200 H1N1 cases and one death confirmed in Ohio prior to the reporting change, Weiss said the figures were "no was all inclusive" because not everyone would have gone to the doctor or have been tested specifically for H1N1 unless there was a community outbreak or severe illness.
HIGH ABSENTEEISM, FEW DEATHS?
In reality, as long as H1N1 does not mutate during its second wave, Yoakum thinks we'll see situations much like the 1957 Asian flu created - a lot of illness, but fewer deaths. A November 1957 Chillicothe Gazettearticle indicated Chillicothe Hospital limited service to emergency cases only because a high number of nurses were falling ill and patients were developing flu symptoms after admittance. Visitors also were limited to one immediate family member.
Schools were reporting up to 30 percent or more of students absent, and the parochial schools appeared to have been closed for a short time. The Surgeon General also reported in November 1957 that an estimated 8.5 million Americans had gone to bed one or more days with colds, influenza and sinus diseases during the week that ended Oct. 5. The American Red Cross also reported a slump in blood donations as a result of widespread illness.
Chillicothe City Schools Superintendent Roger Crago said there is not an official percentage of staff or student absences that indicates they will close school. However, administrators monitor absences due to illness every year and together they, and sometimes with advice from the health district, they determine whether to close for a few days to allow the illness to run its course.
Although too young to experience the Asian flu, Ricketts remembers having the Hong Kong flu that hit in 1968 and 1969.
"I was sick with it in nursing school. It really was hitting a lot of people," she said.
As a result of the previous flu outbreaks, Ricketts feels the nation now is better prepared to respond appropriately and safely.
"I think we've done our homework. We've done our practice runs. We have done flu clinics over the years and we're better prepared to work with the community," she said, adding that vaccines are much safer too.
DAMNED IF YOU DON'T
The flu is unpredictable, though, and comes in waves, leaving Ricketts especially concerned for the youth and infants too young to be vaccinated. Part of that fear comes from the 1918 Spanish flu, which also was an H1N1 strain and was characterized by a propensity for more severe attacks on the young and healthy.
"We're just concerned the wave is going to come, and it's the bad one. You have to be prepared," Ricketts said. "Flu is so sneaky because it changes so much. Even in one season it changes, and you have a whole other creature to deal with."
In the case there are mass fatalities - even though that's not expected - the health district has been undergoing efforts this year to develop a plan for handling them. The district has had meetings with the public about what is acceptable with regard to body storage and burial and is still in the process of finalizing a plan of action, Yoakum said. In a mass fatality situation, the coroner would be in charge of what would happen with bodies while the health district, as usual, would help make determinations on public gatherings and potential closures.
"It's going to depend on how severe it gets (before we would implement out community containment plan). If people are just getting sick and not dying, there may not be any need to do that. We'll just have to see how things develop," Yoakum said.
Currently, the Centers for Disease Control has issued guidance to schools on H1N1, advising there is not a need to shut down at the first sign of H1N1 unless it mutates into a more deadly form. While typically schools will proceed with normal procedures to help determine closures when there is high absenteeism from illness, the CDC has advised some schools, such as those for pregnant teens or with disabilities affecting their lungs, to consider closure before other schools to protect those at highest risk of severe swine flu disease.
Unpredictable flu leaves local health officials to plan for the worst
BY JONA ISON ? Gazette Staff Writer ? August 16, 2009
Helen Ricketts remembers the first time she had to use a vaccination gun.
It was 1976, and public health officials warned the swine flu could be as virulent as the 1918 strain that killed more than 1,000 people locally at Camp Sherman.
"I remember everybody had kind of pushed their panic button. There was supposed to be a lot (of illness). It didn't turn out to be as bad as we thought it was going to be, thank goodness," said Ricketts, who has worked locally in public health since 1970.
As summer winds down, health districts are busy preparing for the cold and flu season. Although taking precautions to stay healthy always is a good idea, health officials this year are pushing those precautions even harder as they anticipate H1N1 flu infections ramping up as students head back to school.
At this point, scientists and health officials only can speculate about the impact H1N1 will have, but they are hoping today's threat ends up like the 1976 story. Regardless of how the flu returns, however, people are being encouraged to wash their hands and take other precautions.
"Until there's a vaccine, it's really all about public education and awareness, letting people know how to protect themselves and avoid it," said Rami Yoakum, Ross County Health District communications director.
Ohio is receiving $9.8 million in one-time pandemic preparedness funds for states and communities to use in their continued planning and preparations in the event a more severe form of H1N1 flu develops in the coming months. Ohio's share is part of a $260 million national program.
This week, the health district has been handing out information at the Ross County Fair and already has met with school superintendents, the hospital, prisons and the Chillicothe Veterans Affairs Medical Center. Letters also have been sent out to child care providers, churches, nursing homes, grocery stores and the library on best practices to limit the spread of the flu.
PLANNING FOR THE WORST
Although no one really knows how H1N1 will act when it returns for flu season, or how widespread infection will become, Yoakum said officials always prepare for the worst case scenario - the Spanish influenza outbreak of 1918.
"We plan for the worst, but pray for the best," he said.
Of course, no flu has been as bad as the 1918 outbreak which has been credited with killing 675,000 Americans. Yoakum feels part of the reason no subsequent flus have been as deadly is advances in science and the creation of a flu vaccine in the 1930s.
"In 1918, we didn't know it was caused by a virus, not bacteria. Treatment probably weakened people because it killed off the good bacteria," said Yoakum, who wrote a book in 2007 about the 1918 flu.
