Opinion: Swine flu response dismal at best

The first step would be to open a dialog with the terrorists and understand their grievances with human life. Once we understand their issues we would apologize for our existence and do our best to pacify them by giving them things like oil, energy, food and nuclear power plants. If that didn't work we would offer up Israel or Taiwan as a bargaining chip.

I thought the first step was to go on the news, tell everyone they are going to die from some virus unleashed on us from the Mid-Easten barbarians and then let hysteria and mayhem rule the day. It will be so much more interesting when everyone finds out the virus was Viral Gastroenteritis after they went all Lord-of-the-Flies on their neighbors.

http://digestive.niddk.nih.gov/ddiseases/pubs/viralgastroenteritis/

This recent round of H1N1 has underscored one thing: The United States places a much higher premium on open-border commerce than public safety. Despite the initial epidemic in Mexico, nothing was done to close the border, and Americans were encouraged by the President and media to enjoy Cancun, Cozumel and the Yucatan, without any regard for bringing this contagion back into the United States. In fact, Vice-President Joe Biden was castigated - by his own administration - for suggesting that Americans should be careful about traveling in close-quarter environments like aircraft, buses or trains. If this were a dry-run for a hemmorhagic fever or deadlier flu, it appears that we have royally flunked the test. Who believes it would be conducted any differently in another pandemic? Public Health vs. Commerce? In this country, Commerce will win every time...

That border has now permanently been thrown open. No matter what you say or do will change that fact.

Nothing in politics is permanent. The next President may decide to nuke the border and make it a radioactive no man's land for the next century.

James In Denver - That is so true I don't know if I should laugh or cry

No vaccine in the past two decades has killed nearly so many children and adults.

Can you say Freudian slip??

The VACCINE KILLS! MSNBC finally slipped out the truth in this article, albeit accidentally.

Some idiot said:

No vaccine in the past two decades has killed nearly so many children and adults.

Can you say Freudian slip??

The VACCINE KILLS! MSNBC finally slipped out the truth in this article, albeit accidentally.

Hey "Crusaderhead" can't you read English? Or is your dittohead mentatility so degraded by right wing whacko spin that you have lost the abilities of a critical thinker?

Let us parse the sentence.

"No vaccine in the past two decades" This means that for the last twenty years, not one vaccine has...

"kill so many children and adults." which is a comparison to the number killed by the flu.

So, this flu has killed more people already than have been killed by any vaccine in the last 20 years... get it?

The flu is killing many more people than the vaccine, or any other vaccine used in the last twenty years.

Now I know that Rush, Shawn and that Beck guy all tell so many lies each day you probably think that left is right and vice versa, but take a breath and THINK FOR YOURSELF!

Those of us that are chosing not to take it know the risks, so why doesn't everybody just SHUT UP AND MIND YOUR OWN BUSINESS!!!!!

And don't give me crap about people not getting the vaccination spreading it to the rest of society. Read a book...getting vaccinated doesn't stop you from carrying it.

You're right on the money my friend.  This is a man-made disease - just like the Aids virus was.  This is all intentional by the Central Bankers - you know, the people that run the planet!

Agreed - The hostile terrorists are the US Government!

It is interesting that the same neo-con trolls who objected to "pork" in the stimulus bill caused money "earmarked" to develop an alternative to the decades old method of growing vaccines in eggs. That was specifically cited as wast5erful spending and deleted. I guess it was wasteful --- Goldman Sacs got theirs and everyone else can go eat pork.

Chris, you have nobody but your beloved democratic party for this screw up. Remember they are in charge right now. In fact I heard that the shortage is possibly due to the fact that administration officials insisted that the vaccine be in individual portions. That has made it impossible to ship in the regular form that doctors could use the same vial but a different needle for the injections. You idiot liberals will blame the neo-cons, whoever they are, for everything. Your beloved John Kerry blamed Bush for the shortage of vaccine for the Bird Flu. You can't have it both ways. Oh wait, you liberals always have it both ways. Trouble is that most of the time you're wrong.

Approximately 3-4 years ago, the Bush administration took steps to limit the impact of future flu viruses. A process was set to create large quantities of vaccines and the speed which this could happen, was established - so that future flu outbreaks could be handled better than in the past. Private industry was asked to create new egg incubation centers, in order to jump into operation when asked. Doctors were set into a response system to quickly review the vacine needed. So, what happened with the Obama administration when it should have jumped quickly on this outbreak?

Hey JH -- No sense in arguing the point to Chris. Remember the words of Robert Frost..."A Liberal is a man too broad minded to take his own side in an argument."

I do not believe you partisan nuts!

Look, public health is science, period. Now the public, after years of abuse by the government under the Republican House, Senate and White House, have learned to not trust the government. Its got nothing to do with democrats. The present administration did not do anything but continue the programs that were (are) already funded by legislation passed several years ago.

Look, Bush and Cheney made sure to make the government so wasteful and ineffective that the general population would believe that government was to blame and allow them, at some future point, to reduce the size of government. This is like going to the village well and pouring raw sewage in it.

The Bush camp was very good at that. They stacked the deck at every agency with administrators who could not administer and political hacks who understood that their job was to destroy the credibility of government in general. Look what they did to NASA, FEMA and the rest of the good programs that protect people from corporations.

If you want to blams someone for the population resisting a valid innoculation you have no further to look than the past eight years of Bush and company crapping in the well of decent, proper governance.

Quit letting the right wing give you your talking points, think for yourself!

