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The 2009 Flu Season: Ready or Not; Here it Comes!
In a medical office that cares primarily for children and adolescents, the summer months are very manageable. We even have open appointments on the same day. However, when school starts, the flood gate of illnesses will start to come in.
High on the list of fall season illnesses has got to be influenza. The H1N1 strain of influenza (formerly called the swine flu) still has health officials worried. Now that H1N1 has been officially declared a worldwide pandemic, no one is really sure what will happen when the real flu season begins. Are we going to have thousands or even millions of victims? Should we expect massive school closings and work absenteeism? In this fragile economy, will this pandemic push us over the edge? No one really knows, but planning for the worst-case scenario is probably prudent.
There was a time when I could give away flu shots, even with all of my persuasive arguments. At the opening of a new urgent care facility several years ago, the owner's decided to give free flu vaccines to everyone on our first Saturday. The clinic opened at nine AM. The crowd began forming hours before. By the time we arrived at the clinic, the line of people, mostly an impatient mob of assertive and highly-vocal senior citizens, stretched down the street. Expecting a smaller turn-out, we only had one medical assistant assigned to the flu shot clinic. Even at full pace, the most she could administer was about one injection every five minutes or so (including registration and medical history). That is only about twelve an hour if everything went smoothly. There were at least 200 people in line! You do the math. As the hours progressed and tempers flared with the waiting crowd, someone announced that we were running out of vaccine. Lord, help us if that happened. I was sure that I would be caned to death during the inevitable riot. Some quick thinking resulted in "rain checks" for the ones at the back of the line. They weren't happy about it, but when you run out, you run out.
Because of this past experience, I often fear for my own personal safety when we run out of vaccine in our office. For the last two years, we were frequently required to ration our rapidly-depleting stores of vaccine to the most critical patients. I sure hope that the supply this year will be plentiful. I would hate to see those angry mobs again. The federal government, known for their efficient way of handling public health issues, promises there will be plenty of vaccine to administer. We will see.
Each person may need THREE flu vaccines: one for the regular seasonal flu and two for the new swine flu strain (one now, and then a second booster in a month). Multiply that by the number of patients we see in our clinic every day (over three hundred), and we may have a shortage of medical assistants just to administer them.
A few days ago, I had three patients come in to evening clinic. All had been to an orientation and band camp at the local high school, and all three were very ill with flu-like illnesses. I saw two of them; one was positive for Type A flu (H1N1 is a type A flu) and started on Tamiflu, and the other was negative. My partner saw the third patient and clinically diagnosed him with influenza and started him on Tamiflu. The next day, the news service had picked this up - "Three Confirmed Swine Flu Cases in Local High School." I suspect that one of the parents called the media. First, it takes about two weeks to confirm the one type A case was H1N1 or not, so there are no confirmed cases at the moment. Of course, this would not a newsworthy. As you might imagine, the school system went into panic and sent out phone announcements to all of the parents. This resulted in dozens of people streaming into our office to be tested for H1N1, none of which even had classic symptoms or known exposure.
All three of those students, including the one that may have had H1NI, wanted to go to school anyway, where they would have freely shared their illness with umpteen others. This is exactly how local epidemics begin.
One of the parents worried because a neighbor, three houses down, supposedly died from H1N1, so she was worried if the flu could be airborne this far, or if fleas on rats could have carried it to her home! Apparently, she is confusing influenza with the Bubonic Plague. So much misinformation...
We have not received any flu vaccines in our office, not even the seasonal flu, but I suspect the demand will be high. If the new H1N1 vaccine is approved, and I suspect it will be, then I can only hope that we get our share of vaccine to distribute.
All medical providers hate to ration vaccine, but high on the list of people to get the vaccines first would be the medical providers. It is not that we are looking out for ourselves first, it is just that we are on the front line to get an infection. Since influenza is contagious a day BEFORE, we could be infecting hundreds of people without knowing it.
Ready or not, the 2009 Influenza Season has really begun (or perhaps, never ended from last year). Medical providers are on high alert. Health departments are gearing-up. Are we really ready? That is the big question.
