Is a National Emergency Declaration for Swine Flu Necessary?

[russ_watters]

Obama has declared a national emergency due to swine flu: http://www.usatoday.com/news/health/2009-10-24-Obama-swine-flu_N.htm

This allows for suspension of federal rules/guidelines governing the operation of hospitals in order to speed care, segregate patients, etc.

The move was pre-emptive.

So my question is: does the evolution of the outbreak so far suggest this is really going to be necessary?

 

[Evo]

Obama has declared a national emergency due to swine flu: http://www.usatoday.com/news/health/2009-10-24-Obama-swine-flu_N.htm

This allows for suspension of federal rules/guidelines governing the operation of hospitals in order to speed care, segregate patients, etc.

The move was pre-emptive.

So my question is: does the evolution of the outbreak so far suggest this is really going to be necessary?

No. He just doesn't want to be said to have acted too late, so he'd rather act unnecessarily.

 

[Astronuc]

Some data - http://www.cdc.gov/flu/weekly/

The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold.

http://www.cdc.gov/H1N1FLU/

Situation Update
During the week of October 11-17, 2009, influenza activity continued to increase in the United States as reported in FluView. Flu activity is now widespread in 46 states. Nationwide, visits to doctors for influenza-like-illness are increasing steeply and are now higher than what is seen at the peak of many regular flu seasons. In addition, flu-related hospitalizations and deaths continue to go up nation-wide and are above what is expected for this time of year.

 

[hypatia]

The ability to move emergency medical care off site, is a very good idea.
Last week here in Michigan, they closed 70 schools state wide because more then 50% of the students, at each of the schools, had the flu. We have several state buildings prepared to handle this over-flow, if needed.

 

[Pythagorean]

It got over-hyped right away and people realized it and now there may be a natural reaction to under-hype it. I'm obviously under-hyped by it, since I don't really care about vaccinations or prevention. But I may be wrong to be under-hyped by it, I guess.

 

[Evo]

Some data - http://www.cdc.gov/flu/weekly/


http://www.cdc.gov/H1N1FLU/

This is more a case of people seeking treatment when in the past they would not have.

Where they wouldn't have gone in the past, more people going to the doctor due to fear from the media causing more people to worry . This results in the increase in hospitalization, and the testing of every patient causes more cases to be detected.

I'm not seeing a larger number of sick people at work. Just that one woman, and she didn't even miss work, she just went to the office clinic and got some cough syrup.

I *DO* want to emphasize that I think that everyone that can, should get the flu vaccine. I'm getting mine next week. Since I started getting the vaccine (they come to our office and give it to us at work), I have not had the flu, and it's wonderful to not get sick, the flu is nothing to take lightly.

 

[OmCheeto]

The ability to move emergency medical care off site, is a very good idea.
Last week here in Michigan, they closed 70 schools state wide because more then 50% of the students, at each of the schools, had the flu. We have several state buildings prepared to handle this over-flow, if needed.

hmmm... I thought there might be a bit of exaggeration on your part:

http://www.publicbroadcasting.net/m.../114.Michigan.Schools.Closed.by.'Swine.Flu'."
ANN ARBOR, MI (Michigan Radio) -
(2009-10-21)

114 Michigan schools have closed so far this school year, amid concerns that Swine Flu is spreading.

I guess not.

We're a bit behind out here:

http://news.opb.org/article/5919-swine-flu-closes-rural-oregon-school/"
BY ROB MANNING
Portland, OR September 29, 2009 8:51 a.m.

For the first time this fall, an Oregon school is closing due to the H1N1 virus.

The K-12 public school in the small southwestern Oregon town of Prospect will be closed Tuesday, and plans to stay closed through the end of the week.

State officials say that Prospect has seen about 40 of its 120 students sickened by the flu virus. In addition, half the teachers are out.

They're getting pretty serious at work about it. If you have flu symptoms, you have to go home, and not come back for 7 days, period. Even if your symptoms go away after 3 days, you still have to stay home for the full 7 days.

Of course, upon hearing this, everyone in my office claimed to have a fever.

 

[Sorry!]

This is more a case of people seeking treatment when in the past they would not have.

Where they wouldn't have gone in the past, more people going to the doctor due to fear from the media causing more people to worry . This results in the increase in hospitalization, and the testing of every patient causes more cases to be detected.

