Testing It Up

Have you ever heard of a swine flu party? Reading about these sorties caught me by surprise; we do not mean to offend anyone’s beliefs, but we certainly do not agree to the point behind such a gathering. Apparently, there are parties where the “guest of honor” is someone who is sick with swine flu. The guests then hope against hope that they catch the virus, get sick with a mild illness, and gain immunity.

This is not such a good idea, according to the Centers for Disease Control and Prevention (CDC), and it is only one of a few things that anyone should not do when it comes to preventing swine flu.

Another one is to think that if you already have the seasonal flu vaccine, then you should be all set. The reason behind why there are efforts towards developing a specific vaccine for swine flu is precisely because the seasonal flu vaccine is not going to cut it. While those of us who do not fall under the priority demographic for swine flu vaccine will have to wait for our turn, there is a need to get both vaccines if we would like to be protected.

Donning a face mask also does not mean guaranteed protection. It will work, though, in conjunction with other prevention steps such as washing your hands often and avoiding touching one’s eyes, nose and mouth. The CDC does recommend that sick people wear a face mask in order to avoid infecting others. Also, face masks are meant to be worn once and then discarded; don’t wear one, stick it in a drawer somewhere, and keep it for use another day.

Do not forget to clean up – whether it is at home or at your tiny cubicle in the office. Flu viruses have a tendency to stick around on doorknobs, tables, linens – basically anything and everything that you touch or that touches you. If someone in your household has the flu and you have to wash the linens, don’t hug the laundry on your way to the washer and set your dryer to hot. After handling dirty laundry, do not forget to wash your hands with soap and water, or use an alcohol-based hand gel.

Health officials in the United States can probably take a cue from what is being done in Europe in as far as the distribution and administration of swine flu vaccine is concerned.

In London, for instance, one will not see long, snaking lines of frustrated and disappointed people waiting to be vaccinated against swine flu. Doctor’s offices are not inundated with calls for vaccine. There are also no issues regarding seeming injustice as to who gets to get swine flu first. In North America, people have complained about the fact that bigwigs such as Goldman Sachs and Citigroup were able to acquire swine flu vaccine while community clinics still waited for vaccines to arrive. In Canada, professional hockey and basketball players were administered with swine flu vaccine before children.

European countries employed an approach that is the exact opposite of the free-for-all system being practiced in North America. Instead of announcing the availability of vaccines and launching campaigns to encourage people to get them, some European countries have decided to adopt a by-invitation system. Health officials in Britain, for instance, made a list of those who are to be prioritized for vaccination, and these identified citizens were sent notices. These include pregnant women, health workers, and people with chronic health conditions such as diabetes, cancer and AIDS.

Probably due to the fact that the cases of swine flu in European countries are not as widespread as those in the United States – Britain reportedly has an estimated 600,000 flu cases against the millions of cases in the United States – some Europeans have been relatively indifferent and unconcerned. There are those who have received notices to come in for shots who have opted to ignore these notices.

But then again, what works for one may not necessarily work for another. Whether this system will work in the United States cannot be assured at this time, although it does seem like the European system is more effective in reaching those who ought to be reached.

The Centers for Disease Control and Prevention is urging citizens to just sit tight – there are more doses of the much sought-after swine flu vaccine due to arrive. At this time, there are reportedly more than 31 million doses of the vaccine that is available, with 10 million more due to arrive before the week is over.

Still, though, the rate of arrival is not nearly as fast as health officials would like it to be; lines are still rather long in the vaccination centers. More doses are definitely needed in order to stave off the frustration and impatience that is currently being felt both by the general public and the health care providers over the shortage of flu vaccine supply. Health officials are basically also placed in a bind, as they try their best to strike a balance between preaching the importance of getting vaccinated while ensuring that there is enough of the vaccine to serve everybody.

One thing that they would like to manage is the frustration of patients who are not immediately administered with the vaccine due to issues experienced with supply. These patients may no longer come back at a later time for the vaccine, which means that they will miss the chance to get protection against the H1N1 virus.

There is reportedly still a high demand for both the swine flu and seasonal flu vaccines, although most of the flu that is being diagnosed right now is H1N1. While there have been almost no cases of seasonal flu, this fact does not discount the possibility of still catching the virus, so a shot against it is still considered prudent.

Also, people are encouraged to seek treatment proactively and in a timely manner, especially those who have underlying medical conditions such as asthma. Persistent cough and fever should merit seeking professional help.

Prevention is still key, so everyone must wash their hands thoroughly and regularly, cover their nose and mouth when sneezing and coughing, and stay home when sick.

The supply of swine flu vaccine may not seem enough and the lines to get the vaccine may not be getting any shorter, but there is another aspect of the pandemic that does not seem to be getting enough attention — treatment.

U.S. health officials are saying that not everyone who should be getting treatment for swine flu are actually getting it, and it is not because resources are not enough to accommodate them. Despite the fact that all indications point out that swine flu continues to spread, only about half of patients who need immediate treatment for H1N1 flu are actually seeking treatment. Even among those who have underlying conditions such as asthma, heart disease and lung disease, only half reportedly sought medical treatment.