You are corect about all of this starting with Bush and Cheney. Maybe even before that with Papa Bush. It seems like years since I heard anyone willing to admit the anti-government sentiment and hysteria of the Bush days. However, I don't for one minute believe that there is actually a different party running the show. They just changed hats. The mistrust is still there with good reason. Back in August I watched a situation on T.V. of a "SWAT team on steriods" attempting to extricate a man from his car in L.A. The lengths to which they went were spellbinding. Mace or probably CS was used on him numerous and still he continued to sit in his car unaffected. HumVee with "microwaves" were used to disable his car,(although I don't know why since the front was smashed in and steam was pouring from the engine). It did effectively block his phone. Gee, wouldn't you think they'd WANT to communicate with him? Especially since the news reporters were saying he threatened to "blow up the White House" and made threats against Obama. In L.A.? He apparently called a radio station and spoke on the air according to one news reporter. (Hmmm, I thought at the time, what is it they don't want him to say publicly?) He was finally extricated from his car by a robot.

Before the day was over, It was alleged that the man was an Israeli (aren't they allies?) Microbiologist!!!!!! The plot thickens....Turns out the radio station said he never once said anything about Obama or the White House....He said he had information that Baxter was making biological weapons in Ukraine and intended to pass them off as vaccines.......hmmmm, flu shot anyone?

Here's the real compelling stuff...Google Joseph Moshe....

Then read about the deadly mysterious virus pandemic which Ukraine authorities say is NOT the swine flue

http://whatreallyhappened.com/content/deaths-four-ukraine-doctors-raising-suspicions-cover-ukraine

The problem is the idiots who don't know the value of vaccination are also the same idiots who are writing the health care legislation. The problem with representative democracy is that any idiot can get elected.

The problem is the idiots who don't know the value of vaccination are also the same idiots who are writing the health care legislation.

Politics has no place in medicine.

So basically you're saying that you watched a fictional movie once and now have no faith in the science of vaccination? Sadly you just might be a perfect example of a "typical American."

Also you clearly don't understand what a "Sophie's Choice" is. It is a choice between two unbearable options. Even I hate needles, but getting vaccinated is hardly an unbearable option.

I'll tell you what, go witness a child getting the flu vaccine, and then visit a second unvaccinated child with the flu at the hospital. Then tell me which choice is unbearable.

If there were something a parent could do to save thier child from the flu they would do it right? There is, so why don't they?

By your "survival of the fittest" comment I assume that you are in the "let them die" camp.

Nah, I'm not in the "let them die camp." I'm saying some people who take care of themselves and stay well may have a better chance of fighting the seasonal flu and/or swine flu. We do not know what ill consequences will come of this new vaccine. I am hardly alone in my thoughts about it. And yes, I do feel it is a choice of "two unbearable options"--as do other people. Why are some health care workers resisting the vaccine? Is it just because it's a civil rights issue or perhaps they, too, sense this vaccine was made too fast. And what if a third strain comes along? It's a mixed bag of problems and nobody has the perfect answer.

P.S. That beginning scene in "I Am Legend"--re: a cancer cure via vaccine NOT? Sure, it's a film. But I believe something similar could also happen in real life and negative effects will follow.

We do not know what ill consequences will come of this new vaccine

Actually we do and they are very well documented, and the benefits still out weigh the risks for the vast majority of the population.

Actually we do and they are very well documented, and the benefits still out weigh the risks for the vast majority of the population.

Can you reference these claims or attempt to rationalize your opinions? After all they are "well documented".

The 2009 H1N1 swine flu vaccine is made exactly the same way as the seasonal flu vaccine, by the same manufacturers using the same materials -- except for one shiny new piece. What has changed is the piece of the virus the vaccine uses to prime the immune system.

The H1N1 Vaccine is Safe according to WebMD:

http://www.webmd.com/cold-and-flu/features/is-the-h1n1-swine-flu-vaccine-safe

CDC Seasonal Flu Vaccine Information:

http://www.cdc.gov/Flu/protect/keyfacts.htm

H1N1 Specific Information:

http://www.cdc.gov/h1n1flu/qa.htm

CDC.gov? Rightttt!

Could you tell us how long the follow up was on the trial participants to assure us all that there is no long term consequences?

How do you know what my benefit to risk ratio is? If you put me in a box and relegate me to just a number. What is my risk of not getting or completely recovering from the influenza virus? Any of them.

Just based off of gambling numbers (which is misleading in healthcare) I wouldn't benefit from the vaccine >99.999% of the time. Yet I would expose myself from the unknown risk of vaccine toxicity. The majority of the population has these same odds.

To say that the benefit outweighs the risk is coming from a position of ignorance. The only thing you can do is switch the point of your argument. And then we can go from there.

Callie, your arguments are, unfortunately laughable. I don't mean that to sound as rude as it does, but they are. You obviously do not have even the slightest understanding of how vaccines and vaccinations work. Your argument is akin to saying that athletes shouldn't wear protective gear because there was a movie once in which a star athlete died because his pads were made of a carcinogenic plastic! The healthcare workers who are refusing to get the immunization should loose their license to practice. They do in fact have a moral responsibility to protect their patients; and if even one patient dies because of a nosocomially acquired case of H1N1 that was intorduced to the clinical setting by a non-vaccinated healthcare worker it is too many! Referencing fictional movies to justify your irrational phobia of the vaccine is silly. My jury is out that you are, as you claim, a "health author"...and if you are (goodness forbid) I think that you might likely not be a good one.

James -- You make some very well thought out commants and arguments.

And finally, Robert...Nice try dude! You can pick up your testicles at the door on your way out. James cut 'em off in no uncertain terms. (I hope you actually took the time to read the refferences he provided!)

And finally, Robert...Nice try dude! You can pick up your testicles at the door on your way out. James cut 'em off in no uncertain terms. (I hope you actually took the time to read the refferences he provided!)

FYI, its not a study reference, its the CDC website, kid.

The healthcare workers who are refusing to get the immunization should loose their license to practice. They do in fact have a moral responsibility to protect their patients; and if even one patient dies because of a nosocomially acquired case of H1N1 that was intorduced to the clinical setting by a non-vaccinated healthcare worker it is too many!

