CanadaSue
07-07-2009, 12:30 PM
So much for summer waning. In the last few days, I've seen few 'official' sets of numbers. I haven't gone looking for them too hard, save for Canada's & that one is MIA with no explanation why, other than numbers were 'delayed'. I'm assuming from that we won't see numbers until tomorrow evening. What I am seeing is an increase in news articles from all over the world & they ALL point to more cases... more & more & more... If you consider that a great many jurisdictions are testing much, much less, that's a matter of increasing concern.
We're in July, JULY & case numbers are going up. I EXPECT them to rising & quickly, in the southern hemisphere where flu season is well underway. But the UK? Canada? The US? Much of Europe? Ain't supposed to be happening but it is. Why?
It is a novel strain - probably explains some of it along with the significant increase in travel that means many are all over the world on any given day.
The weather has not been outstanding here. But that's HERE in the east of Canada & the US northeast. I'm not sure how widespread the cooler, wetter weather is. Even if it's 'everywhere', is it cool & wet enough to matter that much? It's not as though to cold enough to keep everyone huddled around stoves, indoors & shivering. People are outside.
Schools are closed in most areas for the summer & much has been made of the effect of that on slowing transmission rates. I don't think it's going to work out that way. Yes, kids are germ factories but they congregate in far more places than schools. When not in school, many of the younger ones are in day care. Many do sports & other activities. Summer camps. Simply playing at each others' homes & outdoors.
And even if spread is slowed because not as many kids are congregating in the same places, they may still spread flu to their parents.. who bring it to work, shopping & THEIR chosen leisure activities.
Pah! Impossible to predict & I don't know why I bother trying - but we all do.
Another point being made much of in the last few days - numbers of hospitalized & increased number of deaths. This does NOT necessarily indicate the virus is taking a turn for the worse. We've seen a lot of new cases in the past few weeks & I think, (MY opinion only), that inevitably, some are getting sicker & needing to be hospitalized and some are dying. If you look at the overall numbers of deaths for any of the nations that keep track, total deaths are still pretty low compared to seasonal flu. I'll grant it's early days yet & if we follow a wave pattern, we might be getting off very lucky right now.
So... we have the summer to get through & even if matters don't get any 'worse', the summer will bring a lot of serious challenges. On the health care front: this is the time of year most acute care hospitals slow up for a much needed break. Staff is booked for summer holidays & badly need those by now. A higher number of cases requiring hospitalization puts holiday time at risk, as does a larger number of emergency room visist by those seeking assurance they or their loved ones don't have H1N1 flu.
It's not a light or lazy matter - this whole business of summer holidays. Health care staff have families too & have worked hard all year. If we're facing a large or huge increase in demands on the health care system starting who knows when, it behooves us all to have health care workers as rested as possible. Once this gets really bad, who knows when they'll next get a break? An exhausted, stressed staff means more mistakes, a higher number of staff becoming ill & possibly transmitting the disease within health care settings.
It can be quite difficult in summer to get routine appointments or have fairly minor medical issues taken care of - mainly because of the holiday issue. I would urge anyone with issues as yet undealt with - TRY. Try to make sure they're at least checked out & evaluate if it might impact on a possible case of flu you may end up with later in the fall... or even later in the summer. Finances & physicians permitting, try to have at least SOME extra meds around, especially if they're crucial to your continued well being. They may be hard to get later for various reasons.
Speaking of hard to get and other logistics problems.... yeah, I'm into non-sequitors. Increasingly, my mind is turning to the whole question of vaccines. Everywhere now, I'm reading that this will be a two shot deal. Three weeks between shots & full immunity won't happen until two weeks after the second shot. The implications logistically are staggering. An awful lot of administrative type work is going to be necessary to make this happen in anything close to resembling timely & efficient.
When I get my seasonal shot, I have plenty of choices. I get an invitation from my family practice to attend one of several shot clinics held at the practice. The local public health unit also holds a good 2 dozen clinics across the city, spread out as well in terms of days & times. That gives anyone who WANTS a shot, plenty of opportunity to choose the time/place most convenient for them.
