71 replies to this topic

[bordercolliefan]

Here's an article published today that will scare you...


Critics say 'mild' a misleading term for H1N1
Updated Sun. Jun. 28 2009 2:45 PM ET

The Canadian Press

TORONTO -- Officialdom's mantra about swine flu -- "it is overwhelmingly mild" -- might seem incongruous if we knew the number of children, teens and young adults in ICU beds right now alive only because a breathing machine has taken over for their ravaged lungs.

The heavy reliance on the word "mild " could be creating a false impression of what is actually going on and what the world may face in coming months, some experts worry.

Peter Sandman, a risk communications guru from Princeton, N.J., suggests if authorities are trying to ensure people don't panic about the new H1N1 outbreak, they are concerned about the wrong thing.

"In North America, swine flu panic is much rarer than swine flu deaths," Sandman says.

"The problem isn't panic or even excessive anxiety. The problem is complacency, both about what's going to happen and about what might happen."

When the new H1N1 virus burst onto the world's radar, it was, for awhile, the hottest story of the 24-7 news cycle. The long threatened pandemic, it seemed, was finally underway.

But instead of the 60-plus per cent death rate of H5N1 avian flu -- seen for years as the pandemic frontrunner -- the wire was tripped by a seemingly wimpy virus that is causing a lot of flu, but is no viral monster.

In many places, public health officials have bent over backwards to tamp down anticipated panic. The results? Within a few weeks, most people appear to be convinced the pandemic was (past tense) a non-event, a blip of flu activity over-hyped by the sensationalist media hoard.

"When we're told that swine flu is mild, we don't think, `It will infect a half to a third of the world population and kill a few million people, mostly young people, before it's over,"' says Sandman. "We think, `It's like having a bad cold."'

Well, swine flu isn't over. And it's not like a bad cold sweeping the globe.

But officials and experts are having a hard time striking the balance in messages to the public, unclear what they are dealing with now and what it might become.

"I think the problem is we don't know how to paint this picture properly," says Dr. Allison McGeer, a flu expert at Toronto's Mount Sinai Hospital.

"Because it's perfectly true that most cases are mild. But it doesn't mean that you shouldn't worry about it."

Regular flu, as anyone who has had it know, is no walk in the park.

And with this new flu, a small subset of people gets very, very sick. Their lungs are overwhelmed by an aggressive viral pneumonia one doctor described as looking like a "white out" on an X-ray. A number of hospitals are struggling to keep these people alive.

Generally much younger than the typical hospitalized flu patient, many of these people have been on ventilators for weeks. And every day, officials in some part of the globe announce that a 15-year-old boy, a 24-year-old woman or an otherwise healthy pregnant woman in her third trimester has lost the battle.

"When you look at those things then you begin to say `Well, is it really accurate, is it really fair to say that this is a mild phenomenon?"' says Dr. Keiji Fukuda, the World Health Organization's top flu expert.

Fukuda and his team have been warning for some time that the unusual age pattern of severe cases, the odd out-of-season spread and the fact that the virus is killing some previously healthy young adults makes the term moderate a more appropriate severity assessment.

That pattern, seen in previous pandemics, makes flu watchers sit up and take notice. "What it really leads you to conclude is that boy, we'd better watch this pretty carefully," Fukuda says.

There still isn't a good estimate of the percentage of total swine flu cases that becomes gravely ill, or the percentage that succumbs to the virus's onslaught. Currently the numbers may seem small; 25 deaths in Canada, 127 in the U.S., 263 worldwide. (Swine flu has already beat bird flu in terms of death tolls.)

But as a human pathogen this virus is still a baby, despite its rapid global spread. No one knows what it is going to be when it grows up.

Some things are clear, though. Since most people seem to have no immunity to the virus -- some people over 60 may have some -- huge numbers will probably catch this flu over the next couple of years. In a relatively tight time frame, lots of people will come down with the flu -- far more than would be seen during a regular flu year.

To understand that impact, think back to elementary school arithmetic. If the denominator (the total number of cases) gets substantially bigger, the total number of people falling gravely ill or dying (the numerator) will rise sharply, even if the proportion of severe cases (the percentage) doesn't change.

And sheer numbers could make the outbreak get nasty, fast.

Several centres in North America are already struggling under the load of critically ill patients -- and this is summer, the season when flu viruses don't transmit as efficiently as they do during the cold winter months.

"If this is as bad as it's going to get, this is still not going to be a cakewalk," says Dr. Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

"We still have relatively few people in the population getting sick. We don't know -- 10 per cent? Five per cent? We don't know yet."