And your welcome to prove you baseless case that vaccinated healthcare workers can somehow protect the immunecompromised. Influenza vaccine strategies don't work. So it doesn't matter how much you wish them to.

If you "believe" they do, how many lives does influenza vaccine save every year?

I stay as fit and healthy as I can -- I exercise daily and eat well, but I can't replace the spleen that I NO LONGER HAVE BECAUSE OF A DRUNKEN DRIVER that caused my family's car crash when I was a teenager. The risks of a secondary infection from the flu are many times higher for me than for somebody with a functioning spleen. This I was told after my emergency surgery, and I was instructed to get the vaccination every year. Yet I haven't been able to get the H1N1 vaccine. But you'd rather I just die.

Callie, you are a total @!$%#. People like you are incapable of putting yourselves in other's situations. Lots of people have health problems beyond their control.

Flu vaccines are not effective in children under two. Furthermore, the live nasal vaccine is going to spread the virus not contain it. Squalene which is in the nasal vaccine, when combined with proteins in the human body causes sterility.

The statistics being reported by the ambiguous "health community" are not necessarily truly from the swine flu and the deaths occur in people with other complicating conditions. The CDC has already stated that the reporting of the incidence of swine flu is not reliable due to sloppy testing and reporting.

So this pandemic is a ficticious event. A person has very little chance of dying from the swine flu if they have a good immune system. If they contract the swine flu their immune systems are able to prevent them contacting it again whereas the vaccine doesn't offer the best immunity. Doctors are saying that it is relatively mild flu. People die from the "regualr" flu every year

It is a bit difficult to take this outbreak seriously when you receive link to a paper titled "Investment Essentials: Picking Winners for Pandemic Profits Actionable Information for a Flu-Crazed Market" on a medical/professional listserv. This is a Bull Market Report--special report Q4 2009. the websites listed in the article are: www.bullmarket.com or www.nextinning.com. The link to the article is:

http://medicalconsumers.org/2009/09/24/why-the-h1n1-virus-is-not-a-major-threat/

Makes it hard to decide what is the truth about this outbreak/pandemic. I was in school during a big flu outbreak in the 1960s--and our classrooms were almost empty. they cancelled classes for a week or so over the entire state and workplaces were also empty. Has this happened during this outbreak? I have heard of schools being closed in some cities, but it didn't seem as though it was happening as wide spread as in the '60s. maybe it will get worse later...?

It is a bit difficult to take this outbreak seriously when you receive link to a paper titled "Investment Essentials: Picking Winners for Pandemic Profits Actionable Information for a Flu-Crazed Market" on a medical/professional listserv.

You are getting close to the real truth with that link. This isn't about securing our populations health. Obviously, few really care about that in the US. What this is about is what has been happening for over a year now. Huge sums of money being funneled to corporate interests. First, the hand picked banks, then the hand picked car companies, then a few retailers through appliances, and now, 25.00 a pop for millions upon millions of flu shots. That would be a pharma bail out garanteed by media induced panic.

You should check your facts, Obama declared a "National Emergency" that set in motion where the vaccine is distributed, Wall Street is one of the areas that get priority because of the markets, their collapse would be disastrous for the country. Which recent history bears out. I know the left hates the traders and CEO's but they are not to blame for the governments action plan. The above blogger is correct the government in their infinite wisdom decided to order the vaccine in individual doses so that they would be mercury free and more acceptable to public. Notwithstanding that the mercury autism link has been debunked study after study.

No this failure belong's to Obama, his leadership is lacking. I am amazed that the state run media was allowed to run this story, maybe there are fissures developing in his facade after all.

Seasonall flu kills approx. 36,000 each year, swine flu has killed 1240. From everything I've heard and read swine flu has the same symptoms as seasonal flus. Prevention is generally the same, wash hands, (a lot), try to keep your immune system healthy, get a shot if you're high risk, etc. Treatment is pretty much the same, plenty of rest, clear broth and liquids, asprin for fever, etc.

People should take a collective deep breath...and calm down...

Shhh... don't let the facts disrupt a fine example of fearmongering.  Both my kids (5 & 10) had it (H1N1, not the immunization) about a month ago.  They were miserable for a few days with typical flu symptoms but they survived without hospitalization (shocking, I know). 

The best part is, they have a real immunity to it.  They don't need to worry about whether it's going to wear off in a few years or if it took at all.  I'm still not quite sure how I managed to avoid catching the swine death - I mean the flu - since I was in direct contact with them for 5 days, but I'm not going to complain.

Has anyone around you (say at the office) fallen ill since then? It is entirely possible to be contagious without ever manifesting symptoms.

We had one person get sick in our dept (out of 50+ I'm in contact with on a typical day). It's *possible* I was the carrier but not very *probable* considering she has contact with a lot more people all around our complex due to her position.

what makes you think its the same flu?

The fact that it is H1N1 means that it is the same strain as the 1918 Spanish Flu.

The 1918 strain was much more virulent. Also In 1918 there were no antibiotics to treat senconday bacteria pneumonia, the most common mechanism of death from influenza.

RHD, that's right. In addition to that here is a clip from my doc's newsletter:

FYI, James in Denver,

Except for the fact that the DNA of this virus is suspect, we should not expect to have an epidemic that kills many people. One of the reasons is that viruses usually do not kill people—they just make you feel bad. What killed the majority of people in 1918 was that the flu allowed people to get bacterial pneumonia from Streptococcus. That is what kills you. We are much better able to deal with bacterial pneumonia now than they were in 1918.

The ignorance and misinformation spread about this flu are astounding.

Oh, the irony...

