Some doctors seem to think so. Per The Canadian Press:
TORONTO — Officialdom’s mantra about swine flu – “it is overwhelmingly mild” – might seem incongruous if we knew the number of children, teens and young adults in ICU beds right now alive only because a breathing machine has taken over for their ravaged lungs.
The heavy reliance on the word “mild ” could be creating a false impression of what is actually going on and what the world may face in coming months, some experts worry.
Peter Sandman, a risk communications guru from Princeton, N.J., suggests if authorities are trying to ensure people don’t panic about the new H1N1 outbreak, they are concerned about the wrong thing.
“In North America, swine flu panic is much rarer than swine flu deaths,” Sandman says.
“The problem isn’t panic or even excessive anxiety. The problem is complacency, both about what’s going to happen and about what might happen.”
When the new H1N1 virus burst onto the world’s radar, it was, for awhile, the hottest story of the 24-7 news cycle. The long threatened pandemic, it seemed, was finally underway.
But instead of the 60-plus per cent death rate of H5N1 avian flu – seen for years as the pandemic frontrunner – the wire was tripped by a seemingly wimpy virus that is causing a lot of flu, but is no viral monster.
In many places, public health officials have bent over backwards to tamp down anticipated panic. The results? Within a few weeks, most people appear to be convinced the pandemic was (past tense) a non-event, a blip of flu activity over-hyped by the sensationalist media hoard.
“When we’re told that swine flu is mild, we don’t think, ‘It will infect a half to a third of the world population and kill a few million people, mostly young people, before it’s over,”‘ says Sandman. “We think, ‘It’s like having a bad cold.”‘
This should be a huge concern to a country that routinely has to send its preemies to small hospitals in the United States because Canadian hospitals do not have enough NICU beds to care for their population.
Regular flu, as anyone who has had it know, is no walk in the park.
And with this new flu, a small subset of people gets very, very sick. Their lungs are overwhelmed by an aggressive viral pneumonia one doctor described as looking like a “white out” on an X-ray. A number of hospitals are struggling to keep these people alive.
Generally much younger than the typical hospitalized flu patient, many of these people have been on ventilators for weeks. And every day, officials in some part of the globe announce that a 15-year-old boy, a 24-year-old woman or an otherwise healthy pregnant woman in her third trimester has lost the battle.
“When you look at those things then you begin to say ‘Well, is it really accurate, is it really fair to say that this is a mild phenomenon?”‘ says Dr. Keiji Fukuda, the World Health Organization’s top flu expert.
Fukuda and his team have been warning for some time that the unusual age pattern of severe cases, the odd out-of-season spread and the fact that the virus is killing some previously healthy young adults makes the term moderate a more appropriate severity assessment.
I’ve noticed that there has been an uptick in reported swine flu deaths as well as new cases of the disease here in Florida over the past week. Are these people that lost the battle after a lengthy stay in the ICU or new cases? The news reports do not say.
The new flu is mutating around the world. How will these affect the upcoming flu season? Nobody knows. Will a vaccine being developed now be effective against what will surely be a mutated flu that will be back in the winter season? Nobody knows.
Some things are clear, though. Since most people seem to have no immunity to the virus – some people over 60 may have some – huge numbers will probably catch this flu over the next couple of years. In a relatively tight time frame, lots of people will come down with the flu – far more than would be seen during a regular flu year.
To understand that impact, think back to elementary school arithmetic. If the denominator (the total number of cases) gets substantially bigger, the total number of people falling gravely ill or dying (the numerator) will rise sharply, even if the proportion of severe cases (the percentage) doesn’t change.
And sheer numbers could make the outbreak get nasty, fast.
Several centres in North America are already struggling under the load of critically ill patients – and this is summer, the season when flu viruses don’t transmit as efficiently as they do during the cold winter months.
“If this is as bad as it’s going to get, this is still not going to be a cakewalk,” says Dr. Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.
“We still have relatively few people in the population getting sick. We don’t know – 10 per cent? Five per cent? We don’t know yet.”
“But if in fact we’re stretching medical resources, particularly in the pediatric community now in many communities, people will start to die with higher frequency with the same disease spectrum if care is compromised and we can’t get every kid on a pediatric vent(ilator),” Osterholm warns.
“Even if the disease severity doesn’t change but this fall we see more people get sick at the same time, we’re in trouble. Now, add in the potential for this virus to obviously change and cause more severe illness – I mean none of this is good. I don’t know how we can sit here and say ‘Oh, this is mild.”‘
Some people worry the constant refrain that swine flu is mild may be keeping people who are becoming severely ill from seeking care as soon as they should. They also worry young people – the demographic least likely to get a shot for seasonal flu – may decide they don’t need to bother when H1N1 vaccine is ready.
McGeer thinks by that time the virus will have issued its own assessment.
“Unfortunately I think the number of deaths in the end is going to be high enough that people will get the message and generally will get their vaccine.”
If the vaccine is effective against the strain that will exist in the fall and if enough is produced in time, that is.
If a national health care policy is passed per Obama’s desires, there will be far fewer ventilators available for those sick pediatric patients (and for all patients, for that matter).