It seems that aside from encouraging people to get themselves vaccinated, health officials also need to find a way to encourage people who actually develop swine flu to seek the appropriate care, treatment and help. When we come right down to it, at this point, when there are still some issues with the supply of the vaccine, it may be prudent to put more focus to getting people to seek medical attention if and when they need it.

That does not mean, though, that health care professionals in emergency departments are just sitting by idly. They are still inundated by patients, alright, just not the ones who need medical care.

The challenge here may be helping people recognize the symptoms and make that critical decision to seek help at the right moment. While the CDC and local health officials have widely circulated the symptoms since this health-related issue started in April, the fact that the symptoms themselves may be misconstrued as something else that is not all that worrisome may be confusing to some people. What we the citizens can probably do is to try to achieve that appropriate mix of not overreacting but still being keen in determining whether or not it is time to seek help.

It is an extremely difficult question to answer, and at this point, there may be no way of telling. For the most part, what we do have are mixed feelings and mixed reactions. The United States government has been getting both flak and praise for how they have been and are handling the outbreak of swine flu in the country.

On the one hand, people and health care providers have been frustrated due to the lack of vaccine experienced in the past week. On the other hand, a vaccine was developed in record time and anti-viral stocks were pushed out when they were needed.

Still, there is the fact that the number of swine flu cases has now reached millions, a figure that is enough to make some people quite anxious. In a span of about three months or so, the number of cases reportedly reached almost six million, according to calculations released by the Centers for Disease Control and Prevention (CDC).

These numbers are not exactly count-by-count figures; to arrive at these estimates, the CDC needed to extrapolate somehow. For one, most people who developed swine flu may have only experienced mild symptoms and recovered without the benefit of medical care or even getting tested for the virus. The assumption that was used was that for every one confirmed swine flu case, there may have been as many as 80 cases that were unaccounted for.

It was also assumed that for every hospitalization that occurred at that time, there were probably three others who were hospitalized.

At any rate, people are still dealing with living with the disease in their midst in whatever way they think is best. Demand is still high for both swine flu and seasonal flu vaccine, despite the disappointments and frustrations that have been widely publicized. If anything, the reported shortages seem to have heightened demand all the more.

To close, we still are far from being able to conclude that things are looking up; but we urge everyone to make the most of what we do have, and go from there.

It seems like swine flu is bringing nothing but challenges for health officials. When the disease first came out, the challenge was diagnosis and quarantine, as well as the dissemination of information regarding steps towards prevention and what to do in the event of contraction. Then came the challenge of developing a vaccine to protect the population against the disease. And now that the vaccines have been manufactured, the challenge is to convince people to get immunized.

According to a report posted by Reuters on Friday evening, a school in Maryland was ready to administer H1N1 vaccinations – but only 20 percent of the children had the proper parental consent to receive immunization. The rest of the children either had incomplete paperwork or were not allowed to receive immunization at all.

The fact that the disease is new has lead to the conclusion that the vaccine itself is also new; hence, some parents feel that it has not been tested enough to be considered as safe. This is probably complicated further by the fact that the concept of immunization has been doubted by some people to begin with, although that is an entirely different issue in itself.

Dr. Anne Schuchat of the Centers for Disease Control and Prevention, however, expressed surprise at all the misinformation as well as doubts that have been circulating regarding the swine flu vaccine, as reported on a post by the Associated Press. The benefits of getting immunized, especially for those who are highly susceptible to contracting swine flu such as children, far outweigh the potential risks that may arise as a result of getting vaccinated. The vaccine, she says, still remains to be “the best way to protect children and adults from both strains of the flu,” seasonal and H1N1.

Health officials are also trying to clarify that the process for developing the vaccine is not new, in the hopes of allaying the concerns of some parents regarding the newness of the vaccine and the amount of testing that has been done with it. While the virus that caused this swine flu pandemic is, indeed, new, the concept of a vaccine against the flu in general is not new. Swine flu vaccine is manufactured using the same process used in manufacturing seasonal flu vaccine.

Even as the distribution of swine flu vaccine is ongoing across America, the number of deaths among young people due to swine flu continues to rise. This will probably give parents more reason to have their children as well as themselves vaccinated, or lead some of those who have initially elected to forego vaccination to have a change of heart.

The spike in the number of deaths has caused alarm since the rate is unusual, even for the flu season. In the past week alone, 19 deaths among children and teenagers were reported; this is said to be the highest pediatric death rate in a single week since the start of the swine flu pandemic last spring. Last week’s count has increased the total number of deaths of those under the age of 18 to 76 for this year, a high number compared to the 46 to 88 deaths due to seasonal flu per year among children over the past four years.

In total, more than 3,800 Americans have succumbed to complications associated with the flu, more often the H1N1 virus. This count includes at least 28 pregnant women.

