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We aren't quite done with this particular flu outbreak. The 2009 H1N1 pandemic (aka swine flu) is declining in most places in the US (not in New England yet, but that will come) and we have no idea whether there will be a third wave in spring (maybe), or whether lower amounts of H1N1 illness will hang out like it did all summer (probably.) Vaccine can help to mitigate that, so get your shot when it becomes available (use google maps to find one near you). There's room on line for everyone, but the head of the line belongs to pregnant women and children, followed by older children as well as 25-64 year olds with underlying conditions. And even as flu declines, we already know that we can learn some lessons from what has already occurred in the spring and fall.

1. Expect the unexpected

No one saw an H1N1 pandemic coming. Moat of the planning was for a more severe H5N1. This had implications, because a less severe pandemic needed more flexibility in planning. Schools didn't close, so school buildings could not be used for mass dispensing areas for vaccine and tamiflu or alternate care clinics (and school personnel were busy with their day jobs aqnd not available to help.) HHS and DHS figured out how to get tamiflu to hospitals but not to private pharmacies (how to you give pre-purchased free-to-the-public medicine to retail stores?) While tamiflu shortages didn't materialize in the fall (spot shortages in children's preparations were addressed with instructions to pharmacists to compound adult capsules into syrup), they were a problem in the spring. Flexible responses helped to the point where most of these issues were invisible to the public.

2. Don't over-promise

The response from the Feds and the states, for the most part has been good. The one major error was HHS' over-optimistic prediction of plenty of vaccine by September. Had they simply said "it takes six months (April identification, October production) and it won't all come at once" back on April, they'd not have raised expectations.

3. Don't underestimate the American public (and lose the word "panic" from your vocabulary)

The public only panics when the government tells them not to panic. There's been a relatively orderly approach to vaccine, for example, along with much frustration and angst (see point #2) but given the size of the country and the magnitude of the task, it's a manageable problem. Americans can cope, but only with open and transparent information. See vaccine to Wall Street for what happens when perception is that something unfair is happening.

4. Don't underestimate anti-vaccine sentiment

While a small number of nutters (vaccine is a government plot to implant thought control chips, vaccines are evil) make a large amount of noise, a very big segment of the public has legitimate concerns about vaccine safety and necessity, especially for their children. They need to be treated with respect and their issues patiently addressed (but don't waste time on the nutters.)

5. Public health is under-funded at state and local level

The interface with health reform (get your shot from your doctor) is obvious but nuanced (your doctor may not routinely give shots, you may not have a doctor, you may not be able to afford or find a pharmacy offering shots.) We may be able to (barely) administer 90 million seasonal vaccines each year, but that doesn't mean we can give out 250 million with the same infrastructure. While the feds are in a position to give advice, the locals are not always in a position to carry it out. We've heard from many commenters here about inadequate local vaccine programs, and it is not at all clear that if 250 million vaccines appeared tomorrow, we'd have a way to get it into people's arms. That's the main reason vaccine went to Wall Street (intended for the high risk people only.) Some local public health systems functioned admirably, others simply had no plans for identifying high risk populations and getting vaccine to them. A few that had plans (and most that didn't) were not prepared for the communication piece that is needed to run smoothly. You can't just turn public health infrastructure on with a switch if it is not there.

6. A segment of the public will deny that the sun is coming up

Sometimes it's politics (expect the President's opponents to try and politicize this, a really bad idea when it comes to public health, and one that should be strongly resisted.) And sometimes it's the human tendency to deny (40% of the public in surveys simply doesn't like to think about tomorrow, or bad things.) Taken to extremes (positive thinking prevents illness, and other natural disasters), we get Bill Maher.

While we are losing "panic" form our vocabulary, we should also lose "fear-mongering", the definition of which seems to be "you are telling me facts I don't want to hear." The most ironic example, of course, is the internist who writes books about fear and not panicking, whose own kid was exposed in camp to H1N1 — and, of course, panicked (and had to be reprimanded by CDC.)

7. We need novel vaccine production to come on board

Had this been an H5N1 outbreak with its greater virulence, we'd have been screwed. We are almost there. Newer cell-based and recombinant methods will brew up vaccine in vats (without eggs!) but we are a few years away from that coming on line. Those investments of public dollars need to be continued, and we need progress reports from HHS as to where we are at. See this excellent review for details).

++++

There'll be more lessons to learn, but every institution need to be planning for the next pandemic. Maybe it'll be needed in the spring when a third wave hits, and maybe it won't be needed for a few years to come. But pandemics happen. And when they do, they mean shortages (staff, space and stuff.) Internalize that, be prepared, and expect to be flexible in your response. If you do, and with some cooperation from the virus, you just might mitigate the effects.

Originally posted to Daily Kos on Sun Nov 15, 2009 at 06:08 PM PST.

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Comment Preferences

  •  What a dumbass fool Bill Maher is. (23+ / 0-)

    I sure did lose about 80% of my respect for him.

    This is not what I thought I'd be when I grew up.

    by itzik shpitzik on Sun Nov 15, 2009 at 06:11:13 PM PST

  •  Out of curiosity, in your opinion, what (4+ / 0-)
    Recommended by:
    AKMask, cdkipp, CMYK, deltadoc

    "legitimate concerns about vaccine safety" are there?  Are you being politically correct or do you really believe there are "legitimate" concerns?

    It's an honest question.

    I'm shocked to learn that 1 in 12 Americans do not know that the bird, is in fact, that word.

    by dansac on Sun Nov 15, 2009 at 06:13:44 PM PST

    •  There has just not been enough time (0+ / 0-)

      since the emergence and recognition of a pandemic strain.  

      To accomplish the research, development, and large-scale production of a vaccine going to hundreds of millions of people in the space of six months is a monumental task.  

      There was not enough time for testing anywhere near what precedes even seasonal flu vaccine roll-out, much less a product for a strain not known to exist even six months ago.

      So those quality control and standards tests used for normal vaccine testing were not thoroughly exercised with high levels of repetition, etc., that leaves legitimate questions.

      Then you've got Bill Maher-paranoia on top of 'legitimate'. I never would have expected that I'd agree with Frist before Maher!

      •  not true (7+ / 0-)
        first of all, there were 4800 people tested in August by NIH

        second of all, this is the same technology, same ingredients in flu vax for the last decade.

        not new, very safe.

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Sun Nov 15, 2009 at 07:07:59 PM PST

        [ Parent ]

        •  Yup. (1+ / 0-)
          Recommended by:
          DemFromCT

          It's just different dead virus cells in the same old injectable liquid medium (for the shot), and different not-entirely dead, but modified-so-they-can't-cause-the-flu cells in the same old liquid spray medium for the spray.

          The kids and I got ours yesterday after only 3 hours in line (the first half of which was spent outdoors in 40 degree drizzle).

        •  I know the technology and ingredients are same (1+ / 0-)
          Recommended by:
          CMYK

          It's H1N1, after all, so I'm not talking about the underlying technology.

          But you don't recycle the eggs, for example, from last season's trivalent production.  

          Any time there's new materials brought into any 'same old process', there exists an opportunity to contaminate resource streams, or bring in production lots of growth media, etc. that differ simply because they're different production lots.

          Just one hypothetical example and trying to account for their gearing processes up to address pandemic quantity production levels.  

          One more, however, as my understanding is that trivalent vaccine production begins life earlier in the typical timespan of the flu season, no, and would provide for a longer window of testing?  What's the normal seasonal testing cycle/regime?

          But, you're the specialist and I'd guess you get more directly from the production front-lines than I from obsessive report-tracking.

          Thanks!

