Hey, guess what? While you were sleeping, the world didn't change. But for reasons of timing and international politics, the same swine-derived (H1N1) novel influenza A that has already spread from North America to nearly every continent is now "on the verge" of being declared the first influenza pandemic in 41 years by the only person that can: Dr. Margaret Chan, Director-General of the World Health Organization.
WHO Director-General Dr Margaret Chan was to hold a news conference on the outbreak at 1600 GMT (12:00 p.m. EDT). Flu experts advising Chan, who met earlier on Thursday, were expected to recommend moving to the top phase 6 on the WHO's six-point scale, the sources said.
But meanwhile the virus does what flu viruses do (spread, infect, cause miseries, close the odd school here and there, and occasionally kill. Even mild flus do that, and this one is being described by WHO as "moderate".) From WHO:
10 June 2009 -- As of 06:00 GMT, 10 June 2009, 74 countries have officially reported 27,737 cases of influenza A(H1N1) infection, including 141 deaths.
but there's an emergency meeting today to advise the Director-General about what she already knows.
UN health officials are holding emergency talks on swine flu, amid speculation that the first global flu pandemic in 40 years will be declared.
The World Health Organization called the meeting after a steep rise in the number of cases in Australia.
Hong Kong on Thursday announced it was closing all its nurseries and primary schools for two weeks after 12 students tested positive for the virus.
The last global flu pandemic came in 1968 over the Hong Kong flu.
That pandemic killed about one million people.
A disease is classed as a pandemic when transmission between humans becomes widespread in two regions of the world.
Yes, the term "pandemic" can be obscured by academic debate (look what can be made out of the word "empathy" if you are so inclined). Lawrence Altman covers that angle in Is This a Pandemic? Define ‘Pandemic’, well addressed by Mchael Osterholm:
"To me," he continued, "a pandemic is basically a new or novel agent emerging with worldwide transmission."
Swine flu is a new or novel agent, and it's done this (so far) and isn't done yet by any means:
If you want to know how that impacts you, it doesn't... if you don't get sick. And it doesn't if no one you know gets sick. And in certainly doesn't if you don't have an "underlying medical condition" that affects your lungs and heart, such as asthma, diabetes, or pregnancy. And it doesn't affect you if it doesn't close your schools or summer camp.
But, just like seasonal flu, the virus is contagious, it spreads, it does close schools and can affect you or people you know. While the media includes "don't panic' overtly or subtly in every message they put out, complacency is a bigger danger than panic, and the right thing to do is to keep talking about it and bore the hell out of everyone until it's routine to wash your hands, cover your cough and stay home for seven days from onset (or 24 hours of no fever if longer than seven days) before you go back to work or send your kids out to infect everyone else. And if you think ahead, you'll stock up on what you need to stay in the house for a week (or two) in case you're too sick to go out.
Here is what's happening in NYC:
New York City officials on Wednesday reported the deaths of three more people [12 total] with swine flu, and estimated that more than half a million New Yorkers may have become sick from the virus
Because NY is not underplaying this, they've done some really remarkable things. In the name of transparency, they publish every day which schools have high absenteeism, and which schools are closed (in NYC they have all reopened, and they are hopefully past the peak of school closure). They are asking the question of how many are ill and they are reporting the results:
June 10, 2009 – The Health Department released preliminary findings from a household survey designed to estimate the prevalence of flu-like illness in New York City during the first three weeks of May. Some 6.9% of the New Yorkers surveyed said they had experienced flu-like illness between May 1 and May 20. Flu-like illness was defined as having a fever accompanied by either cough or sore throat – symptoms that can reflect a range of different illnesses. "The findings don’t tell us exactly how many New Yorkers have had H1N1 influenza," said Dr. Thomas Farley, New York City Health Commissioner. "But they suggest it has been widespread, and mild in most affected people."
That's not fear-mongering (in flu context, it's an accusative term used by people who can't handle bad news and therefore want everyone else to stop talking about it.) Nor is it a secret plot by former DoD Secretary Don Rumsfeld to sell tamiflu to widows and orphans. What it is is a great example of transparency, and one we are all going to need (if not this summer, than this fall.)
Here are some hard facts:
- Flu pandemics happen, and we are experiencing one. Today, it's expected to be made official.
- Only 7-30% of a community will get ill, but some will get very ill. Even those who don't will feel pretty awful for a week.
- If you have a high risk medical condition, contact your doctor right away if you get flu symptoms (fever, cough, aches and pains, GI upset) but most people can take care of themselves at home.
- Warning signs for flu (seek medical care right away) include:
- has difficulty breathing or chest pain
- has purple or blue discoloration of the lips
- is vomiting and unable to keep liquids down
- has signs of dehydration such as dizziness when standing, absence of urination, or in infants, a lack of tears when they cry
- has seizures (for example, uncontrolled convulsions)
- is less responsive than normal or becomes confused
School's almost out across the country, but the expectations are now that this virus will linger in some form through much of the summer, and no one really knows what will happen in the fall. This is not 1918 flu, but reoccurred in a
"second wave" is
not unexpected. We do not know what to predict for the fall. Could be a mild seasonal flu, could be worse.
Not everyone needs testing (most people don't - if you have flu symptoms in flu season, you've likely got flu.) And people without underlying conditions who are not that ill don't need tamiflu or other anti-virals (but those with an underlying medical condition might.) Go here for more guidance or check with your health provider or local Department of Health (that's why they are there, so pay your taxes and let them do their job.)
And if you can't pay attention to flu news for yourself, do it for your kids. They are in the age range that's being hardest hit.
60% of the cases and 42% of hospitalizations have occurred in people between the ages of 5 and 24 years. hospitalization rates, that is cases per population, are highest in people 5 to 24 and next highest in children under 5. This is quite different than what we see with seasonal influenza where the highest hospitalization rates are in the elderly.
Then again, you see that in pandemics.