Study links pandemic spread to gaps in paid sick leave
February 19th, 2010 | Author: BDempsey
Lisa Schnirring 
Staff Writer
Feb 16, 2010 (CIDRAP News) – Employees without paid sick days were more likely to work when they were sick during the peak of the fall pandemic wave and may have extended the outbreak by infecting their coworkers, according to a research group.
Using data from the US Centers for Disease Control and Prevention (CDC) and the US Department of Labor, the investigators estimate that almost 26 million employed Americans age 18 and older may have been infected with the pandemic H1N1 virus from September through November. They projected that nearly 18 million took at least a part of a week off due to illness and that 8 million apparently worked while they were sick.
The researchers, from the Institute for Women’s Policy Research (IWPR), published their findings on Feb 8 on the organization’s Web site. According to an earlier IWPR estimate, four fifths of low-wage workers lack defined paid sick days, a situation that is more likely to affect women, minorities, and young workers who are on the lower end of pay scales—categories that also match some of the groups at risk from H1N1 flu complications.
Robert Drago, PhD, coauthor of the report, said in a press release from the group that working while sick is a public health issue and that those who worked while they were infected with the pandemic H1N1 virus this fall may have infected as many as 7 million coworkers. Drago is professor of labor studies and women’s studies at Pennsylvania State University.
Central to the report are comparisons between absence rates before and after the fall flu peak between workers in public-sector jobs, which are more likely to have paid sick leave, and those working in the private sector, who have less access to paid sick days.
Kevin Miller, PhD, a senior research fellow at IWPR and coauthor of the report, said in the press release that the findings suggest that only two thirds of private-sector employees took time off work when they were infected with the pandemic H1N1 virus. “Workers without paid sick days must choose whether to go to work sick or lose pay, a choice that many can’t afford to make,” he said.
The United States is one of a few developed nations that doesn’t have universal paid sick days, which the IWPR and others have said impairs the nation’s response to infectious disease outbreaks. According to the IWPR, 89% of state and local government employees and nearly all federal employees have paid sick days, but only two of five private-sector employees have paid sick leave coverage.
Congressional members have introduced legislation making paid sick leave the national standard, but the topic spurred controversy during a legislative hearing in November as the nation’s fall pandemic activity was peaking. Though some members of Congress framed the issue as a public health risk to workers and the general public, others pointed out that compulsory paid sick leave could hurt small businesses and work against flexible paid-time-off policies that others have instituted.
Study details
The researchers made their projections and comparisons using CDC data during the weeks of the fall peak and the US Bureau of Labor Statistics’ Current Population Survey data on work absences covering September, October, and November.
In September and October, absence rates for workers in both sectors rose, the public sector by 84% (1.9 percentage points) and the private sector by 66% (1.2 percentage points).
Though absence rates for both groups declined in November from the October peak, the decline was less steep for those in the private sector (8.9%) compared with the public sector (21.8%).
“The discrepancy in the drop-off may indicate that infections in the private sector continued at a higher rate than in the public sector as the result of presenteeism connected to lower rates of access to paid sick days,” the researchers wrote. They added that the same patterns in the two groups are seen during seasonal flu outbreaks.
They pointed out that some of the results from comparing absences with employment sectors didn’t achieve statistical significance, which they said isn’t surprising with only 3 months’ of data. However, they said the results are “sensible,” with the same patterns between the two work sectors seen over the past three flu seasons.
“The public sector results suggest that the vast majority of employees infected with H1N1 would have stayed home if that were a viable option,” they wrote.
Business perspectives
A. Bruce Clarke, an attorney who is president and CEO of Capital Associated Industries, a North Carolina non-profit with 1,000 member businesses, told CIDRAP News that one key flaw in the study is that it doesn’t take into account that people come to work sick, regardless of their paid sick leave status. “Not many people stay home at the first sign. We are often mid illness before it makes any sense to be gone,” he said.