I'm not seeing a larger number of sick people at work. Just that one woman, and she didn't even miss work, she just went to the office clinic and got some cough syrup.

Here in Ontario in my region I am pretty sure everyone at my prior work had gotten the flu. Many people around my area have the flu and in the next region over where my girlfriend works a large amount of people have gotten the flu and many have died... I personally haven't seen this much since I've been alive so I don't think it flies that 'more people are going to the hospital.' I mean like I myself can see that it is different than other years...

 

[Evo]

Here in Ontario in my region I am pretty sure everyone at my prior work had gotten the flu. Many people around my area have the flu and in the next region over where my girlfriend works a large amount of people have gotten the flu and many have died... I personally haven't seen this much since I've been alive so I don't think it flies that 'more people are going to the hospital.' I mean like I myself can see that it is different than other years...

Do you have a link to the number of confirmed deaths from the flu in Ontario?

 

[Sorry!]

Do you have a link to the number of confirmed deaths from the flu in Ontario?

I'll look for the newspaper reports for local results sure. I know in Halton region was one of the worst hit regions in all of Canada.

 

[Evo]

I'll look for the newspaper reports for local results sure. I know in Halton region was one of the worst hit regions in all of Canada.

Here you go.

The number of deaths in the province since April has risen as well, she said. The number was stable at 24 for "quite a few weeks," and now it is at 28, King said.

"Over the last couple of weeks we've seen a couple more deaths and a few more hospitalizations," she said.

http://www.google.com/hostednews/canadianpress/article/ALeqM5ikJltIHg7P6gufmRm4oFtKGeyTRQ

Most people used to tough it out with over the counter flu medication, and many people get colds and think it's the flu.

 

[Sorry!]

http://www.health.gov.on.ca/english/providers/program/pubhealth/flu/flu_09/bulletins/flu_bul_01_20091023.pdf
Comparative by a week-to-week basis. As well saying that more people are going to the hospital. I really don't buy it you should get YOUR sources for saying that. I had flu the other week and it lasted for 5 days and I didn't go to the doctor while I had it... and I haven't felt sick like that in a very long time.

Towards the middle of the pdf file you'll see a graph comparing yearly week to week results. This year had become substantially higher than other years and remains higher...

(there is one 'botched section') but regardless:

It is clear that the number of laboratory confirmed cases of influenza A reported to date in the
2009-2010 season is much higher than in the previous five seasons at this time.

 

[rootX]

Here you go.
http://www.google.com/hostednews/canadianpress/article/ALeqM5ikJltIHg7P6gufmRm4oFtKGeyTRQ

Most people used to tough it out with over the counter flu medication, and many people get colds and think it's the flu.

It tells the number of deaths only not the time period.

Edit: Clicked Submit button bit late, Thanks Sorry! for putting the time scale.

 

[Evo]

They are testing people now to confirm flu, something not normally done in the past. This makes it "appear" that there are more cases, when in reality, they are doing more testing. People need to use common sense, get the vaccine, and realize that a change in testing and reporting makes figures this year not comparable to prior years.

See my thread here about trying to overcome the idiot internet misinformation warning people not to get flu shots.

https://www.physicsforums.com/showthread.php?t=340467

 

[Sorry!]

It tells the number of deaths only not the time period.

Edit: Clicked Submit button bit late, Thanks Sorry! for putting the time scale.

The file i posted doesn't tell you the week-to-week deaths but if you go to the main website you can click on each week and see all the updates including deaths. As well it goes back a couple years

 

[Sorry!]

They are testing people now to confirm flu, something not normally done in the past. This makes it "appear" that there are more cases, when in reality, they are doing more testing. People need to use common sense, get the vaccine, and realize that a change in testing and reporting make figures this year not comparable to prior years.

Evo, I respect you and all but I just have to say it. You are wrong.

I have already pointed out that in my PERSONAL experience in this area there have even been more illness... a lot of whom I also know didn't even go to the hospital.