          •  well, that's true (2+ / 0-)
            Recommended by:
            CMYK, deltadoc

            Any time there's new materials brought into any 'same old process', there exists an opportunity to contaminate resource streams, or bring in production lots of growth media, etc. that differ simply because they're different production lots.

            but not different from year to year, since you never recycle eggs.

            What we were told is what turned out to be... from the April 21st description until October availability, it took six months.

            Safety tests are run each year, and then FDA licences the vax. Same process, same time frame, only shifted. Trivalent vax is recommended in Feb, then started and available Sept, so very similar time frame.

            "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

            by Greg Dworkin on Sun Nov 15, 2009 at 08:36:15 PM PST

            [ Parent ]

    •  The H1N1 vaccine is very similar (10+ / 0-)

      to regular flu vaccine - just different killed viral particles in it.  Killed.  Many times the seasonal flu vaccine fails to work it is because the "scientists" didn't guess which seasonal flu virus would strike and so got the wrong killed viral particles in it.  With H1N1 the choice of virus is correct - unless it mutates real fast, but then what can you do?  
      Those of us alive when polio was a real threat, and those of us who endured measles, mumps, rubella, chickenpox, etc. and saw friends disappear are a bit more open to vaccines than those who have grown up without those dreaded diseases claiming otherwise wonderful young lives.  
      Sure a rare person has a reaction to the vaccine.  Sure it's tragic.  But the idea of vaccines is to save many lives who would otherwise be lost without the vaccine.  Nothing will ever be perfectly safe.  

      I was wise enough to never grow up while fooling most people into believing I had. - Margaret Mead

      by fayea on Sun Nov 15, 2009 at 06:44:45 PM PST

      [ Parent ]

      •  But all that careful reason and explanation (6+ / 0-)

        doesn't stand a chance when talking to a parent who has heard that it's "dangerous."

        They were giving vaccinations in our school and out of 40 sixth graders, only 4 got permission from their parents to take it ... and some kid who wasn't taking it was going around telling kids that he knew someone who died from it, so my son was freaked out getting it [he still got it, but was scared afterwards].

        It's just a mini-example of how the least rational voices can win out in public communications if they succeed in touching the fear button.

      •  Mary Douglas time (1+ / 0-)
        Recommended by:
        LNK

        British anthropologist Mary Douglas started a nice discussion in the 1960s about the sacred and the unclean. Maybe Bill Maher needs to do a little review to understand why he is saying what he is saying. Basically, outside your body = UNCLEAN. Inside your body = SACRED. This is obvious about most of the fluids and substances in our body when they come out, shit, piss, blood, semen, snot, eye crud, etc., but there also has to be a ritual of sacred transformation to CLEAN and SACRED before something is taken into the body through ingestion or injection. We say grace at dinner, doctors assume a priestly tone, etc. With the right rituals, far more people would be lining up for their shot. Maybe 1-2% of the population is going to get exercised about changes in the receptor binding domain as the H1N1 virus evolves.  

      •  Well said! (0+ / 0-)

        I totally agree. These conspiracy theorists who are so against vaccines are mostly the younger generations who haven't had to live through any of these various epidemics, primarily because of VACCINES and public vaccination programs.

    •  anyone who is pregnant and wants assurance (2+ / 0-)
      Recommended by:
      terabytes, cdkipp

      about what's being injected into them has a legit concern. There happen to be answers to most of the questions for pregnant and non-pregnant patients, but that doesn't de-legitimize the questions.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Nov 15, 2009 at 07:09:31 PM PST

      [ Parent ]

  •  Lesson #8... (9+ / 0-)

    Jenny McCarthy isn't as smart as she looked in those Playboy centerfolds.

  •  Maher lost credibility a long while ago (11+ / 0-)

    His only saving grace is that he's funny. But really, when Frist comes across as the sane human being in a conversation, you need to reevaluate what you're saying, cause somethings wrong.

  •  What is the latest on vaccine availability? (7+ / 0-)

    When will there be enough for all adults to get one? I have a suppressed immune system, and really need one, but my medical condition isn't on the official list of qualifying conditions, so my doc won't give me the shot right now. I'm really worried that I won't get one before I fly over Christmas. Airplanes and airports are giant petri dishes of germs...sorry if that sounds a little Howard Hughes.

    "Women shouldn't be afraid of their governments. Governments should be afraid of women." droogie6655321

    by earicicle on Sun Nov 15, 2009 at 06:21:51 PM PST

    •  I have a chronic condition, too (4+ / 0-)
      Recommended by:
      terabytes, earicicle, cdkipp, CMYK

      Yet, none of the practices for our many MDs except for my kids' pediatrician has obtained it in this area.  I was able to get them in for their first round of shots.

      Meanwhile, I signed up here and continue to look for local opportunities at CVS and other places through online tools.

      "So, please stay where you are. Don't move and don't panic. Don't take off your shoes! Jobs is on the way."

      by wader on Sun Nov 15, 2009 at 06:30:27 PM PST

      [ Parent ]

    •  week by week (3+ / 0-)
      Recommended by:
      earicicle, cdkipp, dsmmom

      and varies by location (each state is deciding). Available in NYC this weekend, not yet in CT.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Nov 15, 2009 at 07:10:43 PM PST

      [ Parent ]

      •  Call around/Not all availability reported (3+ / 0-)
        Recommended by:
        DemFromCT, earicicle, CMYK

        After seeing long lines of people at our health department, fairgrounds, etc., I had pretty much given up on getting a vaccine any time soon for my 2 y.o. based on media reports. Then, just a few days later, I called our doctor's office and learned about availability at our Visiting Nurses' offices -- no lines!

        It seems like availability is getting better? My sisters' kids were vaccinated at school in IN last week.

    •  Sadly, general availability (2+ / 0-)
      Recommended by:
      earicicle, CMYK

      ... is likely to be a ways out, still.

      I called 211 (that's the health department phone number), and a very nice woman helped me find one, however, they were very strict about who was allowed to get a shot. There were nurses walking the length of the line every 10 minutes or so, handing out the list of who could and could not get the vaccine, and reminding people that they should save themselves the long wait if they weren't in one of the groups.

      You may want to ask your doc if he/she will at least let you have the shot 2 weeks before your planned travel date, if the full allotment still hasn't arrived by then - maybe they'll put you on the list for then, since you will be at increased risk when you travel.

      If not, look into getting a good mask, and wear it in the airport and on the planes. Also, drink two cups of green tea a day, and eat plenty of fresh garlic. Both seem to actually help you fight off viruses.

    •  Have you tried your local (1+ / 0-)
      Recommended by:
      earicicle

      health dept?  sometimes they will have vaccine when no one else does, and with your condition, I'm sure they will give it to you, either for free or for a very nominal fee.   You don't need your dr's recommendation for them.

      •  Thank you... (0+ / 0-)

        mataliandy's comment above summarizes the situation in my state (we're both in Vermont). My condition is not on the list, so I'm out of luck for now.

        "Women shouldn't be afraid of their governments. Governments should be afraid of women." droogie6655321

        by earicicle on Mon Nov 16, 2009 at 05:49:30 PM PST

        [ Parent ]

  •  8. Don't Underestimate Anti-Liberal Opportunism n (3+ / 0-)
    Recommended by:
    wader, crose, CMYK

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Sun Nov 15, 2009 at 06:22:14 PM PST

  •  Obama's admin seems to be very effective (1+ / 0-)
    Recommended by:
    mataliandy

    so far.

    From what I can tell by comparing the most severe flu months in Bush and Obama's admins so far, if you take your kid to the hospital with the flu, there's a 4% greater chance of survival under Obama, and that despite the stronger H1N1 strain.

