News

H1N1/Swine Flu: Keeping Perspective

04/28/2009

Amid the media explosion of Influenza A (H1N1) (or "swine flu") news, the most important thing we can do is to keep perspective, says infection control expert and EMS Magazine editorial advisory board member Katherine West.

"There is too much hype," West said in an April 29th interview. "It is an important new virus and we do want people to know what's going on, but the media as usual is overhyping, and the way they present things, especially on cable news, is in a very scary format. And that is not helpful; facts and good information are helpful."

For example, there has been much coverage of the first death to occur in the U.S., but it was not a U.S. case. The patient was a child brought to the U.S. from Mexico. "That changes the picture," West noted. She said there has been some appropriate coverage in the media, in which officials have discussed the importance of recognition of the virus and have stressed that we are in preparatory mode, not in emergency crisis mode. "That's a key difference," she said.

West recommends that health care providers stick to credible websites for flu information, such as the CDC and World Health Organization, and perhaps prepare for pandemic more directly than in the past.

"Now the other thing is -- more people will get sick, this is a flu virus," she said. "Some people will die. And what has been totally missed is that in the U.S. every year, the CDC says, we have over 36,000 deaths due to seasonal flu. And nobody pays any attention to that. So we're going to lose perspective. This is how flu viruses go."

As far as the signs and symptoms of this virus, it is acting like any other flu virus right now, West said. However, that isn't to say that the situation isn't concerning, because there are some important differences in its behavior and we don't yet know why.

"It is concerning, absolutely," West said. "It is a new virus -- components of three viruses have merged to form this new virus. It is right now hitting mostly average age 16. That's unusual - usually flu is the very young and the very old. So this is different." In addition, "It's the end of the flu season that this is occurring, so that's an interesting fact," West said.

It could be that this virus will follow a cycle like the common flu -- run a course, peak, die in the summer and then come back in the fall -- but by then we may possibly have a vaccine, West said. "Maybe this isn't the pandemic. We don't' know."

When treating any patient with a fever and upper respiratory symptoms, getting a travel history is helpful, West said. "Departments should have been doing that routinely since the SARS outbreak." Also, "If presenting with signs and symptoms we want to place a surgical mask on the patient. Basic infection control is to contain at the source." For further guidance agencies should refer to their state and local plans, she said, and keep abreast of the CDC's interim guidelines, which are changing all the time.

"But the main thing is to be calm," West said. "Our mission is to take care of sick people. No matter what they have."

"We have a lot to learn about this new virus but we can't be scared about it," West said. "We have to learn, listen, and decide what we're going to do. If we're scared we can't function. Fear paralyzes people, and we don't need paralyzed responders."

On that note, West recalled a recent study that surveyed nurses about who would respond in a pandemic. More than 50 percent said they would be no-shows due to other commitments. "One thing that has to be part of planning is to anonymously get a true assessment from our staff of who would come," she said. And it is up to all responders to address the question, "What have we done as health care professionals to prepare ourselves and our homes?"

Katherine West, BSN, MSEd, CIC, is an Infection-Control Consultant to Infection Control/Emerging Concepts in Manassas, Va.

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