He also added that some groups that support a national paid sick leave policy underreport the percentage of employers who offer paid time off—with some only counting paid sick days that are specifically labeled. He said that, according to his own survey, 86% of employers offer paid time off that can be used as sick leave. He said a US Department of Labor survey of manufacturers has revealed that 96% have paid time off that can be used during illnesses.
Lisa Koonin, MN, MPH, a senior adviser with the CDC’s influenza coordination unit, said it’s important to keep in mind that it’s not always easy to distinguish when an employee is working sick. She said some flu infections are so mild the employee might not realize he or she is sick. Also, she said the CDC’s illness projections account for the presences of illnesses that are not influenza.
She said the bottom line is for employers to have more flexible sick leave policies during health emergencies. “This is something to think about, especially when the threat is severe,” Koonin said.
“Not all businesses can have the same policy” she said, adding that in a public health emergency, examining ways to make sick leave policies more flexible makes sense and is just one part of a comprehensive strategy to make the workplace safer for employees.
See also:
Institute for Women’s Policy Research press release
Feb 8 Institute for Women’s Policy Research pandemic H1N1 sick leave study
http://www.iwpr.org/pdf/B284sickatwork.pdf
Statement by Dr Keiji Fukuda on behalf of WHO at the Council of Europe hearing on pandemic (H1N1) 2009
January 30th, 2010 | Author: BDempsey
Jan. 26, 2010
WHO is pleased to take part in this hearing, and thanks the Council of Europe for taking this initiative. The H1N1 influenza pandemic has created immensely complicated challenges for countries as well as the global community. At the same time, rising to this challenge has created an unprecedented level of global cooperation and coordination among countries in confronting a fast-moving threat in this increasingly linked and globalized world. There is much to learn about how the world can improve its handling of such events and a need to separate fact from rhetoric. Again, we welcome this opportunity.
For complete response, http://www.who.int/csr/disease/swineflu/coe_hearing/en/print.html
Did the WHO Exaggerate the H1N1 Flu Pandemic’s Danger?
January 26th, 2010 | Author: BDempsey
Top of Form
By EBEN HARRELL Eben Harrell –
Time Magazine
Tue Jan 26, 5:25 am ET
By the summer of 2009, shortly after the H1N1 flu pandemic had first emerged, there was a waiting list for the first several million doses of the forthcoming new flu vaccine. At the head of the line, naturally, were the world’s richest nations. “Again we see the advantage of affluence,” said Margaret Chan, the head of the World Health Organization (WHO), at a news conference on July 14. “Again we see access denied by an inability to pay.” Describing H1N1 as “entirely new and highly contagious,” Chan scolded rich countries at the time for hoarding the “lion’s share” of the global H1N1-vaccine supply.
Six months later, Chan’s admonitions seem prescient. Rich countries’ hoards have become massive surpluses, and many nations are now trying frantically to cancel pending orders of vaccines or transfer them to poorer nations. France, which had ordered enough of the vaccine to inoculate its entire population of 60 million, has so far used only 5 million doses and now wants to cancel 50 million doses and sell millions more. Similarly, the Netherlands has a 19 million–dose order for sale to other countries, while Germany is in talks with drug manufacturers to halve its order of 50 million doses and sell off millions of others. Switzerland, Spain and Britain are also considering giving away or selling the millions of doses of the vaccine they have received or have on order. The U.S., which has so far distributed 160 million of the 251 million doses it purchased to doctors, hospitals and other health care providers across the country, has yet to make a decision on whether it will have an overflow and what it will do with any surplus. (Watch TIME’s video “Chicken Eggs and Antigens: How the H1N1 Vaccine Is Made.”)
The excess in many countries occurred partly because health officials initially thought the vaccine would require two doses instead of one, and many countries signed contracts with manufacturers under that assumption; it turned out that a single dose was enough to build immunity. But the main reason for the surplus is simply that demand for the vaccine fell far short of what was originally expected. Now, after governments have spent billions of dollars on vaccines that were not needed – France alone spent $1.25 billion – some politicians and health professionals are looking to hold someone accountable.
“WHO advised us falsely. They raised a false alarm,” says Dr. Wolfgang Wodarg, who served in Germany’s parliament until September, faulting the U.N.’s global health agency for relying on an inadequate definition of a pandemic. (See what you need to know about the H1N1 vaccine.)
