Pandemic influenza — words that to some instill panic; to others, the phrase is ho-hum. A flu pandemic is one of the most concerning events in the career of a public health officer.
When I received the first e-mail on April 21, that two unrelated persons in Southern California had been sickened with a new variant of the flu virus, I knew instantly that life at the Public Health Department was about to change.
Why? Because, while the term “pandemic” simply means worldwide person-to-person spread of a novel organism, and is not synonymous with death and mayhem, one certainty about influenza is its unpredictability. It can change its stripes (literally) without warning. A small genetic change in the virus can render a once relatively mild disease into one that can indeed cause significant illness and death. Luckily the current pandemic has thus far caused relatively moderate illness, no worse than the flu that comes around every winter.
Regardless of illness severity, a true pandemic needs to be taken seriously for a variety of reasons. As stated, severity of novel viruses can rapidly change. Additionally, rates of infection in a typical flu season are about 10 percent; in pandemics 25-35 percent of the entire population may become ill. Because a majority of the population has no immunity to new viruses, a large percentage may become ill simultaneously. In this situation, absenteeism alone — from work and school — or diminished availability of hospital beds can cause societal disruption. Will this occur now with H1N1? There is no way to know for sure. Yet we must guard against such an occurrence, just like placing levees to hold back rising tides in case an unforeseen storm of the century makes landfall.
While we should not become all-consumed by fear over this relatively minor H1N1 flu virus as it currently presents, it is important for public health officials to work in collaboration with all sectors to respond in ways that will minimize the potential for worse outcomes in the future.
Please do not turn away from messages to wash hands frequently, cover coughs and sneezes with a tissue or shirt sleeve, avoid touching eyes, nose and mouth and stay home if sick. Please try to keep a 6-foot distance from people who appear to be ill with the flu and avoid large gatherings when disease rates are high.
Perhaps most importantly, give serious consideration to having all of your children ages 6 months to 18 years receive a vaccination when it becomes available, as well as for yourself if you fall into one of the target groups: pregnant women, caretakers and household members of infants less than six months of age, young adults ages 19-24, health care workers, or those who have certain underlying medical conditions.
We believe that the county, together with our health care and school partners, will ultimately be able to provide an H1N1 vaccine to anyone who wants it. Nevertheless, we ask for people to be patient because we expect a limited number of doses initially.
In the meantime, stay tuned in. We are working on getting multiple messages out to the public through many avenues such as educational materials, media releases and community presentations. Information can be accessed through our dedicated phone line (788-2903) or Web site (www.slocounty.ca.gov/health/publichealth/swineflu.htm). Your health and the health of the entire community are important to us.
Penny Borenstein is the health officer and public health administrator for the San Luis Obispo County Public Health Department.