H1N1: Here for the Duration

As the flu season heats up and the weather cools down, the media are beginning to more frequently report deaths from H1N1 influenza. Although overall influenza-related deaths are still within the expected range for this time of year, there have been 60 pediatric deaths from H1N1 reported to the CDC since April, including 11 this week, and hospitalization rates are indeed higher than normal.

In the public health arena, many of us are wondering just how the public will react to these reports and the growing numbers of children who are ill or dead. While it's true that an average of 36,000 Americans die every year from the flu, the majority of these individuals are usually elderly or otherwise compromised, and if the number of children who die continues to climb, anxiety and fear will rise proportionately.

The government claims that the H1N1 vaccine is safe, and they are urging every pregnant woman and individual between the ages of 6 months and 24 years to be immunized, among others. I have heard projections that only 20% of eligible Americans may actually elect to receive the new vaccine, but I am not certain how accurate that estimate is. When the vaccine begins rolling out to local health departments, schools, medical providers and municipalities next week, it remains to be seen how the public will respond to well-publicized offers of mass vaccination against a novel disease.

Of course, at times like these, the public can react in many ways. A small percentage feel that the government has overreacted, blowing the risks of H1N1 out of proportion. While this could potentially be the case when the book is finally closed on H1N1, there would be even greater consternation if the government underreacted and millions needlessly died. Hurricane Katrina taught a mean lesson when it comes to government negligence, and it appears that the Obama Administration does not want to repeat such a disastrous mistake at a time when the stakes are so high.

Meanwhile, other segments of the population worry and fret over every sneeze and cough, while others simply wait to be told what to do. Most, I feel, are simply watching the headlines, testing the winds with a tentative finger, and biding their time as the situation develops and changes.

So, the reports of deaths continue to roll in, cases are diagnosed daily, and the entire infrastructure of the global community itself is potentially at risk. You can wager any amount of money that massive contingency plans have been made by most every government on earth, contingency plans that focus on how crucial infrastructures can continue to function in the face of widespread illness.

Plans for continuity of operations are now being drafted by hospitals, newspapers, factories, schools, and many companies and organizations that realize the potential for massive disruption if widespread illness should visit their particular organization. Just imagine if you run a high school. What would you do if 50% of your teachers were ill, or 75% of food workers, custodians or bus drivers called in sick? Woe to those who leave their plans undrafted.

The wave of H1N1 is indeed beginning to swell, and just how powerful and far-reaching that swell will become remains to be seen. To be sure, it will be a historic flu season in many ways. Whole economies may be impacted greatly by the disease, schools may be closed, factories may lay idle, and governmental and non-governmental organizations may be crippled by absenteeism and illness. And when it comes to the children, we can only hope that the number of deaths is kept to a bare minimum in the larger scheme of things.