Wodarg notes that the agency declared the H1N1 pandemic based only on the new virus’ transmissibility and did not take into consideration the severity of the strain. Wodarg blames the WHO for raising the alarm over a virus with little destructive potential, leading countries to embark on expensive mass-vaccination programs. He has organized a public parliamentary hearing on behalf of the Strasbourg-based human-rights group Council of Europe, titled “The Handling of the H1N1 Pandemic: More Transparency Needed?” The hearing, scheduled for Jan. 26, will explore the question of whether the WHO and governments overreacted to the threat of H1N1.
Keiji Fukuda, the WHO’s special adviser on pandemic influenza, who will head a delegation to the Strasbourg hearing, counters that the WHO’s definition of influenza pandemics has always been based on transmissibility and has never had anything to do with the lethality of a virus; it was no different with H1N1. In response to accusations of overreaction to what has amounted to a mild disease, Fukuda says that once the 2009 H1N1 pandemic had been declared, “WHO consistently made it clear that it could not predict the future course of the pandemic but consistently provided sober, balanced and scientifically supported information and guidance.” (See how not to get H1N1 flu.)
Fukuda says also that claims that H1N1 is a mild pandemic are wrongheaded. “There have been over 14,000 deaths that have been laboratory-confirmed, many in young, previously healthy people. Who is going to tell their families that the virus is mild?” Fukuda wrote to TIME in an e-mail.
Indeed, it is not difficult to imagine an alternate scenario in which critics would now be accusing the agency of failing to warn countries properly of the H1N1 threat. Hugh Pennington, a microbiologist at the University of Aberdeen who has advised the British government on past public-health crises, says the WHO was obligated to raise the alarm as soon as H1N1’s spread matched the medically accepted definition for a pandemic. He points out also that early news reports from Mexico and the U.S., where the virus first emerged, suggested a highly lethal disease. (See the top 10 medical breakthroughs of 2009.)
Still, Pennington says there are lessons to be learned. He says the vaccine surplus in many cases can be ascribed in part to countries’ own pre-existing pandemic-preparedness plans. Many such plans, which were put in place in the mid-2000s, were based on the worst-case-scenario assumption that the next pandemic virus would be some variation of the highly lethal H5N1 bird-flu virus, which has so far killed 263 people. The U.K.’s plan, for example, which was automatically enacted when the WHO declared the H1N1 pandemic, predicted between 50,000 and 750,000 deaths from a flu pandemic. So far, there have been 400 British deaths from H1N1.
As part of their plans, many governments lined up multibillion-dollar advance-purchase agreements with pharmaceutical companies to buy vaccines during a pandemic. When the WHO declared H1N1 as such, governments were locked into these contracts, if not legally then politically – amid news reports of a new and potentially lethal virus spreading around the globe, governments could not responsibly pass on the option for vaccine. In this context, governments may have felt the only prudent course was to err on the side of caution.
Pennington says that to avoid similar situations of oversupply in the future, governments may want to plan a range of responses for the next flu pandemic, based on a virus’ severity. But such evaluations of deadliness of an emerging disease are much harder to carry out than one would hope – if not impossible. And delaying action in response to an unpredictable new virus could potentially mean an increase in preventable deaths. “I think all countries recognize the desirability of flexibility in implementing pandemic plans. But exercising flexibility is really hard especially when large and complicated events like pandemics are often very confusing, and the expectations of populations can swing dramatically over short periods of time,” says Fukuda.
The current glut of vaccines in rich nations may at least prove useful to the 95 countries in the developing world that have no access to vaccines, 86 of which have written to the WHO requesting help obtaining supplies. The WHO already has 200 million doses for such countries, and the first doses of that stockpile arrived in Mongolia and Azerbaijan this month. These doses will be supplemented by bilateral deals: France, for example, plans to sell 2 million vaccine doses at cost to Egypt and 300,000 to Qatar, according to a report in the Parisien newspaper.