Maybe this is just an isolated pocket where more people are randomly getting sick completely unrelated to the pandemic. The region right nextdoor is getting hit even worse though? I have been there personally as well... and I have friends from even further out towards hamilton (I live near toronto) and its even worse out there. So this pocket is quite large... a bit larger than to just ignore and brush away as 'more people are getting tested' and I'm certain I didn't forget last years flu season and this year is definitely comparatively worse and I'm not going off test I'm going off objective findings of my own.

 

[Evo]

Evo, I respect you and all but I just have to say it. You are wrong.

No. They are doing testing now for the flu that has not been done in the past. That's a fact.

Increased Testing
CDC has developed a PCR diagnostic test kit to detect this novel H1N1 virus and has now distributed test kits to all states in the U.S. and the District of Columbia and Puerto Rico. The test kits are being shipped internationally as well. This will allow states and other countries to test for this new virus. This increase in testing will likely result in an increase in the number of confirmed cases of illness reported. This, combined with ongoing monitoring through Flu View should provide a fuller picture of the burden of disease in the United States over time.

http://www.cdc.gov/h1n1flu/updates/050809.htm

 

[Sorry!]

No. They are doing testing now for the flu that has not been done in the past. That's a fact, I had the article on it, but my computer crashed a couple of months ago and I lost it, but will need to find it.

No I believe you and if you look over the source I posted they even included a segment on the testing they do and how it skewered the results and what they have done to normalize the results.

Read the rest of my post though. You can't ignore the fact that it's visible all around not just in hospitals...

 

[Evo]

It's a shame that the flu vaccine isn't can't be made available sooner. A few years ago, I came down with the flu the day before my scheduled shot in early November. My employer has now moved up the date where we can get it for free at a clinic as soon as the vaccine becomes available in early October, or get it at the office in late October.

I really encourage everyone to get the vaccine. Even if you don't mind if you get the flu yourself, consider the fact that you might infect someone that might die from it.

 

[Moonbear]

My students have been getting the seasonal flu already. I know because they need a doctor's note to have an excused absence from my class, so they all get tested when they get sick. Only one has had swine flu so far. All the rest have been regular flu. So, both versions of flu are already going around campus.

The downside on swine flu is that they seem to be contagious longer, so even when they feel better, we've been told the students with it can't return to classes until 5 days after their fever is gone. With regular flu, they just have to wait 24 hours.

We do know of a number of "unreported" cases in the local elementary schools. Students and teachers are already coming down with one of the flus, but not getting tested. Unfortunately, knowing that one type of flu will mean missing less work than the other means people are purposely avoiding testing and just returning after the fever breaks without knowing if they are still contagious. So, pretty much by the time the vaccine shows up in our state, anyone who was going to catch flu will have already had it.

We did have some free vaccinations available for seasonal flu, but they ran out and haven't been able to restock, so had to cancel most of the clinics planned. Apparently, they're ready to set up clinics within 24-48 hours of receiving the swine flu vaccine, but our state is lowest on the priority list because we have some of the lower incidence...which is stupid. I think they're sending it to the states where it has already run its course rather than to the ones where they could actually still prevent it.

So far, swine flu seems far milder than the regular seasonal flu. Though, overall, I've had fewer students absent than I usually have by this time of year. I haven't had to give a single make-up exam yet, which is very unusual. Usually, by the mid-October exams, there are enough cases of colds and flus that I need to give at least a few make-up exams.

Edit: I should point out that the seasonal flu going around is also predominantly of an H1N1 subtype, but is NOT the swine flu variant.

 

[B. Elliott]

So my question is: does the evolution of the outbreak so far suggest this is really going to be necessary?

Our command has been in direct contact with the CDC about this since the beginning of this more recent outbreak. So far, it's more hype than anything else. Per the CDC, there is currently no evidence that the swine flu will change into something more harmful. All they're doing is taking proper precautions 'just in case'.

 

[B. Elliott]

But to answer your question, I don't agree that it should be considered a national emergency.

 

[russ_watters]

Evo, I respect you and all but I just have to say it. You are wrong.

I have already pointed out that in my PERSONAL experience in this area there have even been more illness... a lot of whom I also know didn't even go to the hospital.

Maybe this is just an isolated pocket where more people are randomly getting sick completely unrelated to the pandemic.

Personal experience doesn't really count for much on such issues. You've seen a lot of people who have gotten the flu - I personally don't know anyone who has gotten it, nor have I heard any local news stories about significant outbreaks. Neither of our two stories is necessarily representative.