This will be different. If two shots are needed & at a fairly specific time interval, (I'm not sure if 3 weeks is rigid), then it would seem best that both shots are given at the same location. It might initially, seem that this is best done at a person's family practitioner but considering the numbers of people who might be intersted, this will be problematic for many pracititoners. How many have the waiting room size needed to do this without completely clogging up space? What about staff? Most have JUST enough staff to do daily, routine activities as it is. Having to add flu shot clinics is going to be a nightmare.
Now if you place the responsability on local public health, they're going to need a robust tracking system to make sure those who want their shots can get them & that follow up shots are given at the appropriate time interval. In Canada, most residents are covered by provincial health insurance & all issue health cards. Swipe your health card & ideally, a note is generated telling you wehn to come in for your next shot after you get the first one.
It's also going to be very important that people are apprised of the potential risks of flu shots. Every year, I have to read & answer 'risk assessment' questions. They're straightforward & straight up about when you shouldn't get a shot & I know plenty of people advised to either not get one or to wait a few weeks... & that's for well known, seasonal formulations. We don't know what these shots are going to be? Traditional egg based? Cell culture based? With or without adjuvents? The risk may be a good deal higher this year, for the pandemic shot.
Here in Ontario, shots are free. In much of Canada, they're not unless you fit certain high risk parameters. I wonder how they're progressing on making thses decisions in regards to the pandemic shot. The risk groups are different but I'm not inclined to think that the traditional high risk groups are at any less risk. So who gets free shots? If the strain turns evil enough by the time flu vax is available, will jurisdictions be motivated to offer them free to all? Especially when you consider that for many, flu shots simply don't seem to work? That being the case, you'd want as high as uptake as possible. Awfully hard for financially challenged people to find the money for that - especially two shots. Especially if they have to pay bus or taxi fare to get there. It may not sound like a big issue but believe me, if you're really stretching your pennies, it's huge.
Flu shots are some months away yet I can't escape the feeling that these & other, unforseen issues are going to prove to really be problematic. One issue I'm not at all concerned about is mandatory shots. It's going to be hard enough to get needles in the arms of those wanting them without wasting time chasing after those who do not. As it stands, I calculate it will take a year or so to produce shots for everyone who might want them & that's assuming we have the human infrastructure to deliver the product, give the vax & keep up the records. No guarantee that will be anything close to smooth.
And day by day... we stumble on.
Anyone else have the feeling we've wasted years on stupidities when so many of these matters might have been better dealt with & decent frameworks laid out?
We're in July, JULY & case numbers are going up. I EXPECT them to rising & quickly, in the southern hemisphere where flu season is well underway. But the UK? Canada? The US? Much of Europe? Ain't supposed to be happening but it is. Why?
It is a novel strain - probably explains some of it along with the significant increase in travel that means many are all over the world on any given day.
The weather has not been outstanding here. But that's HERE in the east of Canada & the US northeast. I'm not sure how widespread the cooler, wetter weather is. Even if it's 'everywhere', is it cool & wet enough to matter that much? It's not as though to cold enough to keep everyone huddled around stoves, indoors & shivering. People are outside.
Schools are closed in most areas for the summer & much has been made of the effect of that on slowing transmission rates. I don't think it's going to work out that way. Yes, kids are germ factories but they congregate in far more places than schools. When not in school, many of the younger ones are in day care. Many do sports & other activities. Summer camps. Simply playing at each others' homes & outdoors.
And even if spread is slowed because not as many kids are congregating in the same places, they may still spread flu to their parents.. who bring it to work, shopping & THEIR chosen leisure activities.
Pah! Impossible to predict & I don't know why I bother trying - but we all do.
Another point being made much of in the last few days - numbers of hospitalized & increased number of deaths. This does NOT necessarily indicate the virus is taking a turn for the worse. We've seen a lot of new cases in the past few weeks & I think, (MY opinion only), that inevitably, some are getting sicker & needing to be hospitalized and some are dying. If you look at the overall numbers of deaths for any of the nations that keep track, total deaths are still pretty low compared to seasonal flu. I'll grant it's early days yet & if we follow a wave pattern, we might be getting off very lucky right now.
So... we have the summer to get through & even if matters don't get any 'worse', the summer will bring a lot of serious challenges. On the health care front: this is the time of year most acute care hospitals slow up for a much needed break. Staff is booked for summer holidays & badly need those by now. A higher number of cases requiring hospitalization puts holiday time at risk, as does a larger number of emergency room visist by those seeking assurance they or their loved ones don't have H1N1 flu.