"But if in fact we're stretching medical resources, particularly in the pediatric community now in many communities, people will start to die with higher frequency with the same disease spectrum if care is compromised and we can't get every kid on a pediatric vent(ilator)," Osterholm warns.

"Even if the disease severity doesn't change but this fall we see more people get sick at the same time, we're in trouble. Now, add in the potential for this virus to obviously change and cause more severe illness -- I mean none of this is good. I don't know how we can sit here and say `Oh, this is mild."'

Some people worry the constant refrain that swine flu is mild may be keeping people who are becoming severely ill from seeking care as soon as they should. They also worry young people -- the demographic least likely to get a shot for seasonal flu -- may decide they don't need to bother when H1N1 vaccine is ready.

McGeer thinks by that time the virus will have issued its own assessment.

"Unfortunately I think the number of deaths in the end is going to be high enough that people will get the message and generally will get their vaccine."

[wreathlady]

Here's an article published today that will scare you...


Critics say 'mild' a misleading term for H1N1
Updated Sun. Jun. 28 2009 2:45 PM ET

The Canadian Press

TORONTO -- Officialdom's mantra about swine flu -- "it is overwhelmingly mild" -- might seem incongruous if we knew the number of children, teens and young adults in ICU beds right now alive only because a breathing machine has taken over for their ravaged lungs.

The heavy reliance on the word "mild " could be creating a false impression of what is actually going on and what the world may face in coming months, some experts worry.

Peter Sandman, a risk communications guru from Princeton, N.J., suggests if authorities are trying to ensure people don't panic about the new H1N1 outbreak, they are concerned about the wrong thing.

"In North America, swine flu panic is much rarer than swine flu deaths," Sandman says.

"The problem isn't panic or even excessive anxiety. The problem is complacency, both about what's going to happen and about what might happen."

When the new H1N1 virus burst onto the world's radar, it was, for awhile, the hottest story of the 24-7 news cycle. The long threatened pandemic, it seemed, was finally underway.

But instead of the 60-plus per cent death rate of H5N1 avian flu -- seen for years as the pandemic frontrunner -- the wire was tripped by a seemingly wimpy virus that is causing a lot of flu, but is no viral monster.

In many places, public health officials have bent over backwards to tamp down anticipated panic. The results? Within a few weeks, most people appear to be convinced the pandemic was (past tense) a non-event, a blip of flu activity over-hyped by the sensationalist media hoard.

"When we're told that swine flu is mild, we don't think, `It will infect a half to a third of the world population and kill a few million people, mostly young people, before it's over,"' says Sandman. "We think, `It's like having a bad cold."'

Well, swine flu isn't over. And it's not like a bad cold sweeping the globe.

But officials and experts are having a hard time striking the balance in messages to the public, unclear what they are dealing with now and what it might become.

"I think the problem is we don't know how to paint this picture properly," says Dr. Allison McGeer, a flu expert at Toronto's Mount Sinai Hospital.

"Because it's perfectly true that most cases are mild. But it doesn't mean that you shouldn't worry about it."

Regular flu, as anyone who has had it know, is no walk in the park.

And with this new flu, a small subset of people gets very, very sick. Their lungs are overwhelmed by an aggressive viral pneumonia one doctor described as looking like a "white out" on an X-ray. A number of hospitals are struggling to keep these people alive.

Generally much younger than the typical hospitalized flu patient, many of these people have been on ventilators for weeks. And every day, officials in some part of the globe announce that a 15-year-old boy, a 24-year-old woman or an otherwise healthy pregnant woman in her third trimester has lost the battle.

"When you look at those things then you begin to say `Well, is it really accurate, is it really fair to say that this is a mild phenomenon?"' says Dr. Keiji Fukuda, the World Health Organization's top flu expert.

Fukuda and his team have been warning for some time that the unusual age pattern of severe cases, the odd out-of-season spread and the fact that the virus is killing some previously healthy young adults makes the term moderate a more appropriate severity assessment.

That pattern, seen in previous pandemics, makes flu watchers sit up and take notice. "What it really leads you to conclude is that boy, we'd better watch this pretty carefully," Fukuda says.

There still isn't a good estimate of the percentage of total swine flu cases that becomes gravely ill, or the percentage that succumbs to the virus's onslaught. Currently the numbers may seem small; 25 deaths in Canada, 127 in the U.S., 263 worldwide. (Swine flu has already beat bird flu in terms of death tolls.)

But as a human pathogen this virus is still a baby, despite its rapid global spread. No one knows what it is going to be when it grows up.