Related Topics:
High on the list of fall season illnesses has got to be influenza. The H1N1 strain of influenza (formerly called the swine flu) still has health officials worried. Now that H1N1 has been officially declared a worldwide pandemic, no one is really sure what will happen when the real flu season begins. Are we going to have thousands or even millions of victims? Should we expect massive school closings and work absenteeism? In this fragile economy, will this pandemic push us over the edge? No one really knows, but planning for the worst-case scenario is probably prudent.
There was a time when I could give away flu shots, even with all of my persuasive arguments. At the opening of a new urgent care facility several years ago, the owner's decided to give free flu vaccines to everyone on our first Saturday. The clinic opened at nine AM. The crowd began forming hours before. By the time we arrived at the clinic, the line of people, mostly an impatient mob of assertive and highly-vocal senior citizens, stretched down the street. Expecting a smaller turn-out, we only had one medical assistant assigned to the flu shot clinic. Even at full pace, the most she could administer was about one injection every five minutes or so (including registration and medical history). That is only about twelve an hour if everything went smoothly. There were at least 200 people in line! You do the math. As the hours progressed and tempers flared with the waiting crowd, someone announced that we were running out of vaccine. Lord, help us if that happened. I was sure that I would be caned to death during the inevitable riot. Some quick thinking resulted in "rain checks" for the ones at the back of the line. They weren't happy about it, but when you run out, you run out.
Because of this past experience, I often fear for my own personal safety when we run out of vaccine in our office. For the last two years, we were frequently required to ration our rapidly-depleting stores of vaccine to the most critical patients. I sure hope that the supply this year will be plentiful. I would hate to see those angry mobs again. The federal government, known for their efficient way of handling public health issues, promises there will be plenty of vaccine to administer. We will see.
Each person may need THREE flu vaccines: one for the regular seasonal flu and two for the new swine flu strain (one now, and then a second booster in a month). Multiply that by the number of patients we see in our clinic every day (over three hundred), and we may have a shortage of medical assistants just to administer them.
A few days ago, I had three patients come in to evening clinic. All had been to an orientation and band camp at the local high school, and all three were very ill with flu-like illnesses. I saw two of them; one was positive for Type A flu (H1N1 is a type A flu) and started on Tamiflu, and the other was negative. My partner saw the third patient and clinically diagnosed him with influenza and started him on Tamiflu. The next day, the news service had picked this up - "Three Confirmed Swine Flu Cases in Local High School." I suspect that one of the parents called the media. First, it takes about two weeks to confirm the one type A case was H1N1 or not, so there are no confirmed cases at the moment. Of course, this would not a newsworthy. As you might imagine, the school system went into panic and sent out phone announcements to all of the parents. This resulted in dozens of people streaming into our office to be tested for H1N1, none of which even had classic symptoms or known exposure.
All three of those students, including the one that may have had H1NI, wanted to go to school anyway, where they would have freely shared their illness with umpteen others. This is exactly how local epidemics begin.
One of the parents worried because a neighbor, three houses down, supposedly died from H1N1, so she was worried if the flu could be airborne this far, or if fleas on rats could have carried it to her home! Apparently, she is confusing influenza with the Bubonic Plague. So much misinformation...
We have not received any flu vaccines in our office, not even the seasonal flu, but I suspect the demand will be high. If the new H1N1 vaccine is approved, and I suspect it will be, then I can only hope that we get our share of vaccine to distribute.
All medical providers hate to ration vaccine, but high on the list of people to get the vaccines first would be the medical providers. It is not that we are looking out for ourselves first, it is just that we are on the front line to get an infection. Since influenza is contagious a day BEFORE, we could be infecting hundreds of people without knowing it.
Ready or not, the 2009 Influenza Season has really begun (or perhaps, never ended from last year). Medical providers are on high alert. Health departments are gearing-up. Are we really ready? That is the big question.
Related Topics:
2 Comments:
When the first news of a possible swine flu pandemic, was in the media; I heard that if you had the Hong Kong flu in the late 1960"s, that you possible will be immune to the current Swine Flu. Is this true?
The longer we live on this planet, the more flu-like pathogens we are exposed to...and exposure tends to impart immunity, or at least, partial immunity. Flu viruses rapidly change and mutate, but there have been many H1N1 strains that we have encountered. Yes, we may have partial immunity still hanging on, but because this strain may be biologically different and unique, it still would be wise to immunize.
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