    This is a bad flu, but we shouldn't let anyone get away with saying Obama isn't protecting kids, when he's actually improved their chances of surviving the flu via intense focus on the problem and coordination with health services and parents.

    We shouldn't over-politicize it, but we also need to make sure the media keep it all in context... because we all know they won't if left to their own devices.

  •  Do you need the vaccine if you had H1N1? (6+ / 0-)

    My daughter and I had it in Sept/Oct. No official H1N1 test, but they tested for influenza A and it was positive, so they said that is H1N1 (seasonal is type B). We did get the seasonal shots. But once you have had it, does it provide immunity in the same way the vaccination would?

    Forget about the pursuit of happiness; that way lies grief. Concentrate on the happiness of pursuit.

    by kimtcga on Sun Nov 15, 2009 at 06:24:09 PM PST

    •  If you actually had H!N! which is likely (2+ / 0-)
      Recommended by:
      mataliandy, wa ma

      since you had influenza A, it is the same as having had the shot.

    •  Ehh, its a toss up (0+ / 0-)

      You probably developed immunity, but its not a sure thing. Biology rarely is. Some kids can get the chicken pox more then once before the get immunity. Hell, something like 1 in 5 people have 3 set of teeth in their life, 2 sets of immature teeth before they get their adult teeth. Just to show you a lot of things we consider biological 'laws' are only really approximations.

    •  If you are over 50 you may (1+ / 0-)
      Recommended by:
      cdkipp

      have some immunity from the previous outbreaks of H1N1 which were in the 50's and 60's. However, that is not a garauntee, and if you have anyone at high risk in your family, get the shot if you  can.

      Necessity is the argument of tyrants; it is the creed of slaves.-- Wm.Pitt the Younger

      by JeffSCinNY on Sun Nov 15, 2009 at 06:28:49 PM PST

      [ Parent ]

    •  My understanding ... (0+ / 0-)

      is that they can only test as far as strain of flu A or B. Beyond that they're guessing. Having it should provide immunity. That's really all the vaccine is doing, giving you exposure to let your immune system build up the antibodies.

      •  They can test for subtype (0+ / 0-)

        But once there stopped being any significant number of "A" influenzas in the US that were non-H1N1, they stopped bothering, except for random sampling to verify that, statistically, there are almost no seasonal A's.

        My understanding is that they do sub-type most who are hospitalized with influenza A, and almost all who die from an influenza A (which show almost exclusively H1N1).

        •  Subtype testing still expensive (2+ / 0-)
          Recommended by:
          DemFromCT, mataliandy

          The type A testing is quick and cheap, but the subtype testing, at least here in Finland, still is costing about 140 euros a pop. Doctors order the test only in the rare instance it makes sense, as something like 97% of the testing is coming up H1N1. Obviously, the cost of the test is dropping all the time, but H1N1 has dethroned the H3N2 virus for the moment, reestablishing its dominance after a half century (although it seems to have been lurking in the background since 1977.

  •  All those who squawked "1919! 1919!"... (2+ / 0-)
    Recommended by:
    dark daze, godlessheathen

    for days and weeks on end are just getting laughed at, even more than they were before.

    It's a flu.

    •  EXACTLY (2+ / 0-)
      Recommended by:
      sneakers563, godlessheathen

      Not that the regular flu in and of itself isnt deadly, but this strain was none more so than any other year.

      If I didnt know better it almost smells of public relations campaign in order to try to get more funding.

      (regarding the bank mess) They want to cure the patient but not deal with the disease.

      by dark daze on Sun Nov 15, 2009 at 06:28:18 PM PST

      [ Parent ]

      •  This is not over. (6+ / 0-)

        It is nice to see the numbers drop but we are still heading into winter and any mutation can be a game changer.

        •  Agreed,flu tatistics at this point are incomplete (2+ / 0-)
          Recommended by:
          sneakers563, cdkipp

          ...and thus can be misleading.

          It's good to see a diary on this subject that uses the data in such a responsible fashion.  To the administrations credit, they have not tried to politicize this pandemic, as some have.  Especially with the data incomplete as it is.

          I applaud the diarists thoughtful use and presentation of this data.

          I am that gadfly which God has attached to the state, and all day long and in all places...arousing and persuading and reproaching you.-Socrates

          by The Navigator on Sun Nov 15, 2009 at 06:41:20 PM PST

          [ Parent ]

      •  The rate of pediatric deaths/year (5+ / 0-)
        Recommended by:
        mataliandy, begone, terabytes, cdkipp, deltadoc

        related to flu appears up.

        "So, please stay where you are. Don't move and don't panic. Don't take off your shoes! Jobs is on the way."

        by wader on Sun Nov 15, 2009 at 06:41:13 PM PST

        [ Parent ]

        •  Certainly for this time of year. (5+ / 0-)

          We are comparing oct/nov numbers of H1N1 to prime time flu numbers of previous seasons.

          Long way to go folks.

          As people spend more and more time indoors esp in the cold climate areas, the numbers can go right back up.

        •  people keep talking about 'mild strain' (6+ / 0-)

          But Bill Frist's example was quite real and disturbingly more true of the younger demographics than of others.  

          That's a general characteristic of pandemic flu strains, apparently, they are more lethal among younger people than are 'typical seasonal flu'.

          This bug has a nasty habit of attacking deep lung tissue compared to 'seasonal strains' which is probably one reason its fallout maybe different.

          •  It's also much more likely to lead to pneumonia (3+ / 0-)

            It's not "just a flu," it's a flu that does more damage to tissues, and that is not recognized by the immune systems of those who were not exposed to the prior swine strains until it's had a good while to settle in and start doing real damage.

            It is much more likely to result in a secondary pneumonia infection, and, because the patient is already so weak, to lead to serious complications and death - especially among children.

            •  It apparently targets or can at least infect (2+ / 0-)
              Recommended by:
              mataliandy, wader

              a much wider range of tissue types, as I understand, including cardiac and other organs.  Am I remembering correctly?

              It sounds like you or DemfromCT could also answer a question I have.  

              When there's evidence of the cytokine storm effect, the rapid accumulation of fluids in lungs occurs in that out-of-whack inflammatory response.  This is a different phenomenon than the fluids accumulation that occurs with bacterial pneumonia, isn't it?  

              I mean, it's not just a 'really fast pneumonia', right?

              •  Same phenomenon in both cases (2+ / 0-)
                Recommended by:
                wader, deltadoc

                Just like the damage from a car accident can be caused by hitting a guardrail or by hitting another car pneumonia can be caused by a virus or bacteria (or more rarely, fungi).

                The alveoli in your lungs are filled with fluid courtesy of your immune system as it tries to fight off an infectious agent.

                Those who are getting sick and dying within a few days are somewhat more likely to be dying from a viral pneumonia directly from the H1N1. Those who get sick, seem to recover, then get sick again, are typically getting an opportunistic bacterial pneumonia.

                •  I think I get it (0+ / 0-)

                  both cases accumulate fluids as part of the IR.  

                  But in the case of secondary bacterial pneumonia, the response doesn't occur at 'storm'-level pace or quantity, correct?

                  Thanks!

                  •  with the rapid cytokine storm effect (2+ / 0-)
                    Recommended by:
                    mataliandy, deltadoc

                    you develop "leaky cappillaries" and ARDS and while it is similar, it is not of the same magnitude, nor does it take place throughout the lung with bacterial pneumonia (not unusual to have a bad bacterial pneumonia in only one lung or even one lobe). Viral pneumonia is usually more diffuse, and can be just as bad.

                    Among the complications of an initial (flu) viral pneumonia are ARDS, secondary bacterial pneumonia, and even pulmonary emboli.