Some things are clear, though. Since most people seem to have no immunity to the virus -- some people over 60 may have some -- huge numbers will probably catch this flu over the next couple of years. In a relatively tight time frame, lots of people will come down with the flu -- far more than would be seen during a regular flu year.

To understand that impact, think back to elementary school arithmetic. If the denominator (the total number of cases) gets substantially bigger, the total number of people falling gravely ill or dying (the numerator) will rise sharply, even if the proportion of severe cases (the percentage) doesn't change.

And sheer numbers could make the outbreak get nasty, fast.

Several centres in North America are already struggling under the load of critically ill patients -- and this is summer, the season when flu viruses don't transmit as efficiently as they do during the cold winter months.

"If this is as bad as it's going to get, this is still not going to be a cakewalk," says Dr. Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

"We still have relatively few people in the population getting sick. We don't know -- 10 per cent? Five per cent? We don't know yet."

"But if in fact we're stretching medical resources, particularly in the pediatric community now in many communities, people will start to die with higher frequency with the same disease spectrum if care is compromised and we can't get every kid on a pediatric vent(ilator)," Osterholm warns.

"Even if the disease severity doesn't change but this fall we see more people get sick at the same time, we're in trouble. Now, add in the potential for this virus to obviously change and cause more severe illness -- I mean none of this is good. I don't know how we can sit here and say `Oh, this is mild."'

Some people worry the constant refrain that swine flu is mild may be keeping people who are becoming severely ill from seeking care as soon as they should. They also worry young people -- the demographic least likely to get a shot for seasonal flu -- may decide they don't need to bother when H1N1 vaccine is ready.

McGeer thinks by that time the virus will have issued its own assessment.

"Unfortunately I think the number of deaths in the end is going to be high enough that people will get the message and generally will get their vaccine."

Everyone has their own opinion, however, Canada has a bad health care system. They also have a lot of different populations. Not to minimize, it is scary, but I was just asking for this area. I did not want this to become another media hype story. Thanks, but we have to know
our information sources, first.

[wreathlady]

I find it troubling that our country didn't act as Mexico did, in doing everything they could to contain this flu to one area.

For our FDA to say this Swine flu was not containable was false. So we endanger the lives like that of the 24 year old Sacramento woman who just died last week, so everything can go on as usual?

I'm sure some would just say, "Well, we can't stop it and her death was unfortunate, but still, some die every year from the flu."

This is also false, in that 24 year old women don't usually die from the flu. I'm sure if one of OUR children were to die from this flu, it would be far more, than just unfortunate. It would be life changing...and most parents would be devastated.

My heart goes out to this mother for her loss.

I agree. Other countries are doing different things to curtail this flu. We just let anyone in and go anywhere they want. I personally think that we could have had less of a problem if we closed our borders. Maybe if a politicians childs is in ICU then maybe something will be done.

[bordercolliefan]

Everyone has their own opinion, however, Canada has a bad health care system. They also have a lot of different populations. Not to minimize, it is scary, but I was just asking for this area. I did not want this to become another media hype story. Thanks, but we have to know
our information sources, first.

1. The main scientist quoted was from Princeton -- right here in the U.S.

2. Some people think that America -- with 40 million uninsured -- has a "bad" healthcare system. (There are no uninsured in Canada). The uninsured avoid going to the doctor -- putting us all at higher risk (i.e., they will keep spreading the virus, hoping it will pass).

3. FYI, we have already had many more swine flu deaths than Canada.

As I've said all along, I hope and pray that those with a blase attitude are correct. I would be thrilled if this thing just fizzles out! Sadly, it shows no signs of doing so.

[bordercolliefan]

From the New York Times:

U.S. Passes Million Swine Flu Cases, Officials Say

Swine flu has infected more than a million Americans, federal health officials said Friday, and is infecting thousands more every week even though the annual flu season is well over.

That total of those who have already been infected is “just a ballpark figure,” said Dr. Anne Schuchat, director of respiratory diseases at the Centers for Disease Control and Prevention, adding, “We know we’re not tracking every single one of them.”

A survey in New York City, she said, showed that almost 7 percent of those called had had flu symptoms during just three weeks in May when the flu was spreading rapidly through schools. If that percentage of the city has had it, then there have been more than 500,000 cases in the city alone, though most have been mild enough that doctors recommended nothing more than rest and fluids.

The flu has now spread to many areas of the country, Dr. Schuchat noted, and the C.D.C. has heard of outbreaks in 34 summer camps in 16 states.

About 3,000 Americans have been hospitalized, she said, and their median age is quite young, just 19. Of those, 127 have died.

The median age for deaths is somewhat higher, at 37, but that number is pushed up because while only a few elderly people catch the new flu, about 2 percent of them die as a result.

