Kate Johnson's Medical Musings

Life through the eyes of a medical journalist

Swine Flu – Getting a Grassroots Grip

By Kate Johnson

As headlines flicker and experts bicker over the science, politics and economics of swine flu policies, let’s not forget that we, the populus are not helpless and defenseless against this threat.

While we wait for national and international action, perhaps the most significant weapon against swine flu is already in our hands. But using it effectively will require a group effort – a grassroots mentality that reaches beyond our normal comfort zone.

With back-to-school and the second wave of the swine flu both looming – on a collision course ahead of us – as a mother and a medical reporter, I am worried.

While politicians and medical experts argue, warning that we’re poorly prepared, I question the basic trusts that allow me to send my child out the door every weekday and into a veritable incubator of germs.

I have often felt this way as summer draws to a close.

When she was younger, my daughter’s immune system clashed with a host of viral and bacterial enemies each fall. Like the rest of the kids, she tracked home colds and stomach flus and pretty much an annual dose of strep throat which usually forced us to the emergency department.

Now almost thirteen, she bypasses many of those coughs and sniffles. But the swine flu has me worried.

Influenza experts are often quoted, with a certain flippancy that even comes across in print, saying the novel H1N1 influenza is a relatively mild flu, with manageable symptoms. Having nursed my own husband through the illness a few months ago, I can attest to that – in general. But in the grand scheme of things, this relatively mild flu has shown that it can morph very quickly into a killer of young and healthy people.

Children, like my daughter, are particularly at risk. As are people with asthma – like me.

When my husband was ill, we strictly followed all the quarantine recommendations – not only to ensure our own health, but to protect others. Visitors to the house stayed away from his room, and used a different bathroom. He stayed away from group gatherings until long after he felt better.

But I do not trust other people to be so careful.

Every fall I rail at the world’s parents who send their sick kids to school. Despite fever, and vomit, and snot and phlegm, they trudge through the cold and into their overheated, airless classrooms to share their misery. Teachers eye them with pity and fear, but mostly, they don’t send them home.

The fact is, there is no-one at home. In most families, all adults work, and there’s no-one available to tend to the sick and snotty. Booking off early to play nurse means a cut in pay, or vacation days – or worse, a label of uncommitted.

North American governments, in their wisdom, are in agreement that school closures should be a last resort when the swine flu returns – arguing that the closings would be more harmful to the economy. France, on the other hand, has a low threshold for school closures.

 But if the virus runs rampant through schools, and families, and office buildings – this too will harm our economy.

Why not play it safe? Many medical voices are warning that we’re playing with fire. Amongst themselves, doctors and researchers are less cavalier than they are in public. Canadian critical care specialists worry that the next wave of this flu could exceed the country’s capacity in intensive care units. While the swine flu might be “relatively mild” in general, subsets of patients are at risk for severe lung injuries and hypoxic respiratory failure. There aren’t enough ventilators in the country’s ICUs, and most of the ventilators that are available are not advanced enough to do the job properly, according to an article in the Canadian Medical Association Journal (CMAJ).

Obstetricians, suddenly forced into the unfamiliar frontlines when their pregnant patients were identified as some of the most vulnerable, are not equipped or inclined, I recently reported.

“We must not underestimate an enemy like pandemic (H1N1) 2009, especially now,” says Dr. Paul C. Hébert , CMAJ editor-in-chief, in a recent editorial.

But while he talks about prevention in the form of immunization, and political leadership, why can’t we talk about parents and teachers? Our local schoolboard has spent time and effort educating us about coughing and sneezing etiquette. Please! Now British public health officials are warning that even school closures are not enough – since they’ve identified that social gatherings were a big factor in a recent string of outbreaks. 

Let’s talk about staying home, staying well and avoiding “the second wave” altogether.

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August 25, 2009 - Posted by | H1N1, Parenting | , ,

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