So basically what RDH, J Guthrie, and Slave are saying is that because we now have vaccines and antibiotics that people don't need to get the vaccine and won't die if they catch this flu because we have antibiotics. That is perhaps the most ignorant thing I've ever heard. Vaccines are not effective if you don't vaccinate a significant portion of the population (it requires roughly 85% of the population to be immunized to protect the remaining 15% through so-called herd immunity.)

RDH, you are very wrong about this flu being less virulent. It is roughly 10 times more virulent than the average seasonal flu. True, we aren't at war and it is not spreading rapidly in the trenches like it did during World War I, but it still spreads very rapidly and proper hygine is critical.

60% of my immediate family has already been wiped out by this virus because dip@!$%#s like you couldn't isolate yourselves when you got sick. Asthma runs in my family and the virus has already caused secondary infections in both my mother and my sister. They have already been bedridden for a week, and could be dead in the next week or so.

Our family doctor has already lost two patients to this virus (one in their 40's and another in their 50's, neither one with any pre-existing conditions) in a pratice of roughly 1,000 patients.

I am well aware that many thousands of people die every year from seasonal flu, but I am also aware that the people who are dying now are not the standard victims of seasonal flu.

I can not get a flu shot because I am not in a high risk group, but it infuriates me when I hear that the very people who should be keeping people alive are the very ones who are refusing the virus and may well be infecting the people that they swore to protect.

Personally I don't want to end up in the hospital and require the life saving treatments that we currently have, and not only that but I am willing to do my part to prevent spreading this disease to other people near me. I will wash my hands, and get the vaccine when available. If I do get sick, I will isolate myself and try not to infect others. It's just sad that to people like you this is one big joke and you don't care who you hurt with your reckless attitudes. Some people can not get vaccinated and have weakened immune systems. They rely on the rest of us to keep them safe, not just this flu season, but every flu season.

"60% of my immediate family has already been wiped out by this virus because dip@!$%#s like you couldn't isolate yourselves when you got sick. Asthma runs in my family and the virus has already caused secondary infections in both my mother and my sister. They have already been bedridden for a week, and could be dead in the next week or so."

Really? If 60% of any family has been killed from this flu, it ought to have been in the news.

Mind if we call your bluff on this?

60% of my immediate family have been bed-ridden for over a week. All three have asthma and may yet be hospitalized. One of which is uninsured and cannot afford even a single hospital visit.

Wiped out can have many meanings, I was using it to mean unable to work and financially strained, not dead (not yet at least.) But when 60% of any population is infected by any pathogen, it proves that it is quite virulent despite RDH's assertion.

60% of my immediate family have been bed-ridden for over a week.

Then you and your family James should get the vaccine if you feel it's effective (which means you'll be safe from anyone who is not vaccinated, right?). My family will not get any flu vaccines as our immune systems function well and we have fought off any influenza strain that has come around so far.

No, basically what we are saying is the scare tactic you are trying to use is weak. Comparing the the situation now to nearly a hundred years ago is ignorant - and willfully so. The facts are that if they had the antibiotics we have now in 1918, the death toll from the flu would have been significantly lower so quoting the death toll as some harbinger of doom is disingenuous at best.

60% of your immediate family is dead from the flu*? Either your family is incredibly unlucky, incredibly unhealthy (asthma runs in my family too and so far there are zero fatalities not just in my immediate family but in the extended one as well), or you are making crap up to reinforce your dire scaremongering (my money's on the latter).

I especially liked this line:

They have already been bedridden for a week, and could be dead in the next week or so.

Yeah, or they could be well on the way to recovery in a week, too. Keep their temperatures under 103, keep them hydrated and quit believing your own hype. Unless they are suffering from some immune deficiency, the odds are in favor of their survival.

Some people can not get vaccinated and have weakened immune systems.

Then *they* should be the ones isolating themselves. I think they make plastic bubbles for this very reason.

* This was written before I the other comments had been posted.

Santino, show me one location where the H1N1 vaccine is readily available and I will be more than happy to get the shot. Unfortunately it will not help my family because they have already been infected. The problem is that it is not available and was not available to those even at high risk.

I hope for your sake that you never encounter a flu virus that you can't fight off, because by then it will be too late.

To use the assumption that if it has not killed you before that it is incapable of killing you is flawed. But it is your mistake to make.

If you choose not to get vaccinated that is fine, unless you are in the health care industry and are charged with caring for people who are already ill or have compromised immune systems.

Also if you do fall ill, it is your responsibility to minimize contact with others and prevent to the best of your ability the spread of such illness.

If you cannot agree upon these basic fundamentals, then you and I have nothing more to talk about. Just don't spread lies and misinformation about the safety of the vaccine - your fear mongering about the vaccine is no better (and is actually much worse) than fear mongering about the disease.

If you choose not to get vaccinated that is fine, unless you are in the health care industry and are charged with caring for people who are already ill or have compromised immune systems.

Studies have shown this theory (vaccinating healthy workers to protect others)not to work. Could you show us some studies where it did. If not, is this just what you think will work? It doesn't.

Just don't spread lies and misinformation about the safety of the vaccine - your fear mongering about the vaccine is no better (and is actually much worse) than fear mongering about the disease.

Fear mongering? Whose the one shaking in his clorox filled rubber boots?

What the vaccine industry is doing to people like you is fearmongering. They are even going after our pets now in a desperate attempt to get compliance. It's becoming silly what they are doing in the name of science and common sense.

The indoor cat was lethargic, had a loss of appetite and appeared to have trouble breathing after it became infected, Sponseller said. It’s owners declined to comment.

Officials said pet owners should take the same precautions against spreading swine flu to pets as they would with humans.

Getting children vaccinated for swine flu can also help prevent the illness from spreading to pets.

http://www.msnbc.msn.com/id/33622253/ns/health-pet_health/

I hope for your sake that you never encounter a flu virus that you can't fight off, because by then it will be too late.

We already have and now have natural immunities.