It appears that even in developing nations, however, the need for vaccines is not overwhelming. Despite fears that H1N1 would hit developing nations hardest, the pandemic is unfolding in those countries “in a similar pattern” to that in the developed world, says Fukuda – which is to say with relatively few deaths. In fact, some developing countries, particularly in West Africa, are reporting lower rates of infection than in the developed world. “Based on the current H1N1 strain, there are higher health priorities in the developing world,” says Sandra Mounier-Jack of the Communicable Diseases Policy Group at the London School of Hygiene and Tropical Medicine, citing illnesses such as HIV, tuberculosis and malaria.
Mounier-Jack’s comment echoes the basic question that Wodarg and other critics of the WHO are aiming to pose at Tuesday’s hearing: Given that other health problems were more deserving of the billions of dollars spent tackling H1N1, how do the WHO and governments explain their decisions?
The U.S. government, for its part, still wants to vaccinate as many people as possible against H1N1. Although it has indeed been a mild flu season so far, says Jeff Dimond, a spokesperson at the Centers for Disease Control and Prevention, “our message right now is that people should get vaccinated. We are aware that a third wave of infections is possible, so we aren’t making any decision yet on whether we will use our full capacity of 251 million doses.”
Student Nurses to Give Flu Shots
January 21st, 2010 | Author: BDempsey
Student Nurses to Give Flu Shots
SLU Hosts Community H1N1 Influenza Vaccine Clinic
Event Details: 1:00 p.m. – 5:00 p.m., January 21, Allied Health Professions Building, 3437 Caroline St., St. Louis, MO, 63104-1111
ST. LOUIS — A free community H1N1 influenza vaccination clinic at Saint Louis University on Thursday will give public health student nurses hands-on experience in protecting people from a pandemic flu. Under the supervision of SLU School of Nursing faculty, students will give H1N1 flu vaccinations to people of all ages at a free clinic from 1 to 5 p.m. on Thursday, Jan. 21, in the multipurpose room in the Allied Health Building, 3437 Caroline Mall.
The event is open to anyone wanting the H1N1 shot.
Supply of H1N1 flu vaccine now exceeds demand
January 17th, 2010 | Author: BDempsey
ST. LOUIS POST-DISPATCH
01/17/2010
Now that the H1N1 vaccine is widely available, health departments can’t give it away.
In a reversal of policy, the city of St. Louis and the St. Charles County health departments announced last week that they would hold free public clinics to distribute the vaccine.
Both departments originally had their allotted vaccine sent directly to doctors’ offices and pharmacies, which charged about $20 for the shot.
“There are providers that have quite a bit of vaccine left over,” said Cameron Satterfield, spokesman for the St. Charles County Health Department. “We have surplus vaccine that’s been returned to us.”
The department will now offer free shots to county residents at its immunization clinic. The H1N1 vaccine was paid for by the federal government, and every public health department received federal funds to distribute it. Jefferson, St. Louis, Madison and St. Clair counties started offering free shots last fall.
Officials in the city of St. Louis, which received $1.1 million, said they spent most of their money on administering the shots to city schoolchildren.
Two weeks ago, city health officials said they didn’t have the staffing or facilities to hold free public clinics for residents.
“I wish we had the luxury of being able to pull our staff off from our routine operations, but we just did not have the staffing to do that,” city health commissioner Melba Moore said at the time. “It was a tough decision.”
On Saturday, the city hosted a free clinic at Vashon High School.
Neither Moore nor the director of the City of St. Louis Department of Health, Pamela Rice Walker, could be reached to explain the change in policy.
For information about obtaining flu shots, see the website www.flu.gov.
Missouri state health officials open H1N1 flu vaccine to everyone
December 9th, 2009 | Author: BDempsey
Officials cite increased vaccine supplies and success at vaccinating groups most at risk
For Immediate Release:
December 8, 2009
Contact:
Kit Wagar
Office of Public Information
573-751-6062
With shipments of the H1N1 flu vaccine arriving daily, Missouri state health officials today encouraged local health departments to begin offering the vaccine to anyone who requests it.
