Sunday, May 03, 2009

WTF is going on with this "killer" flu??

Talk about truth being stranger than fiction. Yes, we nominally do have a so-called "pandemic" -- 16 countries. Yes, the influenza A(H1N1) "swine flu" bug is a killer, nominally -- somewhere between 9 and 100 people dead in Mexico. Yes, it is still spreading [Hey you! Yeah, you! Stop coughing in my direction already! NOW!!] -- but not at a very alarming rate. Yes, it is very possible that the bug could eventually mutate into something much worse -- but it hasn't, yet.

But... the really simple facts are that outside of Mexico, a place that few people consider a paragon of public health, the raw numbers of "infected" are still quite low and the actual health impacts are quite mild. In fact, the average person or even doctor and even a lot of hospitals are unable to tell the difference from "normal" seasonal flu and "swine flu."

So, the public health people are caught in a bind: should they relax and tell everybody to "chill", or should they take more aggressive action of some unspecified sort?

The answer is... about all they can do is offer platitudes about "must remain vigilent", tell us (again) to cover our coughs and wash our hands, and... wring their own hands about how little they can actually do right now and stand back and watch the current mix of swine and "normal" seasonal flu continue to spread incrementally and eventually dissipate.

The bad news is that by raising the alarm so high, "the authorities" have caused emergency rooms and doctor offices to be overflowing with "the walking well" who are merely "concerned", so that the true "at risk" individuals are now at risk of not getting the prompt care which can protect them from more severe effects. Sigh. That's life.

Still, overall, I am fairly supportive of the efforts to date of "the authorities", including CDC, WHO, NYC Health, and the Obama administration. Sure, there are things they could have done and can still do better, but they are doing "good enough" for the actual "threat" that we actually have right now in front of us.

The crazy thing is that even "normal" flu is a killer and a real drain on productivity, so if the health authorities could make a much bigger dent in flu in general, we would have a real win-win, saving thousands of lives in a normal year as well as getting a leg up on "novel" pandemics.

So, here and now, what's next? Are the authorities going to simply "watch and wait" and let the seasonal flu mixed with some amount of "swine flu" play out? My hunch is that is the case, unless they want to station health professionals in public places and detain, test, and treat anybody exhibiting "flu-like symptoms" in public. That would cost a lot, but it might be the right thing to do to be prepared for future "real" pandemics. At least they should consider it on a trial basis.

The bottom line is... don't worry, be happy... and cover your cough, wash your hands, and stay away from coughing people, even in a "normal" flu season.

-- Jack Krupansky

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