Don't write off H1N1 pandemic... yet

You may have noticed an upswing in media reporting on swine flu, or H1N1, cases.  This upswing is in relation to the sudden upswing in human cases of swine flu in the southern states of Georgia, South Carolina and Alabama. 

The truth is that H1N1 cases are on the upswing in many states.  This could be due to several factors, including the beginning of the predicted "third wave" of pandemic influenza.  Or it could be the fact that influenza "smoulders," and we have a few little patches of fire that need to be put out.

One day, the third wave will occur.  It might be the start now, or it could be later in 2010.  Or it could be even in 2011.  No one knows for certain. 

In Georgia, after a period of weeks of inactivity, hospitalizations from H1N1 have spiked.  And so have deaths.  There were more hospitalizations in two weeks from H1N1 in Georgia than in October, 2009, when the pandemic's second wave hit its stride.

But wait, you ask!  Flu season is almost over!  Flu doesn't hit in the late Spring.

That is partially true. Seasonal flu does not normally hit in late Spring.  But a pandemic strain knows no boundaries.  And remember that pandemic flu plays "King of the Mountain," meaning it wipes the floor with seasonal strains.  There is practically no seasonal flu at all, anywhere in the world outside of Asia.  Maybe a little Influenza B here in the States.  But other than that, zero. Zip. Zilch. Nada.

That leaves H1N1 alone to do what it will.  Swine flu is still infecting deep into Africa, and schools in sub-Saharan Africa are beginning to issue closure orders in response to the virus. And H1N1 is still reaching its tendrils deep into remote areas of Asia, where bird flu is re-emerging as a threat. 

The biggest fear is that swine flu will reassort (swap genes) with bird flu in one or more of the flash points where the two strains intersect.  That would be Egypt, Indonesia, and pretty much anywhere in Southeast Asia.

Vietnam, for example, has already had several human bird flu cases (and deaths) since January.

Egypt has already seen over a dozen human bird flu cases since January (about one confirmed H5N1 human case every three days).  At one point this year, Egypt had more confirmed human bird flu cases than America had confirmed seasonal influenza cases!  This statistical quirk was not lost on the WHO, which has stepped up its H5N1 surveillance efforts worldwide.

But even if it does not hook up with bird flu, H1N1 has already been a virus to watch carefully.  Recently, the Center for Infectious Disease Reasearch and Policy (CIDRAP) at the University of Minnesota issued a report on the effects of H1N1.  Among its conclusions: 

  • More than 85% of the H1N1(2009) deaths were in people younger than 60, with an overall mean age of 37.4, as compared with an estimated mean age of 76 in those who die of seasonal flu.

  • the H1N1 (2009) pandemic, so far, has taken a toll of between 334,000 and 1,973,000 years of life lost (YLL) in the United States.

  • The 1968 pandemic, with 86,000 deaths and victims averaging 62.2 years old, caused 1,693,000 Years of Life Lost (YLL).
  • The 1957 pandemic, with 150,600 deaths and a mean age of 64.6, caused 2,698,000 YLL.
  • The 1918 pandemic, with an estimated 1,272,300 deaths and a mean age of only 27.2, exacted a toll of 63,718,000 YLL.
  • An average flu season dominated by influenza A/H3N2-which generally causes more severe epidemics than other strains-causes 47,800 deaths and 594,000 YLL, with a mean age of 75.7.

From the CIDRAP press release:

Thus, the authors say, the lower end of their YLL estimate for the H1N1 pandemic is comparable to the estimate for an H3N2-dominated flu season, while the upper end is greater than that for the 1968 pandemic. Those impacts, of course, are dwarfed by that of the catastrophic 1918 pandemic.

"Based on US mortality surveillance data, we conclude that the YLL burden of the 2009 pandemic may in fact be as high as for the 1968 pandemic-but that at this time the assessment is still tentative," the report states. More waves of H1N1 cases are likely to come over the next few flu seasons, and later waves could be worse, it says.

So what does this mean for you, IT person?  It means you had better get your H1N1 vaccine while it is still viable.  Clinics and health departments are running low on viable vaccine.  Some doses will expire soon and will have to be thrown out.

It also means you need to look again at your younger workers as potential candidates for illness or even death.  When the third wave comes through, there is no way to know how it will impact your workforce.  And contrary to popular belief, this has not been a "mild" pandemic, as the CIDRAP report confirms.  It has been a light pandemic, possibly.  But its impact in years of life lost is far from mild. 

Do not dismantle your telework program.  Instead, test it again.  Go back over your DR and COOP operations with two eyes on target:  One on the third wave (and possible fourth wave), and the other on your natural disaster plans (especially in hurricane-prone and earthquake-prone areas). Finally, go back over that cross-training matrix again.  try to be cross-trained at least three-deep.

And while you're at it, get yourself vaccinated against H1N1.  You are no good to your organization if you are sick - or worse.

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