The new policy will make the vaccine available for the first time to seniors and other healthy adults. Until now, limited supplies of the vaccine forced local health departments to restrict the vaccine to groups that were hardest hit by the new flu strain, including infants, children and pregnant women.
Margaret Donnelly, director of the Missouri Department of Health and Senior Services, said health officials would continue their efforts to vaccinate more pregnant women and young people. But increasing supplies of vaccine throughout Missouri now make it prudent to offer the vaccine to other groups as well.
“With 1.26 million doses of vaccine shipped to Missouri, we know that the people most at risk have had the opportunity to be vaccinated and many are now protected from the effects of the H1N1 flu,” Donnelly said. “The success of this targeted vaccination effort is now allowing us to extend the distribution of the vaccine to the general population.”
The H1N1 flu emerged in Mexico last March. It spread to the United States in April and was declared a worldwide outbreak in June, becoming the fastest spreading pandemic on record.
The H1N1 virus has become the dominant strain of flu throughout the United States. In Missouri, it represents at least 90 percent of the flu cases reported in the current flu season, which began Oct. 4. The highly contagious strain has caused the number of flu cases to skyrocket.
In the first eight weeks of the current flu season, physicians reported 26,307 cases of flu in Missouri. In the first eight weeks last year, they reported 56.
Unlike seasonal flu, the new virus has also disproportionately afflicted young people. Just less than half of Missouri’s flu cases have occurred in children age 5 to 14, which contributed to the 61 school closings so far this school year. Nearly 77 percent of Missouri’s flu cases have been among people 24 years old and younger.
Flu infections peaked in late October, when 6,283 cases were reported in a single week. But health officials warned that flu tends to come in waves and flu season usually peaks in January and February. Therefore, health officials continue to urge people to get vaccinated now, particularly if they have an underlying health problem such as asthma or diabetes that puts them at risk for complications from the flu.
“We appreciate the patience shown by seniors and other adults that allowed us to get the vaccine to the people who needed the protection the most,” Donnelly said. “Seniors make up less than 1 percent of the flu cases reported so far this year and we would like to keep that record intact. So now is the time for everyone to set up a time to get vaccinated against this very contagious flu bug.”
Because the situation can vary across the state, each local health department will decide whether to make the vaccine available to anyone. Some local health departments might continue emphasizing vaccine for young people and adults with chronic health problems if not enough of those groups have been vaccinated in that particular county.
Therefore, Missouri residents should call their local health department to find out about eligibility or to check when a vaccination clinic will be held. A county-by-county schedule of vaccination clinics is available at http://www.dhss.mo.gov/missouriflu/_provider_listing.html.
Local health departments provide the H1N1 flu vaccine for free. Private providers may charge a fee for administering the vaccine.
St. Louis County Announces Second Round of Public H1N1 Vaccination Clinics
November 25th, 2009 | Author: BDempsey
NEWS
For Immediate Release
Media Contact: Craig LeFebvre
Office (314) 615-0116
Cell (314) 591-9502
Alternate Media Contact: John Shelton
Office (314) 615-8922
Pager (314) 460-6148
Cell (314)280-1586
County Health Department Announces Second Round of Public H1N1 Vaccination Clinics
SAINT LOUIS COUNTY, MO – (Nov. 20, 2009) The Saint Louis County Department of Health will be offering free H1N1 flu vaccinations to county residents at five locations on Saturday, December 5th. This is the second round of public H1N1 vaccination clinics in Saint Louis County. Due to an increased supply of vaccine, the department will be targeting a larger number of residents than previously.
“This will be another great opportunity for those in a priority group to be vaccinated,” said Dr. Michael P. Williams, Director of Communicable Disease Control Services for the County Health Department. “And now that the supply has increased, we will not only have more vaccine available at each of our events, but we will be able to target a larger group of residents than previously.”
The five priority groups being targeted for the December 5th events are:
- pregnant women;
- youth from 6 months of age through 24 years of age;
- caregivers of and those who live with infants under the age of 6 months;
- adults from 25 years of age through 64 years of age with an underlying health condition that makes them more susceptible to flu complications; and
- emergency medical service personnel and healthcare workers.