 

[Sorry!]

Personal experience doesn't really count for much on such issues. You've seen a lot of people who have gotten the flu - I personally don't know anyone who has gotten it, nor have I heard any local news stories about significant outbreaks. Neither of our two stories is necessarily representative.

I'm talking about a generally large area which includes a majority of ontarios population and even a majority when it comes to this nations population as an entirity...

 

[russ_watters]

So far, swine flu seems far milder than the regular seasonal flu.

What do you base that on? The links posted earlier suggest that the swine flu has killed more people than is normally expected by this point in a flu season. Is that differences in fatality rate, differences in infection rate or differences in reporting?

Ie, it is possible for swine flu to be only 3/4 as severe as regular flu but if twice as many people have it (or have reported it) than usual by now, there will be 50% more deaths.

I know people don't always report getting the flu, but when someone dies from the flu, is it typically reported accurately?

 

[russ_watters]

I'm talking about a generally large area which includes a majority of ontarios population and even a majority when it comes to this nations population as an entirity...

Ontario has a population of 13 million, Pennsylvania has a population of 12 million.

Geographically, I live within three hours drive of probably 50 million people, having New York and Washington in that radius.

 

[Sorry!]

Ontario has a population of 13 million, Pennsylvania has a population of 12 million.

Geographically, I live within three hours drive of probably 50 million people, having New York and Washington in that radius.

And you can make a general statement about this these large populations? Because I just did and I also provided references from the government to substantiate my claims. Which as Evo pointed out can be argued but coupled with the fact that it's even observable in the general population that more people are ill?

 

[Chi Meson]

No. He just doesn't want to be said to have acted too late, so he'd rather act unnecessarily.

The action is pro-active, and prudent, and necessary.

“This is not a response to any new developments,” said Reid Cherlin, a White House spokesman. “It’s an important tool in our kit going forward.”

Mr. Obama’s declaration was necessary to empower Kathleen Sebelius, the secretary of Health and Human Services, to issue waivers that allow hospitals in danger of being overwhelmed with swine flu patients to execute disaster operation plans that include transferring patients off-site to satellite facilities or other hospitals.

http://www.nytimes.com/2009/10/25/us/politics/25flu.html?_r=1&ref=global-home"

Sounds more like a bureaucratic procedure that is inflamed by the hype.

 

[russ_watters]

And you can make a general statement about this these large populations? Because I just did and I also provided references from the government to substantiate my claims. Which as Evo pointed out can be argued but coupled with the fact that it's even observable in the general population that more people are ill?

I can't reference something that doesn't exist - there is no big swine flu problem in my area.

Your generalizations are worth exactly as much as mine: zero. You can't say that because it is bad in your area, it is bad everywhere and I can't say that because it is not bad in my area it is not bad everywhere.

Something else about the early infection rates being higher than normal for seasonal flu - does that not also mean the flu is going to run its course faster than the regular seasonal flu? I've heard that vaccines aren't widely available yet - could the swine flu run its course before they are?

 

[Sorry!]

I can't reference something that doesn't exist - there is no big swine flu problem in my area.

Your generalizations are worth exactly as much as mine: zero. You can't say that because it is bad in your area, it is bad everywhere and I can't say that because it is not bad in my area it is not bad everywhere.

Something else about the early infection rates being higher than normal for seasonal flu - does that not also mean the flu is going to run its course faster than the regular seasonal flu? I've heard that vaccines aren't widely available yet - could the swine flu run its course before they are?

I used statistics given by the government and provided a link to them Evo claimed that this proves nothing because of testing methods so I used empirical evidence that ANYONE can notice by walking through southern Ontario. Which has a significant portion of Ontario's population (which the links I provided for are about) so if I can make a broad general statement using empirical evidence about a majority of the population coupled with the fact that the government statistics supports this for the majority of Ontario then yes. I can come on here and my claim that this years flu season in Ontario is worse than the other years... I don't see how this is wrong...