If you choose not to get vaccinated that is fine, unless you are in the health care industry and are charged with caring for people who are already ill or have compromised immune systems.

Another false claim.

If you cannot agree upon these basic fundamentals, then you and I have nothing more to talk about. Just don't spread lies and misinformation about the safety of the vaccine - your fear mongering about the vaccine is no better (and is actually much worse) than fear mongering about the disease.

Please show me one lie that I've written?

But when 60% of any population is infected by any pathogen, it proves that it is quite virulent despite RDH's assertion.

In such a small sample size, it proves nothing - especially when the sample size is closely related. It is just as probable that your family has a genetic defect making you overly sensitive to this specific strain of flu. There could be enviornmental factors increasing your chances of infection. Or about a million other possibilities. Compare it to the actual population and your get a more representitive stat.

According to the CDC (and this includes all flu cases after they stopped counting H1N1 specificly) there have been 26907 hospitalizations and 1265 deaths. That's well less than 0.1% of the population who have required hospitalization and less than 10% of those who actually died from it. The CDC also said it has around a 12% chance of infecting others in the household (which is lower than the seasonal flu and may be why I didn't get sick from it) .

"Best article I've read yet regarding the H1N1 flu pandemic.

The ignorance and misinformation spread about this flu are astounding.

Everyone should be vaccinated, this isn't a game. This very flu killed more people in 1918 than World War One."

"The fact that it is H1N1 means that it is the same strain as the 1918 Spanish Flu."
Yes, James in Denver, the ignorance and misinformation being spread about this flu is astounding.
The 2009 'swine flu' is not the same strain as the 1918 Spanish flu, even though they are both H1N1 serotypes. You are confusing SEROTYPE with STRAIN. H1N1 designates the serotype, not the individual strain. A Mustang and a Pinto are both cars with the same make, Ford. But, anyone who looks at a Mustang and a Pinto can tell they are different models. Serotype and strain are different designations for viruses the same as make and model for automobiles. Try not to be so hystrionic.
I find it ironic an article proclaiming, "the fear factor is simply confusing;" continues to feed the media driven fear and hysteria associated with the 2009 H1N1 pandemic. Dr. Kaplan cites 129 deaths to estimates of 1000 deaths in the US due to swine flu out of "millions more [who] have been terribly sickened." According to the CDC, 36,000 deaths occur annually in the US alone due to seasonal influenza. More deaths occur in the US alone, each year, compared to the total number of deaths due to swine flu world wide. How many of those 36,000 deaths due to H3N2 were televised last year? I can't recall a single case.
In the majority of healthy patients who do not fall into one of the high risk groups, the swine flu may produce fever, headaches, body aches, sinus congestion, sore throat, cough and less frequently nausea, vomiting, and diarrhea for 5-7 days, sometimes longer. The majority of patients do not require any anti-viral medications and recovery on their own. Clinically, those patients this year with the swine flu seem to have milder symptoms compared to seasonal influenza in years past.
In the vast majority of patients, the benefits of immunizations far out weigh the risks. However, immunizations are not 100% risk free. Adverse reactions range from mild to life threatening. Some adverse reactions are so rare the rate of incidence cannot be calculated or no link has been established.
In the majority of patients, they need to weigh the benefits of not contracting swine flu (or spreading it to a high risk family member) vs. the risks of receiving the immunization and the risks of the actual infection itself. That is a decision best left to the individual with the information and guidance from his health care provider, not the director of a bioethics center.
A question for Dr. Kaplan; if 6-7 months is too long, how long do you think it should take to research, develop, clinically test, mass produce, and distribute enough vaccine for everyone on the globe to a novel virus? Five months? Two months? Maybe two weeks and I should be able to get it at my local McDonald's drive thru along with my Happy Meal?

Excellent post slave138. I'd love to see your source (not that I don't believe you, those numbers seem fairly accurate for the US population from a few weeks ago.) I just have a few questions related to the data:

1. When is it accurate as of?

2. What are the estimated number of infections?

3. What is the estimate for future infections? (30% of the US population is predicted to fall ill with this flu, so it is critical to know where in the outbreak we currently fall.)

I take slight issue with you taking the number of hospitalizations so early in the flu season and extrapolating against the total population to get your overall hospitalization rate. Far better from a methodology stand point is to say what percentage of the population has been infected vs. the rate of those whom required hospitalization. It is virtually impossible to measure the total number of people infected at this point because there are no reliable metrics to pull data from (most people don't report having had the flu if it doesn't result in a hospital visit.)

As of August 6th, the estimated number of H1N1 infections on a global scale was nearly a 250,000 with the number of cases doubling roughly once every 3 weeks. Using that data as a starting point, you can extrapolate that by now there should be nearly 8 million people globally who have been infected by this virus.

If only 26,907 of those 8 million required hospitalization that would put the hospitalization rate at 0.3%, but more accurately it would be roughly 20 times higher because the US only has 1/20 of the global population. That would put the hospitalization rate at 6.7% with 5% of those people dying.

Extrapolated against the US population we should expect up to 14 million hospitalizations before this pandemic burns out, and 703,000 deaths. Even if we assume that the US comprises half of all global infections (instead of 1/20th,) you still end up with 1.4 million people in hospitals and 70,000 dead.

Let me know if any of my math is grossly off base, this was simply a quick estimate based on very limited information. My main point is that this flu season has only just begun and it's already shaping up to be pretty bad. This virus has a long way to go before burning out. You might want to hold back those "Mission Accomplished" banners for a few more months.

There is an estimated fatality rate of between 0.1 - 0.01%. That gives you a 99-99.99% chance of survival rate.

Just don't spread lies and misinformation about the safety of the vaccine

John you called me a liar and then never presented any comments I made that was a lie...thanks for losing all your credibility. Did you think I forgot?

I confused your comments with the comments of with J Guthrie and Robert.

