After the hype surrounding H1N1 flu last April, and the resulting less-than-disastrous result ("only" 522 people have died), the President's Council of Advisors on Science and Technology isn't backing off from the big numbers. A report says that up to 90,000 people may die.
It's not that the H1N1 flu will be more severe that a typical flu-season strain, it's that more people will get it and, thus, more people will die. Up to half the population of the U.S. will get H1N1. There also isn't the immunity to this strain of flu.
During an online "chat" with Amy Garcia of the National Association of School Nurses today, a questioner from Minneapolis on the Washington Post site asked if the "concern that we just don't know how it will react, as compared to the flu that we usually get every year? Or is it something more than that?"
This strain of H1N1 flu is novel, meaning new. So it spreads easily because people have not been exposed and do not have antibodies to it. This strain of H1N1 concerns me for several of reasons:
1. It disproportionately impacts children and pregnant women.
2. There seems to be a higher incidence of pneumonia, possibly because this virus replicates deep inside the lung.
3. It spreads very easily and quickly. My school nurse friends who have witnessed outbreaks describe large numbers of children getting very sick, very quickly.
4. The H1N1 virus may mutate to be more deadly, and still very contagious.
The experts issue the same recommendations to people they've been issuing since last April: Wash your hands regularly, don't cough in someone's face, and stay home when you're sick.
That last item is the big nut in all of this. People who don't have any sick time, tend not to take days off regardless of their medical woes and the threat to the rest of us. So the same experts are asking employers to "be flexible," another way of saying "don't penalize them for staying home."
After last spring's build-up and resulting backlash, who's left who's still listening to the warnings and advice?
What's the best way to get the word out then? It would be really, really great if it was a whole lot of buildup for nothing, but so much of the difficulty is that we just can't know what will happen.
Part of the problem is that there is no right answer for the public health professionals who are doing things like this. If it isn't so bad (like it turned out to be in the spring), then they are "overhyping the threat" and "fearmongering." If it does get bad, then the screaming will start about the government falling down on the job again (regardless of what they have been doing, of course).
So, what would be most helpful to the public and the media?
I can tell you the hospitals are scared of the h1n1. They don't feel ready for it. The nurses that I know are complaining because it seems the hospital patients families are cause for possible outbreak spreading.
Bring in outside food (in and out of the hospital - great incubation for nasty stuff) and lack of concern for hygiene.
New hand washing and bacteria stations are being installed in many hospitals as we speek. But as of today h1n1 patients are being treated with general population and without any special protocol.
So a cancer patient taking chemotherapy could be put in the same room as someone with h1n1.
Only patients with neutropenic precautions are seperated. But a h1n1 could be on the same floor and be treated by the same Nurse or DR.