DAMNED IF YOU DO
During the 1976 swine flu scare, public health officials and President Gerald Ford were accused of overreacting, especially when the flu didn't really make many waves. Ford asked for $135 million to provide vaccinations for 213 million Americans.
"Unless we take effective counteraction, there could be an epidemic of this dangerous disease next fall and winter here in the United States," he said.
The concern was widespread as was evidenced in a March 1976 photo of Patty Hearst wearing a surgical mask after being diagnosed with the flu. Hearst was on trial for bank robbery at the time. Officials predicted there could be 4 million deaths.
Ricketts recalls being happy she was in a position to help people. The 1976 scare also was one of the first times there had been a mass clinic. People waited in long lines in Central Center where the clinic was conducted at the old Bargain City building that was located at the site of the current Community Markets. Thousands in the area received the vaccination.
Whether the lower incidence was a result of vaccinations or the swine flu just not returning en force is hard to say, Ricketts said. The vaccination program was stopped after 10 weeks when a rare side effect - Guillain-Barre syndrome - was attributed to the vaccinations. The syndrome is a disorder in which the body's immune system attacks part of the peripheral nervous system.
"The vaccine has been cleaned up a lot since then. It's not as hard on a person as it was back then," Ricketts said.
VACCINATION IMPROVEMENTS
The new H1N1 vaccination, which is expected to be provided free to states from the federal government this autumn, is currently in testing before gaining approval for mass production and distribution. Cincinnati Children's Hospital Medical Center this month began administering experimental swine flu vaccine to adult volunteers for a national clinical trial.
Although health officials still are focused on H1N1 preparation, many have appeared to stop worrying about it as a result of the media hype in the spring and minimum casualty impact since.
"There are people who approach it historically and they know (the flu) can be serious. But there are people young enough who don't worry about the flu," Yoakum said. "I hope we're overreacting. I hope nothing happens, but we have to take it seriously."
Reporting of H1N1 changed earlier this month and the state no longer is tracking it as a novel virus, said Ohio Department of Health spokesman Kris Weiss. Currently, the virus is being tracked along with seasonal flu because it is considered more widespread.
"This virus is now part of the influenza that is circulating," Weiss said.
Even though there had been more than 200 H1N1 cases and one death confirmed in Ohio prior to the reporting change, Weiss said the figures were "no was all inclusive" because not everyone would have gone to the doctor or have been tested specifically for H1N1 unless there was a community outbreak or severe illness.
HIGH ABSENTEEISM, FEW DEATHS?
In reality, as long as H1N1 does not mutate during its second wave, Yoakum thinks we'll see situations much like the 1957 Asian flu created - a lot of illness, but fewer deaths. A November 1957 Chillicothe Gazettearticle indicated Chillicothe Hospital limited service to emergency cases only because a high number of nurses were falling ill and patients were developing flu symptoms after admittance. Visitors also were limited to one immediate family member.
Schools were reporting up to 30 percent or more of students absent, and the parochial schools appeared to have been closed for a short time. The Surgeon General also reported in November 1957 that an estimated 8.5 million Americans had gone to bed one or more days with colds, influenza and sinus diseases during the week that ended Oct. 5. The American Red Cross also reported a slump in blood donations as a result of widespread illness.
Chillicothe City Schools Superintendent Roger Crago said there is not an official percentage of staff or student absences that indicates they will close school. However, administrators monitor absences due to illness every year and together they, and sometimes with advice from the health district, they determine whether to close for a few days to allow the illness to run its course.
Although too young to experience the Asian flu, Ricketts remembers having the Hong Kong flu that hit in 1968 and 1969.
"I was sick with it in nursing school. It really was hitting a lot of people," she said.
As a result of the previous flu outbreaks, Ricketts feels the nation now is better prepared to respond appropriately and safely.
"I think we've done our homework. We've done our practice runs. We have done flu clinics over the years and we're better prepared to work with the community," she said, adding that vaccines are much safer too.
DAMNED IF YOU DON'T
The flu is unpredictable, though, and comes in waves, leaving Ricketts especially concerned for the youth and infants too young to be vaccinated. Part of that fear comes from the 1918 Spanish flu, which also was an H1N1 strain and was characterized by a propensity for more severe attacks on the young and healthy.
"We're just concerned the wave is going to come, and it's the bad one. You have to be prepared," Ricketts said. "Flu is so sneaky because it changes so much. Even in one season it changes, and you have a whole other creature to deal with."
In the case there are mass fatalities - even though that's not expected - the health district has been undergoing efforts this year to develop a plan for handling them. The district has had meetings with the public about what is acceptable with regard to body storage and burial and is still in the process of finalizing a plan of action, Yoakum said. In a mass fatality situation, the coroner would be in charge of what would happen with bodies while the health district, as usual, would help make determinations on public gatherings and potential closures.
"It's going to depend on how severe it gets (before we would implement out community containment plan). If people are just getting sick and not dying, there may not be any need to do that. We'll just have to see how things develop," Yoakum said.
Currently, the Centers for Disease Control has issued guidance to schools on H1N1, advising there is not a need to shut down at the first sign of H1N1 unless it mutates into a more deadly form. While typically schools will proceed with normal procedures to help determine closures when there is high absenteeism from illness, the CDC has advised some schools, such as those for pregnant teens or with disabilities affecting their lungs, to consider closure before other schools to protect those at highest risk of severe swine flu disease.