But yes the infection rates being so high early in the season could indicate that maybe the season just came earlier and it will run its course faster but all statistics provided so far show that the pandemic is having more of an upward trend with regard to infection rates. Maybe the downhill portion is yet to come though which is why I figure some people wonder about what Obama did. Based on current statistics though how can Obamas decision be considered bad? Does it have any negative impacts? (I don't really know the American policy on national emergency that well)

If Obama didn't act and suddenly we're in December and infection rates are still climbing what would be said of him then? In fact imagine that he didn't do anything right now but we were still on here talking about the infection rates. I'm certain even some members would bring up Obama's failure to not act here in October... (I'm not sure if that makes sense it does in my head but I'm having troubles articulating it lol)

 

[Evo]

I used statistics given by the government and provided a link to them Evo claimed that this proves nothing because of testing methods

It wasn't a claim, did you see the link I provided to the CDC? They are the ones that say that the reports are skewed by the new testing.

Increased Testing
CDC has developed a PCR diagnostic test kit to detect this novel H1N1 virus and has now distributed test kits to all states in the U.S. and the District of Columbia and Puerto Rico. The test kits are being shipped internationally as well. This will allow states and other countries to test for this new virus. This increase in testing will likely result in an increase in the number of confirmed cases of illness reported. This, combined with ongoing monitoring through Flu View should provide a fuller picture of the burden of disease in the United States over time.

http://www.cdc.gov/h1n1flu/updates/050809.htm

 

[Sorry!]

It wasn't a claim, did you see the link I provided to the CDC? They are the ones that say that the reports are skewed by the new testing.
http://www.cdc.gov/h1n1flu/updates/050809.htm

Yes I did see the link you posted as well as the bolded parts. No I do not think that you providing this as support will substantiate your claim that THATS what's happening. They are making a CLAIM too and your basing your own claim off their original claim. I'm using solid numbers based on observational evidence and numerical data that's been collected which ADMITS to skewed results surrounding new testing methods but since then (a few months ago) the methods for reporting to the numerical data has been pretty much normilized...

The question is did you read the entire report that I posted or are you just dead sure that what you think is 100% correct and the rest of the people that goes against you are crazy, unintelligent, are just trying to start a panic, or are just trying to make money and none of it has any backing what-so-ever.

 

[turbo]

Bowdoin college had over 160 cases of flu by the first of October. They have put affected students in single dorm-rooms and isolated them from others. Meals and medical services are delivered to them in their rooms. After they got positive tests for swine flu back in September, they halted testing and started their containment policy.

http://mainecampus.com/2009/10/01/bowdoin-college-hit-hard-by-swine-flu/

Obama should be applauded for his action. Clearly, there are parts of the nation that are being hit harder than others with flu, and his proclamation frees hospitals to offer emergency care to flu sufferers away from their regular emergency rooms, to help slow transmission of the disease. It's a prudent move. Children are often taken to ERs for injuries and illnesses other than the flu, and the swine flu seems to cause more serious illness and death in young people than in us older folk. Some of us who got vaccinated during the mass inoculations back in the '70s may have residual protection from that. In that outbreak, armories and other public buildings all across the state were opened, and the inoculations were given via the pneumatic guns that the military uses. Much faster than using needles.

 

[OmCheeto]

It wasn't a claim, did you see the link I provided to the CDC? They are the ones that say that the reports are skewed by the new testing.

And skewed by the press:

Thursday Oct 22, 2009
(NBC) - Latest numbers from the CDC show one in five children had symptoms of the flu so far in October. According to researchers, these children likely are showing symptoms of swine flu.

And picked up and rebroadcast by scores of news stations:
Google results 1 - 10 of about 1,720 for "one in five kids had swine flu".

Update, Friday Oct. 23: Dr. Thomas R. Frieden, director of the CDC, said Friday in a news conference that the data was misinterpreted by news media and that it is highly unlikely that most of the cases were swine flu.

 

[Sorry!]

And skewed by the press:


And picked up and rebroadcast by scores of news stations:
Google results 1 - 10 of about 1,720 for "one in five kids had swine flu".

I highly doubt Obama makes his decisions based on media misrepresentation or by googling things... (wasn't it McCain who did that?)

 

[OmCheeto]

In that outbreak, armories and other public buildings all across the state were opened, and the inoculations were given via the pneumatic guns that the military uses. Much faster than using needles.

