Monday, September 21, 2009 | Categories: Dr. Brian's Blog |
Agree or disagree, but our show on the gap between the real and the hypothesized threat of H1N1 swine flu sure prompted you to react. Rather than spreading your postings over several blog entries, might as well stick with our previous blog posting Second Wave of Swine Flu? We Aren't Worried as the focal point for your comments.
I did want to answer a number of points raised so far.
CB, a Canadian-born physician working in Australia writes:
"The Department of Health and Ageing (i.e. the Australian) figures do not show the number of additional presentations to ER's and GP clinics across the country (estimated to be around 20-40% increase from base levels in most urban jusridictions), nor the increased demand for pathology sevices during the period. Australia's ERs struggled but coped during the outbreak - are Canada's emergency departments prepared to withstand this impending extra load?
As for pathology, apparently the pathology services in Quebec and Ontario are unable to cope with the sheer numbers of H1N109 swabs they are getting now... what will it be like in 2-4 months time with the flu season in full swing? How can they hope to contain the spread if they can't provide timely diagnosis of the illness?
2) A small but significant number of those in ICUs across the county were fit and healthy individuals in their 20s or 30s and have required ECMO(cardiopulmonary bypass) up to 2 weeks to survive. In addition, of those on mechanical ventilation, H1N109 patients have tended to required longer time on ventilators and longer times in ICU than the typical severe pneumonia patient. At one point during the outbreak, around 1/5th of all ICU patients in Australia were H1N109 positive.
3) Australian winters are rather mild in comparison, and people don't tend to hunker down as in the northern hemisphere. Simply, while the virus may turn out to be not be all that lethal in the final analysis, it is nonetheless dangerous and presents a massive challenge in terms of resources to any health system."
CB, the valid points you raise can also be used to support the arguments raised on WCBA. What's driving the big increase in clinic and ER visits, as well as testing? If it's a real need, then the expense is worth it. But if it's people being driven to the ER after implied warnings from public health officials that it's better to be safe than sorry, well, then, maybe not. Justified or not, we can certainly agree on one thing: H1N1 sure is putting a strain on health care resources.
Ken posted this entry that we feel is worth highlighting too:
"The show on H1N1 down playing the risks of this flu may be accurate in describing the number of infections but does not adequately speak to the potential seriousness for some of those who do get infected. I'm a healthy 46 year old husband and father of two and like my doctor didn't really worry much about this flu. So when I got sock in late June I figured it would just pass. A few days In It was worse so I went to my doctor who gave me antibiotics and sent me home. I end up going for a different script the next day when the first set didn't agree with me. The doctor did chest x-ray and noted I had some pneumonia starting. Two more days at home were uneventful but by the third night my cough had gotten much worse and by morning I was having trouble breathing and having chest pains. My wife drove to the local rural hospital emergency and they repeated the x-ray and found both lungs now full of pneumonia and my O2 stats dangerously low. I remained in the induced coma for 2 weeks on respirator and at one point had 13 iv's running. In the first few days I suffered a heart attack and major organ failure and kidney shutdown requiring dialysis 3 times. For the first few days they could not tell my wife if I would live. Once stable it took another week before I started to improve, two weeks before they were able to bring me out of the coma.
In all I spent 5 week in hospital and another month recovering at home. I had caught H1N1 and developed a secondary pneumonia in both lungs. I also went from being very healthy to nearly dying in just over 7 days!!
While it may only be some people who get this sick it is critical that patients and doctors very carefully and closely monitor anyone who does get sick with this flue because it can go from a benign infection to life threatening illness very quickly, as it did in my case. I nearly died and would have left behind two teenage children and a wife. Most of the story I only learned later after they woke me in ICU in the third week.
So the message should be don't panic but if you have the flu be very careful and you need to be proactive with your doctor if things get worse. You should also let people know what are the signs and symptoms indicating that your condition may be getting serious or life threatening. I didn't know, and it nearly cost me my life."
Thanks for writing in, Ken, We're very glad you're feeling better. Couldn't have said it better myself. To an individual who gets a life-threatening case of swine flu, it's an unmitigated disaster. But to a population at risk, it may be a different story. Some of us are very susceptible to the effects of this virus; most others are not. The challenge is to try and figure out who is at risk and to pour Canada's best efforts in trying to protect them.
By that logic, while we may be wasting vast sums of money trying to blanket all of Canada with swine flu protection. That said, I think we should pour resources into at risk remote First Nations communities.
Finally, Tania wrote in to ask when she can download the podcast of "Swinefeld". The answer is, you can download load podcasts of each new show beginning the midnight prior to the show's original airdate. "Swinefeld" is listed under Podcasts with an airdate of September 19, 2009.