I apologise for the miscommunication, I did mention you by name 5 paragraphs prior, but it was not your comments that were saying that the flu vaccine was not safe. However, I do stand by my assertion that health care workers who care for people who are already ill or have compromised immune systems should be required to be vaccinated.

Also in my post I was quoting hospitalization rates, not fatality rates. If you take 5% of a 6.7% hospitalization rate you get 0.335% which I admited could be as much as ten times too high. 0.0335% is clearly in the ranges that you gave which would equate to 30,150 US Citizens dead and 603,000 hospitalized assuming that 30% of the population has natural immunity and only 30% of the remaining get infected. Those values are actually very similar to seasonal flu, but do not seem to correspond to first hand observations of hospitals already overwhelmed with patients. (And yes I made a calculation error in my prior post by assuming that 70% of the US population would be infected instead of 21%)

Apology accepted James.

However, I do stand by my assertion that health care workers who care for people who are already ill or have compromised immune systems should be required to be vaccinated.

Currently in IL there are no mandatory flu vaccinations and all is well throughout our health care systems. Having worked in a hospital for 6 yrs (radiography) I can tell you that a hospital is anything but a sterile environment. Even in the OR which is supposed to be 100% sterile, infections still occur.

Also when a patient is immunocomprimised they are usually put on contact precaution where all staff and visitors have to gown up so that nothing can be passed via patient or health care provider.

One last nugget to think about is that the flu can still be spread whether or not you have been vaccinated (and assuming the vaccine worked effectively). You still catch the flu and are able to pass it on...it will just be a milder version of the illness.

You can't run and hide from the flu...whether you are a patient, health care provider or anything in between. These vaccines are not 100% effective so forcing anyone to take something that is not a guarantee makes no sense to me whatsoever.

James-

The hospitalization rate in the U.S. has been about 3.1% for age 4 and under, and 1.0-1.5% for other age groups (including elderly). http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5844a4.htm?s_cid=mm5844a4_e

The estimated mortality rate has been around 0.01%, maybe less, but not less than 0.001%.

Santino -

ORs are not 100% sterile, and many infections occur when the patient's skin is cut with the scalpel (iodine does not kill 100% of bacteria on the patient's skin. Fomites are another source of infection.

ORs are not 100% sterile, and many infections occur when the patient's skin is cut with the scalpel (iodine does not kill 100% of bacteria on the patient's skin. Fomites are another source of infection.

Hi NU...you must have missread my comment...

Even in the OR which is supposed to be 100% sterile, infections still occur.

Please note I said "supposed" to be sterile not "is" sterile. You already know my opinion on forced vaccinations for health care workers.

p.s.

How about that win against Iowa?

The timeframe was through 10/31/2009 and the numbers came from two reports at the CDC (numbers near bottom):

http://www.cdc.gov/h1n1flu/updates/090409.htm (Prior to 8/30/2009)

http://www.cdc.gov/h1n1flu/updates/us/ (8/30/2009 - 10/31/2009)

I agree that the numbers aren't as conclusive as they would be with an infection rate comparison, but we will never have accurate numbers for that so you work with what you have.

The CDC has reported an increased number of people coming to the hospital with flu-like symptoms (was down slightly this week but not by much) in the last few months but I would argue that the increased media attention (hype) and the fear mongering has gone a long way to inflating that number. If the common cold was reported with such hysteria it's quite likely the number of people going to the doctor with cold-like symptoms would also increase drastically. I wouldn't be surprised to find out the media hysteria has significantly contributed to the infection rates by bringing people who normally would have stayed home sick out into public looking for unnecessary medical help.

Hi Santino, I know what you meant. I invite you to read my other article. http://bogenbmg.newsvine.com/_news/2009/11/08/3475338-2009-pandemic-h1n1-influenza-a-where-do-we-stand-now

Beating Iowa was nice, but I knew they were overrated, so I wasn't too excited. Their quarterback got injured, but ours was too. And Iowa's defense let us convert 9 of 18 3rd downs. I'd love to say we are awesome, but we're not. Iowa is overrated, and will lose big to Ohio State. We might not be able to beat Wisconsin or Illinois, but I hope we do go to a bowl.

Thanks for the f/u article NU. A small excerpt with a question:

If I may offer my educated opinion, I predict we will see fewer than 10,000 deaths in the U.S. this flu season. The overall mortality rate will "only" be approximately 0.01% (1 in 10,000). The pandemic strain will continue to be the dominant strain of influenza in the community.

The CDC has stopped officially recording new cases of H1N1 correct and if so how will they be able to properly measure the outcome of the H1N1 vaccine on the public?

I hope your Cats get to a bowl...

Correction to post 12.20 - the hospitalization rate is not "%," rather is per 10,000 population.

Santino, here's where there is some educated guesswork, using ancillary data (see FluView http://www.cdc.gov/flu/weekly/ on CDC website).

We have a very accurate numerator (i.e. actual hospitalizations and deaths). In almost all cases, hospitalized patients and those who die are tested for influenza using PCR. We also know through surveillance testing that 99.8% of influenza has been the pandemic strain and only 0.2% has been seasonal strains. This is good because treatment is different for pandemic (Tamiflu or Relenza) than seasonal (Relenza or amantadines) influenza. We can assume with 99.8% accuracy that we are treating correctly without testing. Most patients do not need meds, especially those whose symptoms are more "cold" than "flu."