Those wishing to be vaccinated will need to obtain a line ticket from one of the five clinic locations prior to being admitted. A drive-through distribution area for handing out line tickets will be set up at each of the five locations. Line tickets will be available at each location starting at 7:00 a.m. The vaccinations will be administered between 8:30 a.m. and 4:30 p.m.
(more on the next page)
Public H1N1 Vaccination Clinics
Page 2
At least 15,000 doses of vaccine will be available at the Saturday clinics – 3,000 at each of the five sites. A mixture of H1N1 shots and intranasal mist will be available at each site. Because of limited supplies, it will not be possible to honor individual preferences. The type of vaccine used will be based on what is medically appropriate for each patient.
The five clinic locations on December 5th are:
Ferguson-Florissant School District Administration Building
1005 Waterford Drive
Florissant, MO 63033
Kirkwood High School
801 West Essex Avenue
Kirkwood, MO 63122
Parkway-Central High School
369 North Woods Mill Road
Chesterfield, MO 63017
Ritenour High School
9100 Saint Charles Rock Road
Breckenridge Hills, MO 63114
Rockwood-Summit High School
1780 Hawkins Road
Fenton, MO 63126
The vaccination events are for the residents of Saint Louis County, and proof of residency may be required, such as a driver’s license or a utility bill. Participants are asked to consider wearing clothing that will allow easy arm access to help speed the process.
Adults and youth aged 10 and over require one dose of vaccine to achieve immunity; children under 10 years of age require two doses, spaced at least four (4) weeks apart.
“For those with children under the age of 10 who need two doses, this will be a great chance to get that second booster dose needed for full immunity,” said Dr. Williams.
For more information, please visit the Health Department’s flu website at:
www.SaintLouisCountyFlu.com
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Swine Flu Spreading Faster Globally Than Expected
November 15th, 2009 | Author: BDempsey
The H1N1 flu virus is now the dominant influenza virus around the globe, according to the World Health Organization (WHO.) The agency has declared the swine flu outbreak a pandemic, with nearly 500,000 confirmed cases and over 6,000 deaths reported worldwide. National Public Radio Weekend Edition Saturday host Liane Hansen speaks with WHO flu specialist Dr. Anthony Mounts about the spread of the virus and the global response:
To hear the story, follow this link:
H1N1 has killed 3,900 Americans, CDC says
November 12th, 2009 | Author: BDempsey
By Maggie Fox, Health and Science Editor Maggie Fox, Health And Science Editor
Nov. 12, 2009
WASHINGTON (Reuters) – H1N1 swine flu killed an estimated 3,900 Americans from April to October, including more than 500 children, U.S. health officials said on Thursday.
Better data than was previously available shows the flu pandemic has infected an estimated 22 million Americans and put 98,000 in the hospital, the U.S. Centers for Disease Control and Prevention said.
Children account for 8 million of the infected, 36,000 of those hospitalized and 540 deaths.
“We think the 540 number is a better estimate for the big picture that we are getting out there,” the CDC’s Dr. Anne Schuchat told reporters.
About 82 U.S. children die in an average flu season. The CDC said H1N1 has produced the worst flu season in the United States since 1997, when current measurements started.
“What we are seeing in 2009 is unprecedented,” Schuchat said,” Schuchat said.
The CDC said doctors need to treat severe cases quickly with antiviral drugs such as Tamiflu, made by Roche AG, Relenza, made by GlaxoSmithKline or for especially grave hospitalized cases, peramivir, made by BioCryst.
Schuchat stressed the pandemic was not worsening but noted that it takes time to gather data on flu cases and deaths. The count released on Thursday is not an actual reckoning of deaths but an extrapolation based on detailed data from 10 states.
CDC’s previous estimate of U.S. flu deaths was 1,200.
In an average flu season, about 36,000 Americans die and 200,000 are hospitalized with 90 percent of deaths and hospitalizations among people over 65.
With H1N1, 90 percent of those infected and seriously ill are younger adults and children.
