Friday, October 27, 2006

Flu Flurry

The flu vaccines have arrived, and the flurry of vaccination has begun. Sore shoulders and fears of needles are the notions of the day. Hospitals and health centers practice "force protection", vaccinating employees against illness and lost productivity, unless, of course, the vaccine itself lands said employee in bed for a few days, a small price to pay for the ultimate avoidance of full-blown flu.

In the media and beyond, warnings and predictions of a pandemic loom large, some epidemiologists predicting an eventual worldwide scourge that will dwarf the death and destruction of 1918. Although this may eventually occur, it seems best as a healthcare provider to focus on the here and now, teaching self-care, hygeine and handwashing, protection of family and friends, and avoidance of those who are acutely ill. My immune-compromised patients are the ones for whom I am most concerned, as well as my patients with severe respiratory disease.

There is a certain panic that overtakes a segment of the population as the shipment of vaccine is inevitably postponed by the Feds. Even this year, despite previous experience, we received a small shipment which quickly disappeared, followed by utter silence from the Department of Public Health, leaving us in complete ignorance of the arrival of subsequent shipments.

In a recent post, I prayed aloud that the season's supplies of flu vaccine would flow like "champagne at a wedding". While the supply is not yet intoxicatingly large, some 400 doses arrived to the clinic this week, fifty of those routed to our office for vaccination of our "most vulnerable" patients. Who, then is "most vulnerable" among our caseloads? The 35-year-old with completely suppressed AIDS who has a fully reconstituted immune system or the elder with diabetes and COPD? Is it the schizophrenic with hypertension and daily contact with 100 others at a day program, or the morbidly obese homebound woman with asthma? These are rhetorical questions, obviously enough. They're all "vulnerable" and should all be protected to whatever extent we can do so. Hopefully, the supply will be abundant, and everyone who wants a vaccine will receive one forthwith.

In terms of planning for a pandemic, workshops and municipal plans abound, and I belong to a local group of trained volunteers who can set up a mass distribution site and vaccinate thousands in the span of a few days. Still, if people are going to get sick, there's just no stopping it no matter how many workshops we attend.

So, we do our best, jab as many people in the arm as we can, cross our fingers, and hope to survive this flu season unscathed.
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