                    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                    by Greg Dworkin on Mon Nov 16, 2009 at 05:02:30 AM PST

                    [ Parent ]

        •  Not to downplay ... (0+ / 0-)

          but on the other hand, do they test for flu when kids die of any respiratory illnesses of any kind every year? This is hyper sort of alert for health care professionals along with the rest of us. If you test more to see the cause, doesn't that make it likely you'll see more of the cause?

          •  since 2006, pediatric deaths have been reportable (2+ / 0-)
            Recommended by:
            elfling, wader

            so compared to the last few years, this is up. it isn't a "we're looking this year closer than usual" thing.

            "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

            by Greg Dworkin on Sun Nov 15, 2009 at 07:54:40 PM PST

            [ Parent ]

      •  Not in some areas. (3+ / 0-)
        Recommended by:
        DemFromCT, mataliandy, cdkipp

        An MD friend in MN said a few weeks ago he'd never seen anything like it in 20 years of practice.  ICU completely filled with H1N1 pneumonia patients (yes, they were tested)--all between the ages of 18-55.

        He's pooh-poohed the whole pandemic idea 2 months ago.

      •  My thoughts (3+ / 0-)
        Recommended by:
        elfling, mataliandy, terabytes
        1. If the outcome were worse than predicted would you still be decrying the attempts to get more funding? Where do you think the funding goes? To develop vaccines. There's not much left over for other uses, so it really isn't a boon to research groups.
        1. I have a friend and colleague who just died from complications of H1N1. A healthy, young man. This may not be 1918, but it's much worse than seasonal flu.

        "There are those who look at things the way they are, and ask why... I dream of things that never were, and ask why not?" RFK

        by Light Emitting Pickle on Sun Nov 15, 2009 at 07:09:59 PM PST

        [ Parent ]

      •  not so (6+ / 0-)

        anyone with hospital duty knows that you are just wrong. it's hitting the pediatric population pretty hard.

        it doesn't have to be 1918 to be disruptive and significant. See right part of graphs:

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Sun Nov 15, 2009 at 07:13:48 PM PST

        [ Parent ]

        •  That's a LOT of dead kids (0+ / 0-)

          And flu season has just begun. I wish people had a better understanding that this isn't the same as when it first hit the US last May. May is the END of flu season. November is the START of flu season.  There may be a dip in the chart, but the dip isn't even down to the normal peak level, yet, and we're just starting flu season.

          Kids and pregnant women face a real risk of a very, very serious, life-threatening illness, as do those in the other high risk groups.

    •  but we were glad to be proven wrong in (1+ / 0-)
      Recommended by:
      wader

      hindsight. It was a damn sight better than the opposite.

      Necessity is the argument of tyrants; it is the creed of slaves.-- Wm.Pitt the Younger

      by JeffSCinNY on Sun Nov 15, 2009 at 06:30:07 PM PST

      [ Parent ]

    •  The 1918 virus mutated (3+ / 0-)
      Recommended by:
      mataliandy, fayea, cdkipp

      When it originally struck, like this one, it wasn't so severe:

      The plague [1918 flu] emerged in two phases. In late spring of 1918, the first phase, known as the "three-day fever," appeared without warning. Few deaths were reported. Victims recovered after a few days. When the disease surfaced again that fall, it was far more severe. Scientists, doctors, and health officials could not identify this disease which was striking so fast and so viciously, eluding treatment and defying control. Some victims died within hours of their first symptoms. Others succumbed after a few days; their lungs filled with fluid and they suffocated to death.

      Granted, it's not likely, but it's possible this ain't over. Flu viruses can change on a dime, becoming more - or less - deadly.

      This ain't no party. This ain't no disco. This ain't no foolin' around!

      by Snud on Sun Nov 15, 2009 at 06:47:05 PM PST

      [ Parent ]

      •  How much mutation is required (2+ / 0-)
        Recommended by:
        Snud, cdkipp

        to make vaccination for the prior version ineffective?

        Ok, so I read the polls.

        by andgarden on Sun Nov 15, 2009 at 06:52:11 PM PST

        [ Parent ]

        •  I don't know. I was wondering (2+ / 0-)
          Recommended by:
          andgarden, deltadoc

          when I read the above, if the people in 1918 who got sick from the first, mild wave, were resistant to the second, deadly wave. I would think so, but I'm not at all sure.

          This ain't no party. This ain't no disco. This ain't no foolin' around!

          by Snud on Sun Nov 15, 2009 at 07:02:01 PM PST

          [ Parent ]

        •  I don't know if there is a good answer (3+ / 0-)
          Recommended by:
          mataliandy, andgarden, AKMask

          to that/

          Mutation really isn't something that starts and gets progressively worse, it is a one time event, and that mutation then continues as a new virus.

          Think of the vaccines as pictures of a criminal face that are passed out to the police force in your body. They know what they are looking for after the shot so they don't have to spend time getting ramped up while you get sick.

          With a mutation that picture changes, so the face is  only partially recognizable,or not recognizable at all to the police. Consequently, the immune response is not as strong or does not exist at all.

    •  1919 (0+ / 0-)

      My grandfather and a distant cousin were lost to the Spanish flu. Grandpa had TB and was vulnerable.  The cousin went to a dance Saturday night; was dead on Monday. If I remember correctly, the first wave was fairly benign.  The second and third were the killers.  Not if but when.

      •  Indeed. Nothing can prove the squawkers wrong... (0+ / 0-)

        Since there will always be a tomorrow, and tomorrow the sky might actually fall.

        Stick to your guns!

      •  My grandfather (0+ / 0-)

        Was in the army at the time. When he got sick, his CO sent him to the infirmary. He got there and saw nothing but dead and dying people and decided to go AWOL instead, holing up in a rooming house with lots of soup, and taking many baths, which kept him hydrated (though he probably didn't know that baths did that, I think he was just trying to wash the germs away).

        It was killing people in his unit so effectively, that once you got sick, it was assumed you were dead, so his CO was stunned when Grandpa turned up after he recovered. He'd already been written off as dead. Because Grandpa returned post-illness, of his own volition, the CO didn't even punish him for going AWOL.

    •  OK. My weird thoughts on this ... (1+ / 0-)
      Recommended by:
      DemFromCT

      My daughter was exposed to H1N1 (or Type A of some type, guess we can't be sure.) Requisite incubation period, and she had fever and sore throat. Take her to the doctor, nothing conclusive, doctor recommends against test because it's not that accurate. Then I get whatever. Yesterday my son.

      So, I was thinking. And I know my great-grandmother died of swine flu. But no one else in the family seemed to become especially sick. So perhaps there is a genetic immunity to this thing.

      As you say, it is a flu. The flu can kill you. It's really bad. I remember my son (then 3) coming up and saying, "Daddy won't move" when I was eight and some months pregnant. I thought it was funny I was the healthy one in the family. But my husband was really sick, and needed IVs, etc. Less funny.

      So, it's a flu. I think, in general, we underestimate flu.

      I think I'll agree with your sentiment that this one is probably not worse than seasonal.

      •  first of all (2+ / 0-)
        Recommended by:
        mataliandy, CMYK

        I think, in general, we underestimate flu.

        You are very right.

        but second of all, what makes this different isn't the individual that gets it, it's the younger population that's getting it. Instead of mostly over 65 for hospitalization and death, it's mostly under 65 (and a lot of kids.)

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Sun Nov 15, 2009 at 07:51:12 PM PST

        [ Parent ]

      •  In the immortal words of Tonto... (1+ / 0-)
        Recommended by:
        Magenta

        "what you mean 'we', white man?"

        (It would help more if I weren't white, but wutever - it's still a funny punchline.)