Schuchat said the pandemic would likely continue through the winter and early spring. “We have a long flu season ahead of us,” she said.
Most confirmed flu cases are H1N1 and about 30 percent of people who show up at the doctor’s office and are actually tested for influenza turn out to have flu, as opposed to some other infection.
After a few weeks we are back, and boy has a lot happened during that time!
November 9th, 2009 | Author: BDempsey
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Novel Influenza H1N1 Update Dr. Stuart B. Weiss |
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INFLUENZA UPDATE |
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Nov 8, 2009 |
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I want to apologize to our loyal readers for no newsletter over the past few weeks. So let’s review what has been happening and make sure you are up to date.
Current Situation:
- Outbreaks on college and university campuses across the country have surged again after declining. Most cases continue to be mild, according to the American College Health Association. The number of school closings across the country continues to rise, as reported by the US Department of Education.
- The CDC reports that 48 states now report widespread flu activity. Although we haven’t reached the peak yet, flu activity has already exceeded what we have seen in some of the worst flu seasons. Pneumonia and influenza rates continue to rise.
- The WHO reports that there is widespread disease across the northern hemisphere. Mexico is seeing more flu cases now than they saw in the initial outbreak in April/May. Europe is experiencing an unusually early flu season with wide spread cases. A huge outbreak in the Ukraine is causing a big problem for that country. They are estimating that there have been 500,000 cases since mid-October with 24,000 people hospitalized (the country only has 48 million people).
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Vaccine Update:
- Supply of H1N1 vaccine continue to be a problem in the US. As we wrote about earlier, there are significant delays in shipment of vaccine from manufacturers. This is due to the difficulties in growing the virus in eggs, which is part of the manufacturing process.
- Although the US Government had originally predicted that we would have 60-80 million doses by this point, only 38 million have been shipped.
- Vaccine delay has impacted vaccination programs in states across the US and has eroded the confidence in public health initiatives, according to several state health representatives. The Alabama Health Department testified to congress that they don’t expect to receive adequate vaccine to immunize their high priority groups until the end of December or January.
- Around the world, millions of people have received the vaccine and it is proving to be a very safe vaccine.
- Since vaccine campaigns started in October, only 1/3 of parents who tried to get their children vaccinated have been successful.
- Supply of H1N1 vaccine continue to be a problem in the US. As we wrote about earlier, there are significant delays in shipment of vaccine from manufacturers. This is due to the difficulties in growing the virus in eggs, which is part of the manufacturing process.
Disease Update:
o 99 % of the subtyped flu that is tested is the new novel H1N1. Those areas that had seen some early seasonal flu strains circulating, have seen that drop off significantly.
More Mask controversy
o In the continuing discussion of masks, the original study done in China and reported here last month showing that N-95 masks were much more protective than surgical masks has been “re-analyzed” and now is much less conclusive. Due to some changes in the statistical analysis done, N-95’s still show some benefit but the study numbers make the difference not statistically significant.
President Obama declares a National Emergency (on October 26th)
o This was not unexpected and it allows HHS Secretary Sebelius to waive or modify certain provisions in Medicare, Medicaid, Child Health Insurance Program (CHIP), EMTALA and HIPAA programs. It also allows hospitals to respond to this crisis easier.
Medications
o There has been a shortage of liquid Tamiflu and the government has released about 300,000 bottles of liquid Tamiflu from the National Strategic Stockpile. There are also directions for compounding liquid Tamiflu on the CDC website that pharmacists can use.
o The government issues emergency use authorization for IV Perimivir and Zanamivir for critically ill patients that don’t respond to Tamiflu. A few cases were recently presented on a conference call and they had good results.
First cat to catch H1N1
o Iowa has reported that a house cat has been documented with the novel H1N1 infection after two of its three owners were sick with flu. This is the first time a cat has been documented to have the disease. Prior to this, infections were only documented in humans, pigs, birds and ferrets.
No more kissing in Turkey
o Last week, the health minister in Turkey advised all Turks to avoid kissing anyone for the next 5 months.
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