Keep this number in mind: 36,000! This is approximately how many people die each year in the United States from the seasonal flu, according to the U.S. Centers for Disease Control and Prevention (CDC) website. Keep another number in mind: 98,000! That is how many people die each year from medical mistakes, the Institute of Medicine reports. Or how about the approximately 50,000 people who die on our roadways each year in traffic accidents?
When I watch all the media hype about H1N1 virus, I cannot help but think of all the things in the past several years that have caused a panic or would wind up killing me. In my recent memory, I have been warned that I could be killed by avian flu and birds, tomatoes from Mexico, falling space junk, SARS, killer bees, peanut butter, meteors, Big Macs and sunspots. But not everything is bad in Disasterville. I am sure that in a down stock market some people made good money as the stock of companies involved in making facemasks, anti-viral medication and hand sanitizers rose exponentially the morning that the alphabet cable news outlets predicted a dire world-wild pandemic. As I am listening to CNN as I write this, the reporter's voice is rising to a fever pitch as he talks about suspected cases in 10 different states!
As I write this in mid-May, the news of the H1N1 is not at the fever pitch as it was in late April. As of this writing, there are over 2,500 reported cases with three deaths in the United States. Those three deaths include a child in Houston who was visiting relatives from Mexico City and two other people who already had medical complications and comprised immune systems. In late April, my e-mail box was flooded with updates and news flowed via websites, conference calls, interviews on TV, press conferences and news scrolling across the bottom of TV news stations. Travel to Mexico is still not advised and planes coming from popular places like Cancun are being passively checked for anyone who may be sick. The Strategic National Stockpile has been dipped into and anti-viral medications along with personal protective equipment (PPE) have been sent to many states.
When you finally read this, it would be interesting to see where things stand. Will all of this have died down, will we be at a higher level of planning and preparation or, worse, will we will be in a response mode? Chances are is that this will have all died down and we will wait to hear of the next cataclysmic event that will kill us.
Will the H1N1 eventually become a pandemic? This is a good question since this is a different type of flu. It is a combination of swine, human and bird genetics. This type of flu spreads the same way as seasonal flu. Sneezes and coughs are the attributing factor for spreading the virus.
When you consider that 36,000 people die each year in the United States from seasonal flu, is this all being hyped up by the media? Although I am sure we will see more deaths from this H1N1 virus, will it surpass the 36,000 who die each year from seasonal flu? Some theorize this will not occur and I agree. First, pandemics in the past occurred during the normal flu season. This N1H1 virus has popped up at the end of the flu season. Some epidemiologists conjecture that this virus will spike and die off because flu viruses traditionally die off in the summer heat. If it is still hanging around by the fall, when it would spike again, the same epidemiologists say there should be a vaccine by then.
Another factor that may limit the spread of this virus is that it is susceptible to drugs such as Tamiflu and Relenza. Both of these drugs are stored in our Strategic National Stockpile. On April 27, 2009, the Food and Drug Administration (FDA) released the stockpile and, as I write, it is being distributed throughout the United States. We are better prepared than we were four years ago. Under the Bush administration, the federal government worked with manufacturers to accelerate vaccine development, stockpiled crucial anti-virals like Tamiflu, war-gamed pandemic scenarios with senior officials, and increased the CDC's sample-identification capabilities. These activities will all pay off if this H1N1 virus hedges toward pandemic proportions.
Only the future will tell whether this turns into a pandemic. My bet is that it will not — at least in the United States, where we are more medically sophisticated, better prepared and more knowledgeable than we were with the Spanish flu in 1918, the Asian flu in 1957 or the Hong Kong flu in 1968. The death tolls of each of these pandemics decreased as the century progressed.
The only thing that can make this flu escalate in the United States to possibly a pandemic is our failure to stop the spread from other countries because of our refusal to close borders where the H1N1 virus is more prevalent and if the virus radically changes its strain and mutates to something we do not have a vaccine for. Watch what happens in the Southern Hemisphere this summer as people there go though their traditional flu season to see if this virus will come back strong in the United States this fall. In the meantime, don't sneeze on anyone, wash your hands and be ever diligent.
GARY LUDWIG, MS, EMT-P, a Firehouse® contributing editor, is a deputy fire chief with the Memphis, TN, Fire Department. He has 30 years of fire-rescue service experience. Ludwig is chairman of the EMS Section for the International Association of Fire Chiefs (IAFC), has a master's degree in business and management, and is a licensed paramedic. He is a frequent speaker at EMS and fire conferences nationally and internationally, and can be reached through his website at www.garyludwig.com.