The denominator (i.e. number of influenza cases) involves the guesswork. Epidemiologic methods include selective counting. Let me give a non-medical example. Suppose you have a 1 acre lawn, and you want to count the total number of dandelions, but you only have an hour. You count the exact number of dandelions in a representative 1% (or whatever %) of the lawn, then multiply by 100 (or the appropriate multiplication factor). I actually did a similar exercise back in high school biology class. The final result is quite accurate, certainly within a factor of 10 (i.e. an order of magnitude). For infectious diseases including influenza, the CDC and other agencies do very selective counting of proven cases, and extrapolates using ancillary data (e.g. percentage of outpatient visits coded as influenza, ER visits, school absenteeism). If you look at the rates of these ancillary data points for a community, and correlate them with the numbers for the community where an exact count was done, you get pretty good accuracy. Don't expect the CDC to report a mortality rate like I have speculated about, at least, not until the season is over, and they probably won't publicize it (I'll probably find out about this from a medical email).

Many lay people think that the CDC ordered us to stop counting individual cases. Well, I can still run a test whenever I want, but it is just not practical or necessary to to so on an individual level. If it takes 1-2 days to get a PCR test back, this is useless since the patient is probably feeling better by that time, and there is a 24-48 hour window to rx medication if I even elect to rx something. The CDC still does selective counting in representative communities (e.g. some inner city, some suburban, some rural) and uses ancillary data. I've tried to generate a number for estimated mortality rate in order to compare to the estimated vaccine adverse event rate for purposes of my articles. But the really important numbers are total hospitalizations and deaths, which we have very accurate numbers on.

As for predicting the actual effect of the vaccine on the public (i.e. how many hosp or deaths prevented), I have no idea how it will be anything more than a guess. The vaccine has been delayed. We usually have vaccine before a flu season has begun. Many people already have had the novel influenza. A number of people will have already been exposed to the novel influenza and not gotten clinically ill or only mildly so. Some elderly are naturally immune. Others will get the vaccine even if they had documented influenza because on an individual level we are not subtyping patients. Then there are local and regional differences in novel influenza cases and vaccine distribution. So, your question is a good one. We know what we know, and we know what we are guessing about. The lay press is not sophisticated enough to know the difference, and the general public will base their opinions on their different levels of medical knowledge combined with bits and pieces of info and misinformation published in the lay press and blogs (such as newsvine), combined with whatever political agenda or trust / mistrust of govt agencies such as the CDC. This is why I wrote my articles, to try to be a voice of reason in a sea of confusion, and to give patients a rational basis for making an informed decision on the vaccine.

Gotta go. I'll check back tonight, or you can email me directly or comment under my articles. I hope I helped.

This is why I wrote my articles, to try to be a voice of reason in a sea of confusion, and to give patients a rational basis for making an informed decision on the vaccine.

And I think they are well written. FYI I've linked the first one often (especially for people who are new to H1N1 threads) as a well balanced piece that is written by a family physician.

Is the dandelion example the same way a viral load is counted/estimated say for HCV?

Bingo!!!

My 21-year old daughter contracted H1N1. she felt crummy for a few days and then recovered. she went to the ER (cause we can't afford insurance) and was given a 'script for a decongestant and, guess what, tamiflu. this cost me $100 but i didn't have time to research if this would actually help her recover or not, or was just a placebo.

from a biological POV, the human population of the us of a has been artificially immunized via vaccines for about 75 years. on one hand, fewer get sick or die, and from a personal standpoint, that can only be seen as compassionate.

on the other hand, we are much weaker organism because vaccines eliminate the process of natural immunity, which can affect genetic evolution.

suffice it to say, hundreds of billions are being made by the health care machine to keep some alive who wouldn't be and others from getting sick who would be.

as my dad used to say, 'it all depends on whose ox is being gored.'

Your doctor should be sued for malpractice and his license revoked. At what point did his job become spreading misinformation and conspiracy theories? Isn't he trained to prevent and cure diseases? What's worse is that you actually believe him and repost his garbage.

If you studied history for even 10 minutes you'd know that most of what is contained there are lies.

Thanks so much for this posting. i am always hesitant to say things like this because of the reaction it might cause, which only polarizes people and serves no purpose.

james in denver is one of those who is polarized right now. he has decided that his study of history is truthful and your doctor's study of history is not only inaccurate, but a lie as well.

we are a fearful animal. pain and suffering are terrible, and the fear of death is staggering for most, especially when we see the young afflicted.

but in our frenzy to avoid or postpone death, we have created a massive population of malnourished individuals whose behaviors constantly increase the misery not only of other humans, but all other life as well.

many times, things are not as they seem.

he has decided that his study of history is truthful and your doctor's study of history is not only inaccurate, but a lie as well.

And this decision of history interpretation will be easily repeated in the future since they have decided to no longer record and track the H1N1 virus. Maybe someone can explain to me how what the outcome of a vaccine program is if you don't thoroughly track the actual disease?

They are called clinical trials, and they have been done numerous times on flu vaccinations proving both its efficacy and safety to a very high level of degree. This flu vaccine is no different from any other flu vaccine; it just provides protection against a different strain of the disease.

They are called clinical trials, and they have been done numerous times on flu vaccinations proving both its efficacy and safety to a very high level of degree. This flu vaccine is no different from any other flu vaccine; it just provides protection against a different strain of the disease.

Could you please reference those clinical trials so we can proceed to show you some falsehoods in your thinking?

Flu vaccines can't deliver on their promise. You're going to have a hard time proving that they do. Or... you could just believe what medical authorities believe and then you wouldn't have to think very hard.

James I didn't ask you what they've done in the lab...thanks for that though. If you don't record how many people have contracted H1N1 w/ or w/out the vaccine and their survival rates w/ or w/out the vaccine then how do you continue to measure its progress?

That would be like doing a sales forecast without recording your actual numbers.

That doctor frightens me with his misinformation. Wow. How did he get through medical school! I'm so grateful my health care practitioners are all educated on vaccinations.

Some people want and need a nanny government to protect them.