Of those who die, Dr. Schuchat said, about three-quarters have some underlying condition like morbid obesity, pregnancy, asthma, diabetes or immune system problems. Even those victims, she said, “tend to be relatively young, and I don’t think that they were thinking of themselves as ready to die.”

Five American vaccine companies are working on a swine flu vaccine, Dr. Schuchat said. The C.D.C. has estimated that once the new vaccine is tested for both safety and effectiveness, no more than 60 million doses will be available by September. That means difficult decisions will have to be made about whom to give it to first.

[forumreader]

Just another point of view.

http://articles.merc.../Swine-Flu.aspx


Take it or leave it.... Over the past six or so years, I've found this site to be highly informative and on the cutting edge.

[sungod916]

Everyone has their own opinion, however, Canada has a bad health care system.

Hahaha, wreathlady has spoken.
I wonder what their infant mortality rate is compared to ours?
The USA is one of the lowest of the industrialized countries.

[bordercolliefan]

I wonder what their infant mortality rate is compared to ours?
The USA is one of the lowest of the industrialized countries.

Sadly, this is not true. I just read an article stating that our infant mortality rate is, disturbingly, higher than most other first-world countries.

--Was your post being sarcastic? I couldn't tell.

[wreathlady]

Sadly, this is not true. I just read an article stating that our infant mortality rate is, disturbingly, higher than most other first-world countries.

--Was your post being sarcastic? I couldn't tell.

No, I am not being sarcastic. I just asked for this post to be deleted. It is not going the way I meant it to.

[bordercolliefan]

My question about sarcasm was directed to sungod. I wanted to make sure I did not mis-read the intent of his/her post-- I didn't want to contradict him/her if the post was intended to be sarcastic.

Wreathlady, I am puzzled about your approach. It seems like you wanted to throw a topic out there, but then you don't want others to share facts/opinions if they aren't what you wanted to hear. That's not how a forum works... or even a good conversation.

[wreathlady]

My question about sarcasm was directed to sungod. I wanted to make sure I did not mis-read the intent of his/her post-- I didn't want to contradict him/her if the post was intended to be sarcastic.

Wreathlady, I am puzzled about your approach. It seems like you wanted to throw a topic out there, but then you don't want others to share facts/opinions if they aren't what you wanted to hear. That's not how a forum works... or even a good conversation.

I understand how a forum works. However, this forum sometimes goes to far and says more than they need to. I think you went way over the spectrum that was asked. I am just sensitive as I have kids in the age bracket and small grandchildren. So I do not want to hear so much negativity. There is enough out there. I was simply asking if anyone in this area had known of anyone. Thats it.

[4thgenFolsomite]

newsflash

H1N1 has mutated to a drug-resistant version in europe.....

tamiflu won't save us now.

[bordercolliefan]

newsflash

H1N1 has mutated to a drug-resistant version in europe.....

tamiflu won't save us now.

Shhhhhhh!!! No negative info on this forum! This site is for Pollyannas only.

And in case you didn't hear... the economy has recovered, health care is fixed, social security is solvent, everyone's marriages (straight and gay) are happy... and Folsom has found a way to make dog poop vanish instantly! What a wonderful world!!!

[a little bean]

Shhhhhhh!!! No negative info on this forum! This site is for Pollyannas only.

And in case you didn't hear... the economy has recovered, health care is fixed, social security is solvent, everyone's marriages (straight and gay) are happy... and Folsom has found a way to make dog poop vanish instantly! What a wonderful world!!!

Just too bad that there's nothing left to talk about except for sunshine and rainbows...gets boring pretty fast

[sungod916]

Yes, I was being sarcastic.
The USA, sadly, doesn't have the best health care system.

What brought me to this topic is I actually knew the girl (Beth) who died.
I was following her status in the hospital via her facebook when she first got sick (her roommate was updating her page).
It was very sad/scary that she was in UC Davis because I too have heard horror stories.

This was an update BEFORE she was actually dianosed with the swine flu...
"was moved to the ICU yesterday. They have her on a temporary ventilator and have her knocked out. She's not doing very well right now. We're all waiting for her to turn around. She's in the UC Davis Medical Center."

Then another after the diagnoses...

"Beth's taken a dip, her stats have lowers, her blood pressure has risen, and her kidneys are having some problems because of so much antibiotics running through her system. "

Then one of the final updates...

"Outlook is bleak. She's on an ECMO which is oxygenating her blood for her, still on the ventilator, she's on dialysis now because her kidneys aren't working. Doctors are giving her about a 5-10% chance of pulling through."