        I am perfectly well aware that yearly flu deaths number in the 10s of 1000s.

        These numbers are well-known and readily available to anyone.

        In reality, the issue is not underestimating the flu, but overestimating it. Especially combined with American style "zomg! (insert bad thing) is gonna kill us ALL!!!!!!"-ism.

        •  I think we basically agree. (0+ / 0-)

          My point was more that we think of this as "big, bad, scary flu" when the regular flu can kill people. So we (as a society, not each individual who might be in that society) make this a HUGE deal.

          We underestimate the flu as an illness in general, which makes this one more easily inflatable into a crisis. As you say "zomg! this will kill us ALL."

          I mean, this is a society that stocked up on duct tape and plastic tarps. And while I know the numbers on flu deaths are readily available, I think many people see the flu in a casual "every viral illness I get is flu."

          I had an editor once who made me rewrite a story explaining that your seasonal illness that passes in a couple of days isn't the flu. She had the flu, dammit, so how dare I talk to doctors who said otherwise.

  •  how about (0+ / 0-)

    how about we learn to stop "crying wolf" and just do the jobs we are suppose to do in public safety. One day the wolf will come but after all these false alarms it will be able to bite us.

    (regarding the bank mess) They want to cure the patient but not deal with the disease.

    by dark daze on Sun Nov 15, 2009 at 06:27:02 PM PST

    •  how about reading my point #6 (6+ / 0-)
      Recommended by:
      begone, 0wn, terabytes, virginwoolf, cdkipp, CMYK

      it's not crying wolf to prepare.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Nov 15, 2009 at 07:15:25 PM PST

      [ Parent ]

      •  you can be prepared (0+ / 0-)

        you can be prepared without crying wolf.  

        I can GUARANTEE you that you neighborhood has a ton more crime and weird shit happening in it then you know, the police WILL NOT share the data with you because it really doesnt do you any good to be frightened all the time.  The police are paid to protect us and they have ajob to do, maybe the people in charge of this crap can take the hint.  Scaring people helps NOTHING.

        (regarding the bank mess) They want to cure the patient but not deal with the disease.

        by dark daze on Mon Nov 16, 2009 at 08:54:02 AM PST

        [ Parent ]

        •  no one is scared and (0+ / 0-)

          no one is scaring anyone. You sound like the guy complaining that it wasn't a cat 5 hurricane as was predicted, it was "only' a cat 2, and your house is still standing (even if downtown is flooded) so what's the big deal?

          Now, don't get me wrong. I'm not defending "H1N1 - killer flu on CNN at 11". But there's been a rare example of that, with the media being mostly restrained and responsible. If you are complaining about that, then you are just complaining.

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Mon Nov 16, 2009 at 09:48:40 AM PST

          [ Parent ]

  •  Frist right and Maher wrong? (5+ / 0-)

    Weird.

    Someone needs to write this book: The Great Conservative Temper Tantrum of 2009

    by grinning dog on Sun Nov 15, 2009 at 06:27:29 PM PST

  •  Interesting contrast to last year. (3+ / 0-)
    Recommended by:
    mataliandy, wader, fayea

    Last year, a couple of local schools closed after just 1 or 2 suspected cases.

    This year, my daughter's high school shut down, but only after 900 kids were out sick, or 40% of the total school population.

    The had an interesting rationale that almost makes a certain amount of sense, though it flies in the face of everything CDC et al promote: with so many kids out, it was clear that parents were doing a good job of isolating their kids from the population.  Once it hit 900, well...

    Unfortunately, their rationale ignores the likelihood that you're contagious before you know you're sick, etc...but what the heck.

    No panic, and that's a good thing.

    Oh yeah --

    We made flu a family gift.  My wife and youngest daughter barely noticed, the teen and I were knocked to the floor.  We caught here in time for tamiflu to turn her around.  Me?  Let's just say I hate the flu.

    Free speech? Yeah, I've heard of that. Have you?

    by dinotrac on Sun Nov 15, 2009 at 06:29:35 PM PST

    •  the idea was (0+ / 0-)

      close only if enough staff and students are out to be disruptive.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Nov 15, 2009 at 07:16:12 PM PST

      [ Parent ]

      •  That's a change for last year, isn't it? (0+ / 0-)

        I thought they were closing at 10% last year.

        Of course, I would have thought 25% out would be pretty disruptive, but... hey -- it's all going away now, so I guess things have been handled pretty well.

        Free speech? Yeah, I've heard of that. Have you?

        by dinotrac on Sun Nov 15, 2009 at 07:25:43 PM PST

        [ Parent ]

        •  it is a change (1+ / 0-)
          Recommended by:
          dinotrac

          too many schools were closing for a different reason. They were trying to stop spread, but that doesn't work when it is ubiquitous in the community. The Dept of education and HHS collaborated on training sessions over the summer to get on the same page.

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Nov 15, 2009 at 07:28:43 PM PST

          [ Parent ]

  •  What do you think of this CBS New report? (0+ / 0-)

    Saying the prevelence of H1N1 is vastly overstated...are they just playing statistical games here?

  •  Excellent diary on the flu pandemic (3+ / 0-)
    Recommended by:
    terabytes, virginwoolf, cdkipp

    Good to see such an important topic diaried on here much.  You don't read many cogent, well written diaries on such a complex subject, so I'm glad to see this here today.

    Thanks for this.

    I am that gadfly which God has attached to the state, and all day long and in all places...arousing and persuading and reproaching you.-Socrates

    by The Navigator on Sun Nov 15, 2009 at 06:33:04 PM PST

  •  Pfizer's firing Wyeth researchers (5+ / 0-)

    Pfizer will still be producing vaccines in NC but is firing researchers that might make the next vaccine or drug.

    The government should have never allowed the merger which is based on Pfizer making money on patented drugs and firing researchers  and shutting down labs to save money.

    We cut back on research to make Wall St. happy then wonder why we lack capabilities to make new vaccines and drugs....

    look for my DK Greenroots diary series Wednesday evening. "It's the planet, stupid."

    by FishOutofWater on Sun Nov 15, 2009 at 06:34:20 PM PST

  •  Thanks for this diary. (3+ / 0-)
    Recommended by:
    DemFromCT, AKMask, cdkipp

    that's all.

    Just thanks.

  •  should have asked frist (3+ / 0-)
    Recommended by:
    AKMask, cdkipp, godlessheathen

    if healthcare cost more because he used his position in the senate to enact legislation that he personally would benefit from.

    "but I would not be convicted by a jury of my peers. still crazy after all these years".....

    by JadeZ on Sun Nov 15, 2009 at 06:48:57 PM PST

  •  I remember watching Bill Maher that week (4+ / 0-)
    Recommended by:
    moira977, fayea, AKMask, cdkipp

    and really disagreeing with him.  I like Bill Maher, his sarcastic comedy fits me well, but some things I completely disagree with him on.  Getting vaccinated is one of them.  Another one is his involvement with PETA.

    "Individuality begins only when tolerance is sustained."

    by mattc129 on Sun Nov 15, 2009 at 06:49:46 PM PST

    •  I used to like Bill Maher (2+ / 0-)
      Recommended by:
      moira977, mattc129

      now I wish he would join Ralph Nader and just go away.  I am sick of Bill Maher's predictable rants about the food we eat making us sick, that and his support of PETA puts him in the STFU category.  The do not get the vaccine position was completely predictable.

