Health Care Tuesday

• Helen Branswell on what's really happening with H1N1:

  Confirmed H1N1 death tallies capture the blessedly few times someone who caught this bug died from it after testing positive for it. The seasonal flu numbers are estimates, mathematical calculations aimed at capturing all the deaths influenza had a hand in.

  The frequent attempts to equate the two are driving Dr. Kumanan Wilson bonkers.

  Wilson is an expert in public health policy as well as an internal medicine physician at the Ottawa Health Research Institute. He readily admits he never sees anyone die of seasonal flu - a common claim that drives infectious diseases experts crazy.

  Wilson is, however, seeing the destructive power of this strain of influenza.

  "Nobody has seen a flu season like this on the ground level," he says. "If you talk to any frontline worker, they've never seen anything like this. And we keep getting told this is nothing."

• Georges Benjamin, Exec Director of the American Public Health Association, has this to say:

  The U.S. response to the H1N1 flu pandemic has come under fire recently, however, much of the criticism fails to capture the extraordinary achievements we’ve seen thus far.

  Since March when H1N1, also known as swine flu, first emerged, U.S. health officials have acted quickly and effectively to keep the public informed, learn about the virus, and minimize its spread and negative outcomes. This transparency and coordination between agencies has been a hallmark of the flu response since the beginning of the outbreak and has led to an honest conversation with the American people about the risks of and preparation for H1N1.

  During this same time, we witnessed the rapid identification of this novel organism and its genetic sequencing, and the creation of a safe, effective vaccine to protect against its infection.

• From the NY Times:

  A landmark antidiscrimination law — the Genetic Information Nondiscrimination Act — will take effect in the nation’s workplaces next weekend, prohibiting employers from requesting genetic testing or considering someone’s genetic background in hiring, firing or promotions.

• A warning from Doctors without Borders (aka MSF):

  According to the MSF's recent report, titled "Punishing Success? Early Signs of a Retreat from Commitment to HIV/AIDS Care and Treatment", funders' commitment to supporting AIDS treatment for people in poor countries is waning. The report largely focuses on two of the world's foremost programmes that support AIDS treatment. They are the Global Fund to Fight AIDS, TB and Malaria and the US President's Emergency Plan for AIDS Relief (PEPFAR).

  "Last year, in 2008, the Global Fund approved Round 8 Proposals. Unfortunately, because of lack of funding the Global Fund had to cut already approved proposals by $1.5 billion", said Sharonann Lynch, policy adviser for MSF's Campaign for Access to Essential Medicines.

• This was from a week ago, but still quote relevant. it's from ICU doc Christopher Hughes:

  Three of four doctors support health-care reform with a public option. Eight of the 10 largest physician organizations support House Bill 3200, which includes a public option, or something like it.

  A recent survey of physicians published in the New England Journal of Medicine indicated that 73 percent of physicians support either a public and private blend of health insurance or a simple government single-payer system. This is consistent with previous studies

• Controversy over mammograms and breast exams:

  Most women should wait until age 50 to get mammograms and then have one every two years, a government task force said Monday in a major reversal that conflicts with the American Cancer Society's long-standing recommendation of annual screening starting at 40.

  Also, the task force said breast self-exams do no good and women shouldn't be taught to do them.

  The panel has the weight of outcomes-based data. Generally, that outweighs tradition, but with this issue, don't expect automatic acceptance. Entrenched groups have been doing it differently and will defend the status quo.