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Format: 04/24/2014
Format: 04/24/2014


Pittsburgh Tribune-Review: Western Pennsylvania prepares swine flu measures

Thursday, September 10th, 2009

By Allison M. Heinrichs


Schools could close, people could be forced to work from home, and hospitals could fill with miserable, feverish, coughing flu sufferers. 

Or, this winter could be like any other flu season, except for an early start because of a novel influenza strain called H1N1, or swine flu, that has swept the globe since emerging in spring.

Health officials say it is essential to prepare for the worst but emphasize there's no need to panic. They offer common-sense hygiene as the best defense. On Sept. 14, federal officials plan to update guidelines for vaccine distribution and hospital treatment policies.

"This is not something we need to call in federal troops for," said Dr. Bruce Dixon, director of the Allegheny County Health Department. "Still, there's no way to protect people against infectious diseases. They just need to minimize their likelihood of getting infected. And, in spite of our best efforts, some will" get sick.

Throughout Western Pennsylvania, school districts, universities and businesses are preparing for high rates of absenteeism while instituting policies meant to stem the spread of infection. Hospitals are encouraging employee vaccinations and will isolate people with flu-like symptoms from other waiting-room patients.

The President's Council of Advisors on Science and Technology reported last month that H1N1 could sicken up to half the population, lead to as many as 1.8 million hospitalizations and kill as many as 90,000 people. Typically, about 35,000 people die each year from illnesses linked to seasonal influenza, which circulates every winter.

Unlike seasonal influenza, which can worsen in elderly people, H1N1 is disproportionately infecting younger people. Those 5 to 24 years old have 20 times the rate of infection of people older than 65. This is likely because a similar strain of swine flu circulated before 1957 and people older than 52 might have some immunity.

Health officials emphasize people should frequently wash hands, cover coughs and sneezes, and stay home if sick. People with flu-like symptoms should call a doctor before visiting, so the office can try to avoid exposing other patients.

Ready for outbreak

Hospitals are required to have "surge" plans that would help them deal with a large influx of patients, said Bill Smith, senior director of emergency preparedness at University of Pittsburgh Medical Center.

That might include finding hospital wings that could accommodate large numbers of flu victims. People coming into emergency rooms with respiratory symptoms could be asked to wear masks and be guided to different waiting areas.

"But any scenario right now is a guess," Smith said. "We really don't know yet how severe it will be."

Businesses are urged to find ways to let employees work remotely, in case they have to stay home with sick children. Absentee policies should be flexible to keep ill workers from coming to work and infecting others, authorities said.

"A flu outbreak, a very severe one, could seriously impact our businesses," said Commerce Secretary Gary Locke. "It's going to affect every aspect of our lives from our economy to our national security to our education system."

UPMC, Western Pennsylvania's largest employer, with 50,000 employees, has several plans to avoid mass absenteeism, said John Galley, vice president of human resources, operations and services.

"We're in a special role as a health care provider," he said. "Many employers can simply advise their employees to stay home if things get bad. We need employees to come to work if things get bad, unless they're ill. That means a willingness to be at work but also a preparedness to be at work."

UPMC is telling employees they might be asked to perform roles outside their normal workload — for example, administrative employees might direct and move patients.

"Rather than waiting, we're having these conversations now," Galley said. "Let's get prepared, even though we hope none of this happens."

Isolation measures

Universities are encouraged to allow ill students to easily repeat class work so they don't feel obligated to attend when sick. A requirement for doctors' notes verifying an illness should be waived so students don't flood university health clinics with requests. Sick students should isolate themselves, either by going home or arranging for a single dorm room to avoid exposing roommates.

Just weeks after students returned to campus, Carnegie Mellon University had more than 200 confirmed and probable swine flu cases. The University of Pittsburgh reported one confirmed case and a few other students with flu-like symptoms. Both universities followed federal guidance by isolating sick students and keeping them out of class until they were fever-free for 24 hours.

Grade schools are gearing up for flu cases as well.

Ringgold School District in Washington County reported one confirmed and one possible swine flu case at its middle school, and 114 of 262 sixth-graders were sick last week, though absences waned as the week ended, said Superintendent Gary Hamilton.

"We're following a protocol by cleaning our buses every night, spraying the doorknobs, wiping down desks and computers, and putting out hand sanitizer," he said. "I'm really hoping that when students return Tuesday, the worst will be over."

Some school districts scheduled special conferences to teach children why it is important to regularly and thoroughly wash hands. School nurses plan to meet regularly, and many districts said they would be willing to serve as sites for mass vaccinations.

Vaccine by mid-October

Swine flu shots are the best defense for people most at risk, said Katherine Sebelius, secretary of Health and Human Services. Those populations include pregnant women, health care workers, people ages 6 months to 24 years, caregivers of infants, and adults with medical conditions such as diabetes or asthma.

The Department of Health and Human Services expects to have 45 million doses of the swine flu vaccine ready for distribution by mid-October. People might need to be vaccinated twice, two weeks apart, to develop immunity. The vaccines will be divided among the states depending on population and need.

"The problem is that most of us will start our seasonal flu vaccine campaign before the H1N1 vaccines are available, so we'll have to do this in waves," said Cheryl Herbert, director of infection prevention and control at Allegheny General Hospital in the North Side.

To read more, visit the Tribune-Review web site.



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