H1N1: Much ado about nothing?

It has been eight months since the news broke of a new influenza virus sickening hundreds of people in Mexico. For several weeks this past spring, Americans were mesmerized, and a little fearful. The news media went into overdrive with its coverage of the virus we’ve come to know as the novel H1N1 flu virus or, more familiarly, swine flu.

Where are we today? Well, after lingering through the summer and peaking in October, H1N1 appears to be waning. Worries that the virus would become widespread and that it would swamp the health care system never really materialized. We now have a vaccine available to protect against it.

So was it all a big deal about nothing?

Fearmongers have overblown H1N1 into a crisis – a label it doesn’t really warrant, asserts Jeffrey Hall Dobken, a physician and bioethicist. Dobken’s thought-provoking column, which appeared last week in MedNews Today, is titled "About Crying Wolf":

What is the impact on children and families when every 15 minutes there is an "update" on the latest H1N1 news? The Health Department serves up statistics and guidelines to professionals with incredible frequency these days: hospitalization plus morbidity/mortality rates, availability of medication, utilization of medication, changes in vaccine availability and guidelines for use and/or delivery plus demographics as to who is to be vaccinated and who isn’t.

All this interspersed with items reporting U.S. vaccine production shortfalls, then vaccine distribution plans through commercial, big-chain pharmacies and supermarkets but not physician offices, or to special groups on Wall Street or at Guantanamo.

It is all bewildering enough to the professional. What must this be like for the patient, for the child told they are at greatest risk, or the pregnant woman, or the elderly who are advised that they "don’t need it"?

Dr. Dobken concludes with the suggestion: "Perhaps we can tone down the sky-is-falling just a little bit?"

Admittedly, the media hype about H1N1 has bordered at times on frenzy. Many of us in the media are aware of this, and we’ve struggled to balance the need to provide up-to-date information with the tendency toward overkill. It’s hard to know where to draw this line. If you stick to the basics, is it enough? Or should you be giving your audience more? It hasn’t helped that the situation has been extremely fluid, often changing from one day to the next. Even health providers have had a hard time keeping up.

The bigger question, though, is whether H1N1 itself has been exaggerated out of all proportion. From the start, there were doubters and critics of the U.S. reaction to the novel virus. Plenty of people wondered why this was any different from seasonal influenza.

I’m not convinced the critics are right. Even though H1N1 has turned out to be a relatively mild illness, there are still thousands of Americans who have become very sick. Young and otherwise healthy adults have ended up in intensive care, in some cases requiring a ventilator. In Minnesota, 50 people have died from H1N1 since May.

Nationally, it’s estimated more than 50 million Americans have had H1N1, with children and young adults hit the hardest. There have been more than 200,000 hospitalizations – "about the same number that there is in a usual flu season for the entire year," the U.S. Centers for Disease Control and Prevention pointed out in a recent media briefing. And there have been nearly 10,000 deaths – again, mainly among children and younger adults.

Perhaps because we’re accustomed to dealing with influenza every year, we tend to let down our guard and forget that flu can sometimes be fatal. It can be easy to overlook the cost of flu-related medical care and hospitalizations, and the toll that absenteeism takes in schools and in the workplace.

Public health officials can’t always win. If they urge everyone to be prepared and the threat subsequently fizzles out, they’ll be criticized for crying wolf. But if they downplay or brush aside a potential threat that turns out to be serious, watch the blamestorming erupt. The messages about hand washing, vaccinations, staying home when you’re sick, etc., are messages we should be heeding anyway, regardless of H1N1. There’s nothing wrong with reinforcing them, or with pushing the need to plan and be prepared. It’s simply the prudent thing to do.

Photo: Negative stain electron microscope image of the 2009 H1N1 virus. C.S. Goldsmith and A. Balish, Centers for Disease Control and Prevention.

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