Thursday, March 23, 2006

Swine Flu Redux

I was a young paramedic at the time of the swine flu scare, and was loaned out to the County Health Department to assist in their innoculation program and public awareness program.

Basically, I was put on the `rubber chicken circuit’ over the summer and gave lectures at the rotary, kiwanis, Elks, etc. I was part of the civil defense planning commission, inservice instructor for our County EMS, and that fall, gave several thousand flu shots for the health department. We set up in shopping malls, schools, community centers, etc.

I can tell you that, while there was deep concern over a pandemic back then, it didn’t rise to the level we are seeing today. Of course, this was before CNN, and 24 hour cable news, and the Internet. Almost no comparisons were made to the Spanish Flu.

There were probably political considerations at the highest levels, but I believe they really did perceive a threat. The emergence of Swine flu at Fort Dix was a bit of a shock. The feeling was, we’d dodged a bullet in 1968 with the Hong Kong Flu.

While the decision to try to innoculate the nation before additional cases broke out turned out to be ill fated, I believe it was well intentioned. It was debated, and decided, that waiting until an outbreak occured would be too risky. So the decision was to innoculate the country prophylactically.

The vaccine was blamed for a lot of deaths, and cases of guillian-berre syndrome (a form of paralysis). The fear of the vaccine was exacerbated by newspaper speculation. But the truth is, we were vaccinating a lot of elderly people, and many of their deaths, while attributed to the vaccine in the press, may have been from other causes.

We learned a lot about mass innoculations, and the difficulties of pulling off that sort of thing. Lessons that to this day worry me. The glib response that we `could have a vaccine within 6 months’ of the virus going H2H is just a tad optimistic, IMHO.

Sure, we might have it in the lab. Maybe even in quantity. But getting it out to the people will be a logistical nightmare. We managed to innoculate 40 million people in 8 weeks. And this was a national priority. And it was before any pandemic had struck.

I can tell you that my level of concern this time is much higher. Mostly due to the high CFR of H5N1. This is a different critter, altogether. And frankly, my perception is we were better equiped back then to handle an outbreak. Less reliance on just-in-time inventory deliveries.

While we did not see a swine flu outbreak, the following year we did see the A VICTORIA outbreak, and back then, it killed 36,000 people in the US, and overwhelmed the hospitals. We were seeing, and transporting, flu patients every day. Hospitals were often closed due to having no beds. ER’s would shut down due to overload. A lot of nurses and docs were out with the flu, as were some medics. I guess I was lucky, as I didn’t catch it.

So all of this, for me, is a case of Deja-Flu.