President Obama declares H1N1 a national emergency
President Obama declared H1N1 flu a national emergency – a move intended to help overwhelmed health-care facilities absorb the surge of new patients with the flu.
Obama’s proclamation allows U.S. Health and Human Services Secretary Kathleen Sebelius to approve individual waivers that will exempt hospitals and other medical facilities from certain daily regulations that get in the way of treating the flu quickly and effectively. The declaration also allows the health secretary to remove some of the red tape associated with treating patients on Medicare and Medicaid.
Administration officials said said that elevating the pandemic to national-emergency status was a pre-emptive move designed to make decisions easier when they need to be made.
“The H1N1 is moving rapidly, as expected. By the time regions or health-care systems recognize they are becoming overburdened, they need to implement disaster plans quickly,” said White House spokesman Reid Cherlin.
Health authorities say more than 1,000 people in the United States, including almost 100 children, have died from the strain of flu known as H1N1, and 46 states have widespread flu activity. H1N1 is now widespread in 46 states and the U.S. death toll has passed 1,000.
Less than half of the swine-flu vaccine expected to be shipped to doctors, hospitals and clinics in the U.S. this month has been shipped so far, as vaccine makers scramble to fill vast orders using an old technology that requires growing virus in chicken eggs.
The U.S. government is funding newer technologies that hold the promise of a more reliable and expandable vaccine supply, but flu vaccines are not nearly as profitable as other kinds of drugs, and most of the biggest vaccine makers have little incentive to switch from a method with which they are familiar.
Prepare for H1N1 flu
Who should receive treatment with anti-viral medication such as Tamiflu and Relenza?
Last week the CDC said that most people who come down with the 2009 H1N1 flu should just ride it out and not take antiviral medications such as Tamiflu and Relenza. Dr. Anne Schuchat of the CDC said the majority of adolescents, adults and children “can be cared for with mom’s chicken soup at home, rest, and lots of fluids.” But she stressed the importance of early treatment with antiviral medications — within 48 hours if possible — for certain patients at increased risk of complications, especially those hospitalized, under age five, over age 65, or with chronic medical conditions.
A key change in advice from the CDC involves patients at high risk who may have been exposed to the H1N1 virus. Before last week, doctors were advised to give them medication to prevent infection; now doctors are being given the option of “watchful waiting” — observing the patient closely and only starting antiviral treatment if evidence of flu develops.
What warning signs should prompt immediate medical evaluation and treatment?
In adults, warning signs include: trouble breathing, pain or discomfort in the chest or abdomen, dizziness, confusion, severe or persistent vomiting, and symptoms that improve but then return with fever and worse cough.
In children, warning signs include: trouble breathing, bluish or gray skin color, inability to drink enough fluids, severe or persistent vomiting, change in mental status (e.g., not waking up, not interacting, or being unusually irritable), and symptoms that improve but then return with fever and worse cough.
The AP says, “When the coughing stops is probably a better sign of when a swine flu patient is no longer contagious, experts said after seeing new research that suggests the virus can still spread many days after a fever goes away.
“The federal Centers for Disease Control and Prevention has been telling people to stay home from work and school and avoid contact with others until a day after their fever breaks. The new research suggests they may need to be careful for longer – especially at home where the risk of spreading the germ is highest.
“Swine flu also appears to be contagious longer than ordinary seasonal flu, several experts said.”
Health and Human Services Secretary Kathleen Sebelius said that a massive school closing wouldn’t stop the spread of the swine flu virus, saying vaccinations must be the defense against a menace that one report said could infect up to half of the population.
“What we know is that we have the virus right now traveling around the United States,” Sebelius said in a nationally broadcast interview. “And having children in a learning situation is beneficial … What we learned last spring is that shutting a school down sort of pre-emptively doesn’t stop the virus from spreading.”
Sebelius appeared on NBC’s “Today” show one day after a special presidential advisory panel presented a grim report to the Obama White House, saying among other things that a “plausible scenario” for the United States later this year is wide-scale infections, possibly 30,000 to 90,000 deaths, mostly among young children and young adults, and perhaps as many as 300,000 sick enough to require intensive care unit treatment at hospitals.
Asked in the interview what people should do while awaiting the arrival of a vaccine, with first supplies likely by October but most not until the Thanksgiving season, Sebelius said: “I think it’s important that people begin to anticipate that we will have a vaccine. We think it’s likely that we’re going to need two shots for the vaccine.”
She said people should plan ahead for this, particularly those with pre-existing medical conditions, pregnant women and health care industry workers. Sebelius said federal health authorities also are recommending that people should immediately get their regular “seasonal” flu vaccine to bolster their health for the scenario yet to play out later this year regarding the swine flu virus.
“Seasonal flu vaccine is ready at the beginning of September,” she said. “We want the population that is most at risk to begin their seasonal flu vaccine now.”
Prepare your family for H1N1
Nancy Shute helps us prepare for the worst – as kids get ready to go back to school in a few weeks. Here’s what she writes for U.S. News & World Report:
Pandemic flu plans aren’t just for governments: Families need them too, says Ted Epperly, president of the American Academy of Family Physicians and a family doc in Boise, Idaho. And parents need to prepare now.
Here are eight things families should do to get ready for swine flu, according to Epperly:
Stockpile food and medical supplies. Two weeks of food, common cold medicines such as ibuprofen, and tissues would be a good place to start, Epperly says. The idea is to be self-sufficient if schools and businesses are closed or if you want to stay home and avoid the risk of being exposed to flu in public places. Here’s the pandemicflu.gov family pandemic planning checklist.
Plan for school closures. Decide what the family will do if schools or day-care centers are closed, as they are in several states.
Wash hands often, and use alcohol hand sanitizers to reduce the spread of germs. Clean home surfaces with Lysol or another disinfectant to reduce transmission.
Face masks should be worn by a sick family member or by someone taking care of a sick person. “There’s no evidence that they’re of value out in the community,” Epperly says. In other words, no need to wear a mask on the bus, as people are doing in Mexico.
Stockpiling antiviral medication won’t be necessary unless the pandemic gets a lot worse, Epperly says. Relenza, one antiviral that works against swine flu, isn’t approved for children under age 7, he says. That means Tamiflu, a prescription drug, is the only choice for young children. It doesn’t prevent flu, and it needs to be taken in the first 48 hours after symptoms start to be effective.
Follow the news closely to know what’s happening with swine flu nationally and in your community. The federal Centers for Disease Control and Prevention’s CDC swine flu page is tracking the outbreak closely. Check with your local health department and school district to see if you can sign up for E-mail alerts. (You can follow CDC’s Twitter feed, too.)
Stay home if you are sick. “People shouldn’t be going outside if they’ve got the flu,” Epperly says. This means a fever over 100 degrees, muscle aches, and in some cases, vomiting or diarrhea.
Sick family members should be cared for in a separate room with good ventilation-windows open if possible, Epperly says. They should get plenty of rest and drink lots of fluids. The CDC has new advice on caring for children with swine flu.