Crying wolf over swine flu?

Wednesday, January 6, 2010

When Becky Pinkerton's son came down with H1N1 during the peak of the pandemic virus in October, she was terrified.

"As a mom, your kid gets the swine flu (and) you're scared to death," the East Brainerd resident said.

But her 8-year-old son Coleman only developed a low-grade fever and headache and bounced back easily within a couple days. Mrs. Pinkerton's relief was mixed with doubt as to whether her fears had been warranted.

"In my opinion, it was way overly hyped," she said.

Public health officials should have tempered their urgent message about H1N1, "instead of just scaring everybody when they really didn't know a whole lot about it," she said.

So far, the H1N1 virus that has sent hundreds in Tennessee and Georgia to the hospital has been relatively mild for a global flu outbreak.

Now public health officials are acknowledging the early challenges they faced in communicating to the public about a virus that, at first, appeared potentially devastating, while accepting that they may now face accusations of crying wolf.

Tennessee state epidemiologist Tim Jones said he's willing to bear that criticism.

"There's always the risk that people are retrospectively going to say, 'You over-hyped it,'" Dr. Jones said. "I don't take it lightly, but the other alternative is much worse. If suddenly things had blown up and people had died unnecessarily ... then we'd be talking about national fury and ethically feeling like we failed."

LESS DEADLY VIRUS

Even though H1N1 seems to be less contagious and less deadly than originally feared, public health officials are still concerned the disease could mutate into a more virulent, possibly drug-resistant strain, or that a second wave could hit with a vengeance in the coming months.

At the end of December, federal officials said the flu was only widespread in four states - Delaware, Maine, New Jersey and Virginia - compared to a peak of 48 states in late October.

Despite troublesome delays in vaccine distribution, inoculation efforts have mitigated the impact of the disease, said Logan Boss, spokesman for Northwest Georgia Public Health, the 10-county district that includes Dade, Catoosa and Walker counties.

"That is one of the unsung values of public health that people don't really understand or are not appreciating," he said.

An analysis published in the New England Journal of Medicine last week found that H1N1 is less transmissible than other pandemic diseases. In 216 households studied, an average of only 13 percent of family members caught H1N1 from a housemate, though children under 18 were twice as susceptible to H1N1 than those age 19 to 50.

FAST FACTS* Georgia- Vaccines distributed to doctors: 3.5 million- Deaths from H1N1: 41* Tennessee- Vaccines distributed to doctors: 2.4 million- Deaths from H1N1: 51* Hamilton County- Deaths from H1N1: 6 (adults)- Vaccines administered through public health department: 21,000*- Vaccines available at health department: 11,000Source: Tennessee and Georgia state health departments; Chattanooga-Hamilton County Health Department* Private providers and pharmacy chains are also distributing vaccine locally.

Months after experts released alarming predictions that H1N1 could kill between 30,000 and 90,000 people in the United States, a follow-up analysis released last month projected that for every 10 percent of the population to develop flu symptoms, between 7,800 and 29,000 deaths would occur, and that was on the high end.

Although the early release of worst-case scenarios may have unnerved the public, federal health agencies displayed a rather rare transparency in being forthright about their own uncertainty of the risk from H1N1, said Michael Palenchar, a professor of public relations at the University of Tennessee in Knoxville who has a doctorate in risk communication.

"H1N1 was one of the first times in recent memory where federal agencies were willing to talk about things as (the situation) was evolving, when it was uncertain," he said. "They were willing to acknowledge they didn't know everything. That's helpful to the community to make decisions and have an informed citizenry."

As anxiety has lessened, demand for H1N1 vaccine, now plentiful nationwide, also has dwindled, officials in Tennessee and Georgia said.

At least 118 million doses of vaccine are available nationwide, according to the Centers for Disease Control. In Georgia, 3.5 million doses have been distributed to physicians and, in Tennessee, 2.4 million. Not all of those have necessarily been administered to patients, health officials said.

Public health officials are reminding patients that the pandemic is not yet over, and for those who have lost loved ones to H1N1, the virus has certainly been devastating.

"One death is too many if you can prevent it," said Becky Barnes, administrator of the Chattanooga-Hamilton County Health Department. "It's not too late to be vaccinated. That is the single best thing we can do to protect yourself against flu."