Some doctoral advice on H1N1

In an effort to pass along a “stay calm” perspective, this email just came in from my family doc:

This week-end has definitely been one where on the health side of things there were many more tricks than treats.

I. Shortages

It is now official…despite previous assurances to the contrary – the country has a significant shortage of H1N1 vaccine (whether plain or adjuvanted)….to the point that today Dr David Butler-Jones = Canada’s Chief Medical Officer has indicated that it likely be Christmas before everyone who wants to be vaccinated will be inoculated.

By then…likely the second wave of H1N1 will be on its last legs.

II Who goes first? Priority groups

In order to deal with this “unexpected” shortage of vaccine…a list of high priority groups has been established…(who goes first) is now being enforced…as previously it was whoever was in line got the jab.

These are :

1. Pregnant women

2. Children > 6 months but < than 5 years old. 3. Health care workers. 4. People younger than 65 with chronic health conditions........ (if you are > than 65 you likely have some immunity to this virus that you have acquired during your life time. 🙂 )

5.Those who live with or care for vulnerable people.

6. Infants younger than 6 months old.

III Distribution

Today’s announcement that the vaccine is being distributed to doctor’s offices should be viewed in context.

It is being provided to 100 offices (there are 4,000 in the GTA)…and remember that the public flu clinics have run short…and have been running at reduced capacity. Not one public flu clinic was open today in Toronto…Hmmm 🙁

We are back to the basic fact that there is not enough vaccine to go around.

IV Remember these three things

1. Not all Influenza Like Illness (ILI) is the flu. Could be just a bad cold. (Refer to previous email…. “Is it just the common cold or the flu?”) – e-mail to follow….

2. “Most cases of H1N1 are mild; most people recover without medical treatment.” WHO

3. “Stay Calm Carry On”….King George VI 1939.

Or in 2009 parlance…Get A Grip!!

To follow now… my commentary on an article which appeared October 29th in the Toronto Sun.

“Shots Coming Too Late” by Michele Mandel Toronto Sun, Sunday October 29,2009

EVALUATING RISK

This is what the H1N1 scare is all about.

In this article mention is made of Dr. Richard Schabas’ observations…ie an evidence based numeric perspective.

This is the sensible way of evaluating risk rather than out of fear (the “amygdala hijack”)

Paraphrasing Dr Schabas …there is an individual risk of a child dying from H1N1 of about 1 in 250,000. And that same child is 20 times more likely die in a motor vehicle crash than they are to die of H1N1.

This is the most important part of the article….and we need much, much, much more of this kind of rational input to the public discussion.

Numbers and rational thinking…the best medicine for irrational fear the current “Chicken Little…The sky is falling” scenario aka “H1N1 Psychosis”.

MRM