I remember those. A quick google search finds them now only in http://www.sciencemuseum.org.uk/objects/public_health_and_hygiene/1981-1398.aspx"

What's wrong with a http://journals.lww.com/biomedicalsafetystandards/Citation/1986/05150/Inoculation_Jet_Gun_Linked_To_64_Case_Outbreak_of.1.aspx" ?

I highly doubt Obama makes his decisions based on media misrepresentation or by googling things... (wasn't it McCain who did that?)

He probably based it on a recommendation from the CDC when they saw that there was going to be a panic based on the widespread disinformation. I'll bet they got lots of phone calls on Thursday.

It's hard to say though. How will people trying to get swine flu shots compare to http://www.nytimes.com/2008/11/29/business/29walmart.html" ?

 

[OmCheeto]

Oh my god! How come nobody pointed this out before?!

http://www.flu.gov/professional/federal/h1n1emergency10242009.html

Past instances where authority to grant Section 1135 waivers was enabled for recent disaster events include

* Hurricane Katrina (2005)
* 56th Presidential Inauguration (2009)
* Hurricanes Ike and Gustav (2008)
* North Dakota flooding (2009)

And there I thought it had gone quite well.

 

[Evo]

Yes I did see the link you posted as well as the bolded parts. No I do not think that you providing this as support will substantiate your claim that THATS what's happening. They are making a CLAIM too and your basing your own claim off their original claim. I'm using solid numbers based on observational evidence and numerical data that's been collected which ADMITS to skewed results surrounding new testing methods but since then (a few months ago) the methods for reporting to the numerical data has been pretty much normilized...

The question is did you read the entire report that I posted or are you just dead sure that what you think is 100% correct and the rest of the people that goes against you are crazy, unintelligent, are just trying to start a panic, or are just trying to make money and none of it has any backing what-so-ever.

Are you serious? I think you need to come out of left field, where on Earth are you coming up with these accusations? You are being warned, this kind of behavior is not allowed here.

 

[WhoWee]

All of the higher risk groups should be more careful. Pregnant women appear to be at the top of that list.
http://health.usnews.com/articles/h...gnant-women-have-died-from-swine-flu-cdc.html

 

[Sorry!]

Are you serious? I think you need to come out of left field, where on Earth are you coming up with these accusations? You are being warned, this kind of behavior is not allowed here.

So me directing a question to you is not allowable behaviour. Good to know.

 

[Evo]

So me directing a question to you is not allowable behaviour. Good to know.

Making false and unsubstantiated accusations and claims is not allowable.

 

[Virtuous]

I live in Hamilton...and...I don't see the zombies yet. I know people who have had it, and they are over it, and I've been around them, and got nothing. I think the panic is over-hyped. This won't be the first or last strain of the flu that will mutate, it's as close to inevitable as possible. How many times have we heard about it in previous years? Call me when 90% of the world population has died off, then I'll panic ( or maybe a bit before that ;] ).

 

[Sorry!]

I live in Hamilton...and...I don't see the zombies yet. I know people who have had it, and they are over it, and I've been around them, and got nothing. I think the panic is over-hyped. This won't be the first or last strain of the flu that will mutate, it's as close to inevitable as possible. How many times have we heard about it in previous years? Call me when 90% of the world population has died off, then I'll panic ( or maybe a bit before that ;] ).

I'm not saying that it should cause a panic but Evo is saying that it isn't true that this years flu season is worse.

 

[Evo]

I'm not saying that it should cause a panic but Evo is saying that it isn't true that this years flu season is worse.

I'm not the only one either, read the thread. Read the other threads about the flu and not wanting to get vaccines because they don't consider this season to be of concern. It seems I am more concerned than others.

 

[B. Elliott]

If it's available, I just can't see why anyone wouldn't be inclined to get vaccinated.

 

[turbo]

If it's available, I just can't see why anyone wouldn't be inclined to get vaccinated.

I won't, because I would have to be in a public place where the risk of adverse reaction to fragrance chemicals would be much higher than the possible risk of getting the flu. Flu might make me feel bad for a few days - fragrance chemicals could kill me, put me in the ER/intensive care for days, and still make me feel really bad for a few days.

 

[Sorry!]

If it's available, I just can't see why anyone wouldn't be inclined to get vaccinated.

I've already gotten the flu for this season so I don't see any point in getting the shot.