That's what it boils down to.

yup. we have to take responsibility for our own behaviors. if we make choices, they should be informed ones. we have a responsibility to our communities, but, in this case, that does not necessarily mean getting vaccinated.

hygiene and informed behavior will do more to avert massive infections than any vaccination, regardless of the virulence of the disease.

our government is now almost completely under the control of the private sector, even at the level of govt. service workers, whose bosses are political appointees. research and development staffs are mostly private, we have virtually no govt. inspection, oversight or enforcement of CFR laws, no real ability to shut down suspect behaviors, and the Fourth Estate has been entirely co-opted and is now the major propaganda machine for the elite, who are primarily sociopaths.

i appreciate your adamance and the clear manner it was presented.

Unfortunately it does..... There is absolutely no coherent reason not to get vaccinated for any disease for which vaccination is recommended. Do vaccines have absolutely zero side effects, well of course they don't. However if someone tells you if you play the lottery you have a 99.9999 chance of winning it I guess you probably would . All vaccines given in this country are as safe as they can be and inherently safer than driving, flying on a plane and a million other activities people take for granted and undertake every day. Unfortunately vaccination is far from a personal choice, its a public health concern. If it hadn't been for compulsary vaccination programs we would still be facing polio, small pox, hemophilus meningitis, measles, diphteria and a myriad of other diseases which most modern doctors can't even identify anymore. In fact, aside from public sanitation, vaccination has been by far the largest contributor to the increase in life expectancy in the last 100years, without it, probably 25 percent of the people living today would be dead. As a physician I'm sick of so called "experts" who's expertise consists of watching an episode of Oprah discovering that knowledge accumulated through thousands of man years of study and work is wrong simply because luminaries like Rush or Suzanne Summers discovered "the real truth" last night in a dream. Sorry to break it to you but you are a moron. That, is my professional opinion

That, is my professional opinion

Well it sure wasn't stated very professionally.

There is absolutely no coherent reason not to get vaccinated for any disease for which vaccination is recommended.

With an estimated fatality rate ranging from 0.1 - 0.01% that is plenty of reason for my healthy family to not get any influenza vaccines. Why take the risk of any side effects with a survival rate of over 99%?

And here's another coherent reason my family doesn't take the seasonal flu vaccine...it is no more than an educated guess on the correct strain for that season.

So Ed (or should I call you Dr. Ed) how is your GSK stock doing?

Another so called expert which works at "full time research" (where in his garage?)! If he were so insightful about the "truth", he would be publishing his insight in a medical journal rather or a scientific symposium not in some obscure talk show. Of course, since just as the naysayers of global warming, or evolution, etc his truths have no scientific fundament he enlights the populus through a talk show. As good as ghost hunters. When the real Dr.s at Yale, UCLA, Harvard, Mayo, Oxford, Padua and other real institutions of learning, which by the way are the guys that advise the other real Dr.s of the NIH and Public health say he's wrong, its not a difference in opinion....... he's just wrong. As a medical professional trained in multiple (2) of the above mentioned institutions I can attest to that as a fact.

It is certainly a fact that the swine flu is just as deadly as the regular flu but has a slightly different population predilection, and that the "crisis" is a fabrication. However the fabrication is not a government creation, its a media creation. The 24hr news cycle demands a "story", the scarier, the better. In the beginning of the swine flu, as was expected no one knew very well what was going on, not even the real experts. Of course, this was instant fodder for the "news".  The consequent uproar was not due to the government, but rather an ignorant population clamoring for information and guidance which at the time did not exist since no one knew. If you pay attention to Sibelius and the NIH the hysteria would be nothing compared to the existing state of general ignorance that exists. Unfortunately, the real information is not on for 24 hrs, 365 days thus CNN has to "fill" with sound bites while Fox fills in with propaganda and misinformation since the Fox mantra is not news but discrediting anything that the present administration has to say.

As to the fact that the flu is mild in 99% of  cases, that doesn't cover up the fact that 1% (3,000,000) of the population could suffer from severe influenza which would be a disaster for the medical system, aprticularly since its affecting a younger population ie the people that work, take care of kids, pay taxes, etc. Though only a fraction of those would die, the economic impact is enormous.

As to the side effects, millions of flu vaccines have been administered to date with essentially zero significant adverse effects, thus it is moronic to say that you will not take the vaccine for fear of side effects.

Though the swine flu is not an epidemic of such nefarious proportions and morbidity to make it mandatory, saying that you won't get vaccinated for some non existent side effects is a lie, simply say that you don't want it because you don't mind having the flu or spreading it to others.

Both Dr. Mercola and Dr. Blaylock, unfortunately are quacks. But you are welcome to purchase their products (they claim they don't profit directly from them, and they are probably safe, although safety and efficacy are not proven by clinical studies and the FDA does not keep an eye on them). They do not put on their website clinical studies that refute their opinions. I know, because I see many many studies on both sides pro and con. There are no studies done on vitamin D and pandemic H1N1. There are some anecdotal reports of vitamin D preventing seasonal influenza in nursing homes, but when most patients get influenza vaccine in nursing homes, it is difficult to get good data due to confounding factors.

I agree that the lay press does a crummy (either out of ignorance, lack of proper perspective, or worst case, due to political or other hidden agenda) job reporting on medical and scientific topics. I wonder how they do on topics outside of my area of expertise (I doubt the media a lot).

Real nutrients are nothing more than food...some people would like to increase their nutrient intake because nutrients have been stripped from our food. It's not that frightening...you can buy a beer...someone else can buy hopps (an herb)..to each his own.

Sounds like your are passionate about your decision, tammy,  and that is right, so be it.  Though one could turn this around and say, be responsible and don't show up for a handout if you or your child develops some major medical illness due to being vaccinated...

Trust me I have done my homework too.

Bruce,  thank you for incredible information on vaccines!

Wait. Won't duct tape help the flu, too?

Sure. All we to do is use an entire roll, and wrap it completely around our heads, making sure we leave no cracks or openings!