  •  Mcallen tx where my daughter (3+ / 0-)
    Recommended by:
    DemFromCT, virginwoolf, cdkipp

    lives is 5 month pregnant still hasn't been able to get the H1N1 vaccine her OBGYN Dr. only got 20 vaccines and don't know when are if she will get any more, looks like South Tx is being ignored, I'm going to call Rep. Lloyd Doggett office in the morning

    "I want to be in Kentucky when the end of the world comes, because it's always 20 years behind" -Mark Twain

    by vet on Sun Nov 15, 2009 at 06:49:47 PM PST

  •  New England reporting in. (0+ / 0-)

    What the hell did we do?

    "The work goes on, the cause endures, the hope still lives, and the dream shall never die." - Ted Kennedy

    by Lazar on Sun Nov 15, 2009 at 06:51:56 PM PST

  •  We have had (2+ / 0-)
    Recommended by:
    Light Emitting Pickle, cdkipp

    no incidences of the flu here in southern Mexico.  The vaccine will not be available until January.  We are hoping the tourists don't bring it down to us.  So far so good.

  •  Vaccine Concerns and Reality (8+ / 0-)

    Hi There:

    I spoke with my brother today whose community has been rocked by the case of a child, under the age of 12, who is now in a wheelchair and to be so for the rest of her life.  Why? Because her body shows signs of having contracted polio.  Why? Because her family decided to have her not get any vaccines because they had concerns about a supposed autism/vaccination link.  I think they learned a very hard and sad lesson about the connection between not getting vaccinations and contracting diseases which people naively suppose to have been effectively conquered.

    This is a hard reality, a hard lesson to learn.  And people who didn't live with the scourge of diseases like polio are often a bit oblivious to another kind of risk that they are taking by having their kids avoid vaccines.

    I am quite pleased that I had my toddler daughter vaccinated, not only for her safety but for community safety.

    •  This is so sad. (3+ / 0-)
      Recommended by:
      AKMask, cdkipp, KHinSF

      The child suffering based on the parents' ignorance.

      •  Yes, and I disagree that it's only a small amount (0+ / 0-)

        of "nutters" who are the problem.  DemfromCT goes a bit too far in legitimizing the vast numbers of folk who, as he says, have "anti-vaccine sentiment".  These are the people who skip on vaccinations for their kids or won't vaccinate them at all.  There is no amount of information or education that will allay their concerns.  They have completely bought into the anti-vaccine propaganda.

        Sorry, but I don't respect people who willfully ignore scientific evidence.

        •  those aren't the vast nunbers of people who have (0+ / 0-)

          concerns about their kids, and who can be reasoned with. I see them in my practice every day.

          According to surveys they are only about 17% of the population, and I was not being conciliatory towards them.

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Mon Nov 16, 2009 at 02:28:03 PM PST

          [ Parent ]

          •  the 17% "they" being the anti-vax nutters (0+ / 0-)

            who you cannot reason with.

            "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

            by Greg Dworkin on Mon Nov 16, 2009 at 02:29:00 PM PST

            [ Parent ]

            •  Thanks for the clarification. Sorry if I (0+ / 0-)

              misunderstood your post.  

              •  here are some legit questions (0+ / 0-)

                The rest of the world uses adjuvants. The US does not. Should we? Are they safe and tested? Would that allow for "vax for all"? Why does Germany give unadjuvanted vax to politicans and adjuvant to the population?

                If we introduced a new technology such as recombinant vaccine (brew in a vat without eggs, ready in 6 weeks, make as much as you want), would the public accept it, mid-pandemic?

                Should we make H5N1 and inoculate people now? That flu has a 63% mortality.

                That's in addition to reasonable questions that have answers (is this current vax safe (yes, decades long track record)), was it rushed (no, it always takes six months and the virus was identified in April), should I give it to my kids if they were sick in spring (yes, because many things look like flu), etc.)

                "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                by Greg Dworkin on Tue Nov 17, 2009 at 05:58:11 AM PST

                [ Parent ]

  •  interesting take on Bill Maher (3+ / 0-)
    Recommended by:
    AnnArborDem, cdkipp, godlessheathen

    as a holistic health counselor I find Bill Maher very well informed on health issues.  I think it is good to have someone out there that takes a counter position on issues such as vaccines and the meat-based American diet.  I agree that his POV is definitely out of the mainstream but he is not uniformed about alternatives to Western medicine.  

    •  no issue with complementary medicine (1+ / 0-)
      Recommended by:
      cdkipp

      but it's not a replacement or an alternative.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Nov 15, 2009 at 07:22:05 PM PST

      [ Parent ]

      •  You SHOULD have issues with complimentary (0+ / 0-)

        medicine. It's at best equal to more reality based medicine (Chiropractic relieves back pain at the same levels that spinal manipulation performed by a spine specialist does) and at worst negligent homicide (the numerous 'special' cancer diets that give you a much shorter lifespan after diagnosis, or homeopathy which is, as anyone can tell you, water).

        These people pray upon those who are extremely vulnerable all to make a buck. It's disgusting.

      •  some would disagree with you (2+ / 0-)
        Recommended by:
        DemFromCT, AnnArborDem

        I do feel Western medicine cannot be replaced in some instances - for example acute trauma or need for surgery.  However, other procedures, treatments or drugs that are utilized by Western medicine cause more problems than the existing illness, and in some cases can be replaced safely and effectively by alternatives.  The best thing is to be one's own advocate and to be involved in the choices for one's own treatment. Don't always just blindly follow the advice of one's phyisican but question the validity of the prescription. I think this is the crux of Maher's arguments on healthcare and something I agree with.  

        •   it's something i have sympathy for (0+ / 0-)

          but being a doc that gives advice as part of a health care team (that includes the patient and family) I think you both are wrong. Absolutely you should question! But when you get the answer and it's backed by outcomes-based data the way flu vaccine is (and vaccines in general), you stop there. it is not appropriate to generalize the rant to include advixce on all vaccines, as Maher did. it is not appropriate to skip chemo and go with laetrile (scam form the 70's). Etc.

          http://www.quackwatch.org/...

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Mon Nov 16, 2009 at 09:54:08 AM PST

          [ Parent ]

          •  I appreciate my doctors but (0+ / 0-)

            if I don't want to do something, even if they have outcomes based data, I am not going to do it.  My obgyn wanted me to have a full hysterectomy and I didn't feel right about it.  I went for acupuncture and for a time, it reversed the issues I was having (I was hoping to make it to menopause and hopefully not have to go through with the surgery).  When the problems came back I sought another MD's opinion and I have my ovaries because of it. But I asked the questions.  I have a friend that was telling me today about her migraines and how her doctor is prescribing drugs she does not want to take - she has been taking prescriptions to no avail and now the doc is upping the ante, telling her to take this new Rx and take it with ibuprofen (the doctor is aware that this woman ended up in the ER with a bleeding ulcer from taking too much ibuprofen).  When she then asked about possible alternatives - like seeing a DC the doctor was quick to dismiss it.  The doctor also dismissed concerns about all these drugs having an effect on the liver.  A while back, I took my mother-in-law to her doc for some arthritic pain and he wanted to put her on a cox-2 inhibitor (I forget which one), when I reminded him that she had had a mild heart attack after being on this type of drug he sheepishly came up with an alternative.  These are the types of reasons why I have no trouble with a little push back by Bill Maher.  

            •  pushback is fine, and so are second opinions! (0+ / 0-)

              But anecdotes are not data. And if all the opinions tell you the same thing, go with the consensus.

              For any given individual, there are choices to be made. But public health looks at populations, and for a population, the outcomes are beyond doubt.

              This is not the place to argue germ theory and the scientific method.

