August 21, 2009
Greetings,
It’s probably been a while since most of you have heard from me regarding H1N1, but please know that this is consuming the majority of my time as well as others in our office. I apologize if you are receiving this more than once, but I am sending this out to all of my listserv groups to make sure everyone is receiving the information.
Influenza is notoriously difficult to predict. As fall approaches, novel H1N1 could:
- simply go away
- stay with us, but with no change in the severity of the illness it causes.
- develop the ability to cause more severe illness, possibly even mimicking the severe, life-threatening pandemic of 1918.
- A severe pandemic, like the one that occurred in 1918, could turn out to be the greatest public health emergency that any of us will ever see. The result could be widespread illness, many deaths and extensive social disruption.
Most scientists currently expect to see a “second wave” of illness in the fall caused by novel H1N1. Because of the potential for widespread illness and disruption, Nobles-Rock Community Health Services has decided to form a Healthcare Coalition made up of both hospitals and the clinics in our service area. We have also included Emergency Management in these discussions. We have a lot of players and it has quickly become apparent that we needed to start using the Incident Command System. I have attached a copy of what the Organizational Chart looks like for our Incident Command System. Our partners have identified Public Health as the lead for this group and I have been chosen to be the Incident Commander along with the Public Information Officer, since I have been doing these roles up to this point. Again, this is all very fluid and things will change, at least we have some direction now and will make it easier for me to make the day-to-day decisions and communicate the community needs to the Healthcare Coalition and other partners.
The most recent information regarding the vaccines is that there will be a seasonal vaccine as well as a 2-dose (over a three or four week period) H1N1 vaccine. We are anticipating 45 million doses being available to the United States by the end of October and should receive 20 million doses weekly after that. It is the intent of the healthcare providers to vaccinate everyone that is eligible, but it may take up to 10 months starting October for that to happen.
The Advisory Committee on Immunization Practices (ACIP) is recommending the vaccination efforts focus on five key populations. Vaccination efforts are designed to help reduce the impact and spread of novel H1N1. The key populations include those who are at higher risk of disease or complications, those who are likely to come in contact with novel H1N1, and those who could infect young infants. The groups listed below total approximately 159 million people in the United States. When the vaccine is first available, the committee recommends that programs and providers try to vaccinate:
- pregnant women
- people who live with or care for children younger than 6 months of age
- health care and emergency medical services personnel
- persons between the ages of 6 months through 24 years of age, and
- people from ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.
On Tuesday of this week, Jason, Ginny, and myself participated in a Sanford tabletop that included members of the school districts, city officials, along with other stakeholders. At that meeting, we identified the need to include other business partners and Jennifer Weg is working on that.
I have talked with all of the pharmacies in the area and they assure me that their vendors have told them there will not be supply issues with the antiviral medications that help combat the flu-like symptoms. Most of them did not know about the Strategic National Stockpile, so I informed that if for some reason they are not able to get the antivirals, Public Health would be their contact and we would coordinate the activities between them and the state to receive the public shipments.
Speaking for the Coalition, we are really going to limit our “H1N1” talk and use the more general “Influenza” jargon because “the flu is the flu”. Both strains are presenting the same types of symptoms and you would treat or prevent both strains similarly. So, when you hear us talk about Influenza, we really are not making a distinction because we are speaking about the vastness of the disease. If we have information specifically for either the Seasonal or the H1N1 strains, then we will preface the Influenza with the corresponding strains.
We want you to protect yourself against the flu. Experts are saying that 40% of the workforce could be affected by this year’s influenza pandemic. This means that the agencies you work in, businesses you own, businesses you shop at, or places that you frequent may see a 40% reduction in their staff. This will either happen because the employee has become ill or they are caring for someone who has become ill. Imagine this scenario, a child comes home with flu-like symptoms and mom stays home for five days to care for them (see the guidelines below). Then mom becomes ill and needs to take another “recommended” 5 days off of work. Just as she is ready to go back to work, another one of her children becomes ill and she has to take more time off. Is your family prepared to have a wage-earner home for 15 days, hopefully they have the sick time built up, but what if they don’t? Would you shuffle them off to grandparents? What if the grandparents get sick or are in fragile health, do you want to expose them to this illness? What will you do?
Consider many of our local employers that don’t offer sick pay for their employees. Are those employers going to tolerate that mother being gone for 15 days while the mother worries about how she is going to pay the bills because she hasn’t been drawing a paycheck for almost ½ of the month. This is one scenario that we are concerned about because this has happened, is happening, and will happen this fall to someone, somewhere.
A few simple, common-sense precautions are still the most important thing you can do to keep from getting the flu – or spreading it to others. That applies to both seasonal flu and novel H1N1.
- Cover your nose and mouth with your sleeve or a tissue when you cough or sneeze.
- Clean your hands frequently and thoroughly – with soap and water or an alcohol-based hand-sanitizer solution.
- Limit your contact with others who may be ill.
- Clean your hands after shaking hands or having other close contact with others and before eating or preparing food, or touching your eyes, nose or mouth.
- Stay home from work or school – and generally avoid going out in public – if you are sick with symptoms of the flu.
- If you are an employer, encourage your employees to stay home if they are sick with flu symptoms.
- In general, if you are ill with flu symptoms, stay home from work, school or other places where people gather until 24 hours after your fever subsides with the use of medication.
- Health care workers with flu symptoms should continue to observer earlier guidelines: Stay home until seven days after their symptoms first appeared – or 24 hours after their symptoms go away – whichever is longer.
- Guidelines for children who attend daycare and daycare workers are underdevelopment, and should be available soon.
- Be aware of the symptoms of novel H1N1, which are similar to those for seasonal flu:
- fever
- cough
- sore throat
- runny or stuffy nose
- body aches
- headache
- chills
- fatigue
The Coalition members are making themselves available to any group in the community that would like more information about Influenza. You can contact our office and request that someone comes to speak at your event. Also, if you need additional flyers or fact sheets, we can help get those to you as well.
Please share this with staff, friends or family that may find this information useful. If you have any questions, comments, or concerns, please don’t hesitate to ask myself or my staff.
Thank you,
Brad L. Meyer, MHA
CHS Administrator