الأربعاء، أغسطس 05، 2009

Coloradans brace for onset of H1N1 flu season


Coloradans brace for onset of H1N1 flu season
By Michael Booth
The Denver Post
Posted: 08/05/2009 01:00:00 AM MDT
Updated: 08/05/2009 01:42:02 AM MDT


Dr. Connie Price talks about some of the preparations at Denver Health to deal with an expected H1N1 flu outbreak, including the mask she is wearing, which will be used to help protect employees. (Cyrus McCrimmon, The Denver Post)Related
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MOUNTAIN OF DEBT: Americans' debt stress is easingXcel Energy has a priority ranking for which essential employees get company-issued Tamiflu and which ones should stay home and telecommute instead.

The state emergency services division is ready to help find replacement drivers should grocery stores see too many truckers get H1N1 swine flu.

And schools across Colorado are choosing rooms and lining up nurses for an October vaccination rush that will make them a front line in the swine-flu fight.

State health and safety officials say that years of detailed planning since the scares caused by avian and other virus strains prepare them well for an expected swine-flu outbreak.

In snapshots from throughout the state, utility closets are stuffed with breathing masks and Xerox machines print contingency plans for 20, 40 or 60 percent absenteeism. Officials hone warnings that most state residents should get their usual seasonal flu shot along with the multidose H1N1 vaccine arriving in October.

But they have a stern message for all Coloradans: the flu season is not some vague irritation coming "this fall." It starts during the next two weeks, as many schoolchildren return to class and begin the mass congregation of bodies and germs that encourage pandemic flu. And if the public wants to keep going to work, to school, and to a well-stocked grocery store, people need to start following instructions.

"We need to stop using the word 'fall.' It's already here," said Chris Lindley, director of emergency preparedness for the Colorado Department of Public Health and Environment. "There's no better time to start preparing than now."

Normal, seasonal variations of the annual flu strain hit 15 million to 60 million Americans a year, according to the federal Centers for Disease Control and Prevention, causing complications that result in about 36,000 deaths. About 800 Coloradans die each year from seasonal flu.

By contrast, the CDC estimates about 1 million Americans have contracted H1N1 or swine flu since the worldwide outbreak reached here last spring, although many of those cases were never officially confirmed. About 300 Americans have died from swine flu, and Colorado reported its first death, a Colorado Springs woman, last week.

Americans have no background level of immunity to swine flu, built up by exposure over time, as they do for more common flu. That puts extra burden on fall vaccinations, in a brief time window. Moreover, the newness of swine flu makes the impact erratic and potentially fast-changing, though so far the H1N1 strain has proved no more deadly than seasonal flu.

Lessons of the past

In a series of interviews from around the state, health officials and emergency planners emphasized the following H1N1 lessons:

• Immediate school closures from one flu case will not be the rule this academic year. Epidemic watchers found that children and teens sent home from school in the spring or from summer camps congregated elsewhere, reducing the effect of the "social distancing" strategy. Instead, schools will be told to handle swine-flu cases as they would normal flu, asking sick students to stay home.

• While the CDC has emphasized priority categories that would receive a limited supply of H1N1 vaccine, state officials say they are confident they will be able to offer vaccine to anyone who wants it by the time supplies ramp up in late fall.

"I don't think there will be any shortage," Lindley said. Twenty million doses have already been produced, with 120 million — to cover 60 million people — likely in October. The current priority categories, should supplies stay limited, are health care workers, school-age children, pregnant women, the chronically ill and people working frequently with young children.

The bad news for shot-haters? Peak immunity may require two, four or even six doses of H1N1, spread over time.

• The swine-flu vaccination push will begin at two locations: hospital and other nursing facilities, to target health care workers; and schools in each community across the state, to guarantee access for children. The seasonal flu vaccine will continue to be distributed at a wide range of sites.

The vaccination protocol changes almost daily: early last week, state officials weren't sure what the advice would be for pregnant women. By Wednesday, the CDC had targeted them as a top priority. "We have to stay really flexible as we get guidance from the feds," said Joni Reynolds, state director of immunization.

• Every government institution and private business has been pulled in as a partner for the H1N1 fight, drawing on plans first launched for the avian flu strain and the SARS virus. Xcel, for example, knows in detail who needs to be on site, how they could be replaced on a sick day and who has top priority for Tamiflu or other anti-viral remedies stocked by the company. The utility has surgical masks in storage and will hand them out to employees who have contact with the public if the state or the CDC advises it, said spokesman Tom Henley.

Charting the threat

Denver Health Medical Center computers offer real-time charts of all respiratory cases in the hospital at any given moment. High and growing levels trigger meetings and contingency plans; overflow flu patients can be housed at the Rita Bass trauma training center, and if necessary, in tents planned for the parking lot.

Public planning includes making sure a potential health disaster doesn't lead to economic disaster, said Hans Kallam, state director of emergency management. The division is working with business leaders to create a monitoring system for workforce absenteeism in many industries.

At Fort Collins Utilities, which provides power, water and other services to residents, flu planning means details such as stocking up on water treatment chemicals in case sickness interrupts deliveries. Managers double-check to make sure they have cellphone numbers when hiring new employees, said water resources manager Kevin Gertig.

"It's all documented," he said, down to what happens if two-thirds of the utility's 400-plus workers get sick.

Michael Booth: 303-954-1686 or mbooth@denverpost.com



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Frequently asked questions about H1N1 flu
Who's at greatest risk?

H1N1 is particularly dangerous for people who are pregnant or have asthma, emphysema, diabetes, chronic heart disease or compromised immune systems, according to Dr. Bernadette Albanese, medical director for the El Paso County health department.

When can I get a shot?

The H1N1 vaccine has been developed but is awaiting final approval from federal agencies. Colorado health workers have begun preparations for distributing the H1N1 vaccine in late October or November.

Where can I get a shot?

Public-health departments across Colorado are making plans to distribute the vaccine at schools and health fairs

What about the normal flu?

The vaccine for the seasonal flu is nearly ready for distribution and will go as usual to doctors' offices, pharmacies and other sites.



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To find out more
Public-health officials are striving to make flu information as simple and as easily accessible as possible this year. Some of the better websites for flu news and advice:

www.flu.gov

A consumer-friendly federal site managed by the Department of Health and Human Services.

www.cdphe.state.co.us

Click on the flu-related link on the right. It includes access to Google groups or Twitter feeds for instant updates.

www.cdc.gov/h1n1flu

A Centers for Disease Control and Prevention site with some of the same info as flu.gov, but with more wonkish charts and maps for those interested in epidemiology.

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