While the government has already purchased 250 million doses of swine flu vaccine for distribution across the country, it is reportedly ready to purchase even more doses should more people choose to have themselves and their families vaccinated. According to recent surveys, only 40% of Americans intend to get the vaccine; vaccination is completely voluntary for most people.

While the illness brought about by the virus is essentially considered as mild, with some people recovering from it without the benefit of medication, there are those who can get seriously ill when struck with the virus. And the absence of pre-existing conditions such as asthma does not necessarily ensure a speedy recovery; some of the children who have died from swine flu reportedly used to be healthy prior to coming down with the flu.

The initial doses of swine flu vaccine are being administered to recipients who are high up in the priority list as we speak, and with a relatively new illness such as H1N1, it is not surprising that there are a lot of questions on people’s minds.

For those who are interested in having themselves and/or members of their family vaccinated against swine flu and would like to know when these will become available, they already are; at least, doses have already been shipped off and should already have been received by distributors and retailers. However, getting the vaccine will probably not be as easy as popping in at any doctor’s office and paying up. It will be in your best interest if you get in touch with your doctor or with clinics, pharmacies and other retailers in your area regarding the level of availability and what their procedures are for distributing the vaccine.

If the vaccine is ready and available, who gets to receive them first? In the case of swine flu vaccine in the nasal spray form, its use is approved for healthy people aged 2 until 49. At this time, initial doses have already been administered to health care workers who directly interact with patients. Next in line are caregivers and household members who take care and come into contact with infants below 6 months old. The rationale behind it is that these young infants are highly susceptible to swine flu but could not receive the vaccine yet, so it makes good sense to ensure that immunization is done on the people they interact with.

In the case of another high-risk group, women who are pregnant, flu injections are to be administered since nasal spray is NOT approved for use on pregnant women. Adults are to be given one dose of the vaccine; children will receive two doses.

The first wave of swine flu vaccines have arrived in the United States. The arrival of the vaccine coincides with the start of what is usually known as the annual flu season, although the level of activity at this time is reportedly already higher than what the country has seen in recent years, at least according to Tom Skinner, a spokesman for the Centers for Disease Control and Prevention.

The good news at this time is that even if there seems to be a spike this early in the season, it does not necessarily mean that things will only get worse. It can very well be taken to mean that the season peak will be reached sooner and decline sooner as well; such is the unpredictability of the flu. For now, however, the reports are not very encouraging; according to the CDC, 27 states indicated widespread cases of the flu, mostly H1N1 related.

Two forms of the vaccine are expected to be shipped: one is injectable, and the other is in spray form. Twenty to twenty-five percent of the total available vaccine will reportedly be made up of the nasal spray FluMist which is manufactured by MedImmune, a unit of the pharmaceutical company AstraZeneca. There are over ninety thousand vaccination sites spread across fifty states, the District of Columbia, and eight territories of the United States.

According to the CDC, the vaccine is contained in one dose and ten-dose vials and transported by refrigerated trucks. Four distribution sites, the locations of which are not disclosed, receive cartons containing the vials; these sites are reportedly being run by McKesson Corporation, a health care company.

These are then packaged into 100-dose allotments using insulated packaging. Cold packs keep the vials in a temperature-controlled environment (35.6 to 46.4 degrees Fahrenheit) as they make their way to the various vaccination sites. If the vials do not remain at this temperature when they reach vaccination sites, they are returned for replacement.

Although we have been inundated by swine flu news and concerns since the summer, the annual influenza season officially starts today. Swine flu, however, has been around for quite some time and cases upon cases have already been identified and treated across the United States; this year reportedly marked the earliest flu season in the past forty years.

We have already shared with you the news that initial batches of swine flu vaccines are making their way to doctors in the United States, triggering the beginning of what is termed by a Bloomberg feature as “the country’s biggest influenza prevention program”. Nasal spray vaccine from manufacturer AstraZeneca Plc, about 600,000 tubes, is reportedly set to arrive Tuesday next week; between forty to fifty million more doses will be shipped the week after.

Priority for administration of the first batch of vaccines will be given to those who are most at risk, namely health-care workers, children, pregnant women and those afflicted with chronic conditions that place them at risk for complications. The CDC advises adults who do not belong to any of the above groups, as well as the elderly, to wait for additional supplies before getting vaccines for themselves. The prioritization seems to be based largely on data gathered from previous and existing swine flu cases, which seem to hit pregnant women and children the hardest. In contrast, the seasonal flu usually affects the elderly, mostly those who are over the age of 80.

Doses will be provided to individual states and they are given the liberty to decide how these initial doses are to be distributed, according to CDC National Center for Immunization and Respiratory Diseases head Anne Schuchat.

With the opening of the fall term last month, the number of cases increased, with potential 27,000 cases among students spread among college campuses reported by the American College Health Association. The onset of cold weather may also help spread flu, so hospitals are preparing for an onslaught of cases in the coming weeks.