              "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

              by Greg Dworkin on Mon Nov 16, 2009 at 02:24:39 PM PST

              [ Parent ]

              •  i've had a couple of glasses of red wine (1+ / 0-)
                Recommended by:
                DemFromCT

                with dinner so I will let this link talk for me http://articles.mercola.com/...  I don't know if I understand your last sentence either, since your original post was what brought this all up.  Then again, it could be the wine.  ;-)

                •  mercola sells stuff and has been (0+ / 0-)

                  sanctioned by the FDA for false claims. There's no reason to believe anything he publishes. He has neither authority nor expertise nor gravitas.

                  But the red wine, at least, has resveratrol in it. Enjoy!!

                  "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                  by Greg Dworkin on Mon Nov 16, 2009 at 05:11:37 PM PST

                  [ Parent ]

                  •  i did enjoy it (0+ / 0-)

                    Wondering if being sanctioned by the FDA is always a bad thing.  BTW here is Bill Maher's latest on his vaccine pov - sounds pretty reasonable to me.  http://www.huffingtonpost.com/...

                    Just want you to know - I have read you a lot on Dkos, been a lurker (occasional diarist/commenter) since '04 - respect your views.  Enjoying this conversation.  Thanks.

                    •  me, too! (0+ / 0-)

                      note that from the start, flu wiki (my web site) has had a complementary medicine section...

                      http://www.fluwiki.info/...

                      so I don't auto-blast it. ;-)

                      But as for Mercola, funny how people have to jump through hoops (Wondering if being sanctioned by the FDA is always a bad thing) to justify the guy selling snake oil and nostrums.

                      Anyway, that HP piece by Maher was a little more reasonable than his own show. I completely agree that we can't assume doctors are always right, but we can assume that about the scientific method.

                      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                      by Greg Dworkin on Mon Nov 16, 2009 at 07:36:03 PM PST

                      [ Parent ]

  •  Maher just posted on HP (0+ / 0-)

    I just happened to see here.

    Im scared to read and raise my BP unnecessarily before bed.  GL to those that give it a look.

    Maybe tomorrow morning over coffee.

    "If the misery of the poor be caused not by the laws of nature, but by our institutions, great is our sin." - Charles Darwin

    by ViralDem on Sun Nov 15, 2009 at 07:25:57 PM PST

  •  Google Maps Flu Shot Finder = Bogus (1+ / 0-)
    Recommended by:
    CMYK

    Not for nothing, but my mother was asking about this and Google Flu Shot Finder showed no less than 8 places within a 10-mile radius from where she lives.  Each and every one of them shows "Temporarily Out of Stock".  So I would characterize this as bogus and misleading.  Hey, I offer the flu shot too.  Administered by qualified professionals.  Oops!  Out of stock!

    Find an online service that shows where it's IN stock and I'll be impressed.  Otherwise this is nothing but thinly veiled advertising on Google's part.

    •  not really (0+ / 0-)

      give it a week. All the flu locators including the American Lung Association's flucliniclocator.org and HHS's flu.gov (neither has any advertising) simply arent' up and running yet because theres' not enough vax in the out of stock places.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Nov 15, 2009 at 07:35:47 PM PST

      [ Parent ]

      •  That's what I'm saying (1+ / 0-)
        Recommended by:
        CMYK

        If it can't find you a place where you can actually get a flu shot then it's bogus, as in useless.  FWIW the search I did was actually in Connecticut.

        •  no question that (0+ / 0-)

          until there's vaccine, there's nothing to locate.

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Nov 15, 2009 at 08:08:07 PM PST

          [ Parent ]

          •  Right (1+ / 0-)
            Recommended by:
            CMYK

            And if the queen had balls she'd be the king.

            I'm just saying that something that purports to be a "Flu Shot Finder" should actually do what it claims.  They're not touting it as a "Possible Flu Shot Finder".  As it stands, all it's doing is serving as yellow pages type advertising for the pharmacies and clinics that one day MIGHT be able to give you a flu shot.

  •  With the kid's tamiflu, though... (5+ / 0-)
    Recommended by:
    DemFromCT, dotsright, wa ma, vet, CMYK

    this was actually a problem:

    instructions to pharmacists to compound adult capsules into syrup...

    It worked GREAT to make the tamiflu for my REALLY sick 8-yr old... insurance just refused to pay for it, because it looked like an adult dose to them. My very nice pharmacist let me leave with the medicine unpaid for (because it was THAT expensive), while she sorted it out with the insurance co.  Glad she did that-- took 3 1/2 days and 12 phone calls just about my daughter's doseage to finally get them to figure out that every pharmacy in Virginia wasn't overdosing kids- just trying to get them the medicine needed the only way they could.

    Our country can survive war, disease, and poverty... what it cannot do without is justice.

    by mommyof3 on Sun Nov 15, 2009 at 07:32:11 PM PST

    •  it ain't easy (1+ / 0-)
      Recommended by:
      mommyof3

      trying to do this in a country of 300 million is a logistical nightmare, yet the system did work - if only just barely.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Nov 15, 2009 at 07:37:00 PM PST

      [ Parent ]

      •  ...and the tamiflu did seem to work wonders... (2+ / 0-)
        Recommended by:
        vet, CMYK

        with my daughter...  that was more a slam at insurance companies than anything else...

        :-)

        Our country can survive war, disease, and poverty... what it cannot do without is justice.

        by mommyof3 on Sun Nov 15, 2009 at 07:39:23 PM PST

        [ Parent ]

        •  3 in my family were on Tamiflu (1+ / 0-)
          Recommended by:
          mommyof3

          it did the trick the daughter that is 32 was sick for a week,if she hadn't had it she would of been in the hospital

          "I want to be in Kentucky when the end of the world comes, because it's always 20 years behind" -Mark Twain

          by vet on Sun Nov 15, 2009 at 07:55:07 PM PST

          [ Parent ]

    •  Tamiflu and single payer health care (2+ / 0-)
      Recommended by:
      DemFromCT, mommyof3

      how to you give pre-purchased free-to-the-public medicine to retail stores?

      This worked fine in the part of Canada where I live as with the government already being the secondary payer on prescriptions, it was easy to do the billing.

      As far as getting it to them, it was sent to their large suppliers and then sent out to each individual pharmacy.

      The pandemic supply was free to people who had symptoms of the flu. An extra code had to be put in at the pharmacy level so that the government plan picked up the dispensing fee as that was the only cost.

  •  I just arrived back from HI. The guy catty-corner (2+ / 0-)
    Recommended by:
    DemFromCT, CMYK

    behind me one aisle row was sneezing and coughing up a storm. I hope my Purell sufficed.

    Good Night.

    HI to OH time interesting. Time to try sleeping again.

    "They pour syrup on shit and tell us it's hotcakes." Meteor Blades

    by JugOPunch on Sun Nov 15, 2009 at 08:03:29 PM PST

  •  Didn't get the shot, (1+ / 0-)
    Recommended by:
    godlessheathen

    didn't get the flu. Am I allowed to say that here?

  •  The pandemic is yet to come and it's called MRSA (0+ / 0-)

    hospitals are infecting us with disease but profit care is more important than patient care in America.  How many more kid have to die from 'flu' before we address the filthy health care system and demand they clean up their act and stop putting MRSA in our homes and schools.  

    http://www.wisecountyissues.com/...

    Another child died in New York yesterday and we are worried about abortions in a health bill ???

