Is H1N1 still a threat?

This from Jackie Zheleznyak, Colorado's pandemic flu planner:


Every day a plethora of articles are released about every aspect of H1N1. This morning a CIDRAP article caught my eye, entitled “WHO: H1N1 flu more contagious than seasonal virus”.

The reason this cause my eye is because for the past 2+weeks most non-governmental organizations and various federal agencies have been telling us that H1N1 isn’t as ‘bad’ as once thought. H1N1 in the U.S. appears to have lost some of its severity. I have seen the reported U.S. cases, I have seen the news that the death rate in the U.S. is low, and while people are still getting sick, sometimes very sick, they just seem to have the flu.

So why do I need to care that this H1N1 virus may be more contagious than a seasonal flu? Why do I need to pay attention to the WHO talking about the severity of this virus?

I am not a clinician or an epidemiologist. I am a planner. Being a planner I analyze everything about twice as much as actually needed. This is why this particular article on H1N1 being more contagious, and WHO’s statement on how to assess severity is causing my mind to spin today. The question remains ‘Why do I need to be paying this much attention to something that hasn’t even been placed on the Pandemic Severity Index and hasn’t cause an increase in the HHS Pandemic Alert Periods?’

In an article titled, "Assessing the severity of an influenza pandemic," released on May 11, 2009, by the WHO, it states: “H1N1 appears to be more contagious than seasonal influenza. The secondary attack rate of seasonal influenza ranges from 5% to 15%. Current estimate of the secondary attack rate of H1N1 range from 22% to 33%.” \

Reading this statement, the question for me becomes ‘why do I care if its really just like the seasonal flu?’

As a planner, I care because if a virus is truly more than twice as contagious as previously thought, I will have that many more people becoming ill, and I will have that many more people using assets from our public health and medical system. As a planner, I need to be able to support the ‘boots on the ground’ in their extraordinary efforts to respond to their new challenge, and this is why I care.

Nevertheless, I struggle with the abrupt changes from U.S. Health and Human Services in its response to this H1N1 flu virus by making a decision not to follow the pandemic alert levels (which they created their own planning around, and encouraged us to also plan around). I struggle with the fact scientists and the WHO have not yet determined a way to grade this virus’ severity. Both of these facts leave me with a place for doubt to grow. I wonder if I, who am very familiar with the topic of influenza, have doubts, then what is the average Coloradan thinking about all of the variety of information out there? This is the other reason I care.

I want to be able to cast away the misconceptions and doubts surrounding H1N1. My colleagues and I strive to provide accurate and appropriate information to Colorado. While some may think that we never provide enough information, others may have already tuned us out.

Public Health is paying so much attention to H1N1 to be able to provide you, Colorado, with the answers you are looking for to the best of our ability. Some days we will have more answers than others, and some days we will not have any answers, only more questions. We pay attention to H1N1 to keep Colorado informed.

I keep reminding myself that science is full of unknowns and that’s what makes it science. We can only work with what we know, and what we know today is that this seems to be a new virus. We know that washing your hands helps prevent H1N1. And we know that staying home when you’re sick not only is good for you, but everyone in your community.

So, the question never was ‘why do I care about H1N1?’ The question has always been ‘why do we care about H1N1?” Surprisingly the answer is very simple: we care because public health is not just something I do for a living; public health is something that we all do, even if it's just by washing your hands.