Swine flu

Man, the guys in infection control at the hospital have been running around with their hair on fire. They now have something that looks like it can justify their existence after weekly bioterrorism/pandemic flu pages since 2001.

H1N1 has a reasonably high case fatality rate, and it is killing young people, which regular old flu A does sometimes. But apparently the vaccine is protective, and oseltamivir/rimantidine does pretty well (which can't be said about this season's regular flu A, which was largely resistant to oseltamivir). The killing young people is what everyone worries about, and I think that's driving the hysteria in large part. But mostly, like so many things, I think everyone has been waiting for a pandemic flu for so long, and so many resources have been marshalled in preparation, that people are unloading.

We got at least 20 emails about it today. In the MICU, we will be the ones seeing respiratory failure, so we got 15 or so pages on the code pager about mask fitting, and how acute respiratory failure will be assumed to be H1N1. Everyone (visitors, patients, staff) will be screened for respiratory symptoms at the door of the hospital. It sounds like any respiratory failure will be placed on full droplet precautions, with use of gowns, gloves, and N95 masks (which cost $5 apiece) for any contact. All this is planned without any cases in the area, but up the coast a bit. We shall what spreads down from New Jersey. If it starts heading south, and there is evidence for person-to-person spread, it will be interesting to watch how people start to flip out.