    There will only be change when those unaffected are as outraged as those who are.

    by quidam56 on Sun Nov 15, 2009 at 08:31:05 PM PST

  •  My daughter, who is 23, (3+ / 0-)
    Recommended by:
    DemFromCT, LNK, CMYK

    contracted swine flu.  Both she and her roommate were ill with the flu.  They went to the doctor and got symptomatic relief (cough syrup). The roommate got better after a week or so.  My daughter got pneumonia and pleurisy. She's always been healthy and had no underlying conditions that might predispose her to complications of H1N1. When we went back to the doctor, she prescribed a powerful antibiotic (Levaquin) and it worked. I'm a nurse and I was really surprised that my daughter got so sick because I thought she was a little older than the at risk age group but because I had read the CDC guidelines on H1N1 (on DKos), I realized that she probably had pneumonia and made her go  with me to the doctor. Our public health system, which was once pretty good, has been eroded by public policy and by neglect since the 80s. There are some things that only government can do.

    "They had fangs. They were biting people. They had this look in their eyes,totally cold, animal. I think they were young Republicans."

    by slouching on Sun Nov 15, 2009 at 09:00:28 PM PST

  •  Bill Maher (0+ / 0-)

    agreeing with Limbaugh and Hannity on the H1N1 vaccine? The sky is falling.

  •  Bill Maher is a very strange combination (0+ / 0-)

    of gross ignorance coupled with astounding arrogance. I have seen him make statements like the one in the video time and again. He seems to buy the Republican talking point that government is incompetent and can't be trusted. I know many people believe this but if you start from that assumption without examining it and use it as a basis for rejecting vaccinations you're on very shaky ground.  I hate it that he is considered by many to be a spokesman for progressives. This BS about not trusting vaccines is ridiculous. All he would have to do is research the death rate of people who take vaccines and compare it to the people who refuse to take vaccines. I know many of the studies are flawed when examined closely, but all that I have seen show that taking the vaccine produces a benefit.

  •  I thought winter was the problem but... (1+ / 0-)
    Recommended by:
    godlessheathen

    clearly as the weather gets warmer numbers are going down. And the number in the UK are also declining. So it looks like the Meds were wrong, right, wrong!

    I had swine flu, I felt like shit, it's over, it wasn't that bad, no one around me caught it.

    Looking back this swine flu thing will just be a blip and that's it. Except a lot of vaccinations that will be trashed.

    •  it's an interesting conclusion that won't be (0+ / 0-)

      universally shared. I have told my patients for years that a bad flu season is when you get it (and if you don't, and everyone else gets it, it's not so bad.)

      You seem to be proving my point. ;-)

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Mon Nov 16, 2009 at 04:39:54 AM PST

      [ Parent ]

    •  see this (0+ / 0-)

      I had swine flu, I felt like shit, it's over, it wasn't that bad, no one around me caught it.

      and then see this

      Hospitals, clinics handling heavy load of patients

      Swine flu is yet to morph into the widespread killer that officials feared, but that doesn't mean its impact has been insignificant.

      I'm glad you got through it with nothing else.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Mon Nov 16, 2009 at 04:46:06 AM PST

      [ Parent ]

    •  see this (0+ / 0-)

      http://www.boston.com/...

      It is true that for the majority of people H1N1 is a mild illness, generally causing two to four days of feeling lousy. But the virus is highly contagious. The sheer numbers are staggering. A school in Chicago closed last month when 800 of its 2,200 students were sick. With any flu there are people who will have complications and die. As the number of cases continues to climb, statistics are not in our favor.

      For high-risk groups, such as pregnant women, talk of "mild illness’’ is meaningless. Stories are multiplying of the devastating losses of both baby and mother. In our small town there are young adults who were previously healthy now on respirators in intensive care units.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Mon Nov 16, 2009 at 05:11:33 AM PST

      [ Parent ]

  •  DuPage County IL Health Dept. (1+ / 0-)
    Recommended by:
    DemFromCT

    has done a great job of administering the vaccine.  The H1N1 nasal mist became available the 3rd week in October under 50. It's not appropriate for persons with chronic conditions or over 50 so non-priority groups under 50 could receive it. The injectible became available last week and priority is being given to the higher risk groups.  So basically healthy persons over 50 are still having to wait. The health dept is saying there will be enough vaccine for everyone "more is coming" they say.

    Vaccinations are by appointment only so no waiting in line for 3 hours. They have a 24 hr appointment line as well as 24 hour hotline for questions. I've heard some people have had to wait a long time on the phone but I called twice--the first time was only a 10 minute wait, the second for my daughter's 2nd dose of mist was about 2 minutes. It did take 2 weeks from the time the appointment was made until we were seen. But far preferable to waiting in line for hours. When we arrived, there was no line. We checked in, signed the requisite forms, then proceeded to a table to answer a few questions, and get the standard CDC vaccine info sheet, then straight to the nurse for the mist.  The whole thing took maybe 15 minutes top!

    Co-op + Public Option = Co-option. Call your Represenative, Senator, and the White House to Demand Public Option

    by SuburbanGrrrl on Sun Nov 15, 2009 at 09:49:29 PM PST

  •  Sick people should stay home longer (0+ / 0-)

    I keep running into friends and acquaintances in the neighborhood who just couldn't stay home......They felt well enough to go out and they wanted to go out.

    One had a stomach flu....another had respiratory problem, either flu or a cold....doctor not sure yet.

    I would have stood further back from them had I known.........

    Thank goodness you don't catch anything online except for computer viruses, eh?

    Thanks for the good flu advice and updates.

    Ukraine is going nuts:
    http://news.bbc.co.uk/...

    Media Reform Action Link http://stopbigmedia.com/

    by LNK on Sun Nov 15, 2009 at 11:45:07 PM PST

  •  Bill Maher (0+ / 0-)

    is THE biggest ass on television...

    & that's saying something.

  •  Who makes money off of this? (0+ / 0-)

    Those are the people pushing the hysteria.

    We had a flu season that wasn't even twice as bad as one that passed in 2008 with little fanfare, yet it had zillions of times the coverage.

    The question remains: who made the money?

    PS if you're pro-choice on abortion you are pro-choice on vaccines, no?

    a hard rain's gonna fall

    by Paul Goodman on Mon Nov 16, 2009 at 04:22:01 AM PST

    •  there isn't any hysteria (2+ / 0-)
      Recommended by:
      Slaw, ViralDem

      see points #3 and #6.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Mon Nov 16, 2009 at 04:41:57 AM PST

      [ Parent ]

    •  or to put it differently (1+ / 0-)
      Recommended by:
      Slaw

      there isn't any hysteria, just people writing about hysteria.

      There isn't any panic,  just people writing about panic.

      There isn't any fear-mongering, just people writing about fear-mongering.

      There's really no justification for writing about how everyone is reacting hysterically, but people do, mostly to show how wise and sober they themselves are compared to everyone else.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Mon Nov 16, 2009 at 05:06:13 AM PST

      [ Parent ]

  •  With Maher on a lot, NOT this (0+ / 0-)

    He makes it seem as if all everyone has to do is eat fish and salad and you will live to one hundred. Sorry, but genetics provides the limitations, and your choices give you the variance within those limitation boundaries. I can't eat anything that will cure my defective genes.

    He acted bizarre the last show of the season, and hope the vacation is clearing his mind and tempering his male PMS or whatever his problem is at times.

    Discipline is nothing more than stubbornly commiting oneself to making the same decision in a particular circumstance.

    by gereiztkind on Mon Nov 16, 2009 at 05:00:05 AM PST

    •  New article by Maher, clarifying: (2+ / 0-)
      Recommended by:
      DemFromCT, AnnArborDem

      HuffPo article

      Admits that he blew it with some of his remarks. Coming from such an opinionated and often glib person, he must have done some soul searching, which is more than most TV personalities can say.

      Discipline is nothing more than stubbornly commiting oneself to making the same decision in a particular circumstance.

      by gereiztkind on Mon Nov 16, 2009 at 05:45:43 AM PST

      [ Parent ]

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