SWINE FLU: Part 4 – What happens if the H1N1 pandemic gets worse?

In Parts 1, 2 and 3 of this story published Thursday, we outlined the current situation and the potential threat this fall from the swine flu to the Indian River County healthcare system, the local economy and the schools.

INDIAN RIVER COUNTY — As reported in the Sept. 17 issue of Vero Beach 32963, the U.S. Centers for Disease Control and Prevenion region in which Florida is contained is currently at a Category 2 status, based on hospitalizations and deaths related to positively tested cases of the H1N1 flu virus.

Should conditions in Indian River County or on the Treasure Coast indicate a more severe outbreak of H1N1, local health officials do not have the authority to adjust our area up to a Category 3 status. Indian River County Health Department Administrator Miranda Swanson said that kind of directive would have to come from the CDC, in response to the data being tracked. Currently, under a Category 2, recommendations include vigilant hand washing, sneezing into the sleeve instead of hands, using hand sanitizer, going home or staying home if sick and self-isolation of sick people to recover from home. Should the flu ramp up to a Category 3 on the Pandemic Severity Index, Swanson said the Health Department would recommend the following strategies:

*Permit high-risk staff and students to stay home;

* Increase social distances between children;

* Actively screen students and staff for fever and other symptoms of flu;

* Encourage children with ill household members to stay home;

* Extend the time that ill people stay home from the current 24 hours after fever resolves without benefit of fever reducing medicine to 7 days;

* Close early childhood program as a last resort, and balance the risks of flu in the community with disruption it would cause.

* Close schools as a last resort, balancing the disruption dismissals would cause in both education and the wider community. Swanson said the Health Department “would also look at other actions to increase social distancing, such as looking at limiting public gatherings, decreasing the number of social contacts, increasing distances between persons, and modification of workplace schedules and practices.” These measures could affect attendance at local theatres, concerts and festivals, as well as participation in social events, which are the lifeblood of Indian River County’s nonprofit organizations.

As Vero Beach prepares to deal with the impending crisis, the federal government is sending $350 million to state and local governments, including $90 million to help the nation’s 4,897 hospitals and 3,829 emergency rooms prepare.

In addition, the Strategic National Stockpile has more than 116 million masks, more than 52 million doses of antiviral drugs and 4,500 ventilators. Federal officials have also begun to count available ventilators, which could be crucial in caring for the sickest patients. Experts say they expect the virus to linger longer this fall and winter, raising deep concern about whether the stockpiles of supplies, the contingency plans to improvise extra beds and backup plans to call up reserves of doctors, nurses and other health-care workers will be sufficient.

Already in Indian River County, not everyone is being prescribed drugs like Tamiflu when they show up at a doctor’s office or the Health Department. Doctors are trying to prevent the H1N1 virus from developing resistance to the handful of drugs they have in their toolbox to fight the flu, so they’re reserving the drug for people who are very ill or who have conditions such as heart disease or lung disease, which may cause them to develop complications from the flu.

A course of Tamiflu also costs about $140, which is a barrier to some people who are sick, even if they have insurance. The first line of defense will be to persuade those with mild symptoms to stay home to minimize the spread of the virus, and to make sure those who really need care receive it, while still providing treatment for the usual number of heart attack, gunshot and accident victims.

“It is hoped that patients will remain home, as advised, if they have mild to moderate symptoms and call their primary care physician,” said Besty Whisman, spokesperson for Indian River Medical Center. “This will help prevent exposure of other people and patients.”

(Ron Stein of the Washington Post contributed to this article)

SWINE FLU: Part 1 – H1N1 already stressing the healthcare system

SWINE FLU: Part 2 – Employers “play doctor,” employees in tough spot

SWINE FLU: Part 3 – H1N1 and our kids, how the school system is coping

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