It's not a light or lazy matter - this whole business of summer holidays. Health care staff have families too & have worked hard all year. If we're facing a large or huge increase in demands on the health care system starting who knows when, it behooves us all to have health care workers as rested as possible. Once this gets really bad, who knows when they'll next get a break? An exhausted, stressed staff means more mistakes, a higher number of staff becoming ill & possibly transmitting the disease within health care settings.
It can be quite difficult in summer to get routine appointments or have fairly minor medical issues taken care of - mainly because of the holiday issue. I would urge anyone with issues as yet undealt with - TRY. Try to make sure they're at least checked out & evaluate if it might impact on a possible case of flu you may end up with later in the fall... or even later in the summer. Finances & physicians permitting, try to have at least SOME extra meds around, especially if they're crucial to your continued well being. They may be hard to get later for various reasons.
Speaking of hard to get and other logistics problems.... yeah, I'm into non-sequitors. Increasingly, my mind is turning to the whole question of vaccines. Everywhere now, I'm reading that this will be a two shot deal. Three weeks between shots & full immunity won't happen until two weeks after the second shot. The implications logistically are staggering. An awful lot of administrative type work is going to be necessary to make this happen in anything close to resembling timely & efficient.
When I get my seasonal shot, I have plenty of choices. I get an invitation from my family practice to attend one of several shot clinics held at the practice. The local public health unit also holds a good 2 dozen clinics across the city, spread out as well in terms of days & times. That gives anyone who WANTS a shot, plenty of opportunity to choose the time/place most convenient for them.
This will be different. If two shots are needed & at a fairly specific time interval, (I'm not sure if 3 weeks is rigid), then it would seem best that both shots are given at the same location. It might initially, seem that this is best done at a person's family practitioner but considering the numbers of people who might be intersted, this will be problematic for many pracititoners. How many have the waiting room size needed to do this without completely clogging up space? What about staff? Most have JUST enough staff to do daily, routine activities as it is. Having to add flu shot clinics is going to be a nightmare.
Now if you place the responsability on local public health, they're going to need a robust tracking system to make sure those who want their shots can get them & that follow up shots are given at the appropriate time interval. In Canada, most residents are covered by provincial health insurance & all issue health cards. Swipe your health card & ideally, a note is generated telling you wehn to come in for your next shot after you get the first one.
It's also going to be very important that people are apprised of the potential risks of flu shots. Every year, I have to read & answer 'risk assessment' questions. They're straightforward & straight up about when you shouldn't get a shot & I know plenty of people advised to either not get one or to wait a few weeks... & that's for well known, seasonal formulations. We don't know what these shots are going to be? Traditional egg based? Cell culture based? With or without adjuvents? The risk may be a good deal higher this year, for the pandemic shot.
Here in Ontario, shots are free. In much of Canada, they're not unless you fit certain high risk parameters. I wonder how they're progressing on making thses decisions in regards to the pandemic shot. The risk groups are different but I'm not inclined to think that the traditional high risk groups are at any less risk. So who gets free shots? If the strain turns evil enough by the time flu vax is available, will jurisdictions be motivated to offer them free to all? Especially when you consider that for many, flu shots simply don't seem to work? That being the case, you'd want as high as uptake as possible. Awfully hard for financially challenged people to find the money for that - especially two shots. Especially if they have to pay bus or taxi fare to get there. It may not sound like a big issue but believe me, if you're really stretching your pennies, it's huge.
Flu shots are some months away yet I can't escape the feeling that these & other, unforseen issues are going to prove to really be problematic. One issue I'm not at all concerned about is mandatory shots. It's going to be hard enough to get needles in the arms of those wanting them without wasting time chasing after those who do not. As it stands, I calculate it will take a year or so to produce shots for everyone who might want them & that's assuming we have the human infrastructure to deliver the product, give the vax & keep up the records. No guarantee that will be anything close to smooth.
And day by day... we stumble on.
Anyone else have the feeling we've wasted years on stupidities when so many of these matters might have been better dealt with & decent frameworks laid out?