Influenza Update - Sept 15th

Novel Influenza H1N1 Update  Dr. Stuart B. Weiss   INFLUENZA UPDATE WHO PANDEMIC ALERT LEVEL 6 Sept 15, 2009   SUBSCRIBE: Click button at bottom or send email to: sweiss@MedPrepGroup.com More good news about the new influenza vaccine but bad news from the small business sector   DRJ Attendees: I am giving a 1 hour H1N1 update tonight (Tuesday) at 6:00 in Marina-5 room As we continue to monitor sources around the world, we continue to see rising flu cases. In some areas, the flu activity has already reached levels normally seen at the height of the flu season.    Current Situation: Schools and Universities continue to report increasing numbers of cases. The American College Health Association reported that for the week ending Sept 4th, there was a large increase in the number of cases (105% increase from the week before) and 170 new institutions joined the list of locations with suspected or confirmed cases. There is continued good news from vaccine manufacturers and government studies. The National Institutes of Health (NIH) vaccine studies as well as study results from Sanofi and Glaxo indicate that a single dose of vaccine produces good immune results in "non-elderly" adults. Studies are still underway in children and should be out in about two weeks. There is still a chance that children will require two doses of vaccine. Lastly, the government announced that vaccine may be released a week earlier than previously thought and the first doses will go to healthcare workers.  The CDC reported that from April 26 to August 29th, 47 children have died from laboratory confirmed H1N1 infection. This past week, Cornell University reported the death of a 20 year old student and three days ago, an 11 year old child died in Mesquite, Texas. A Harvard Business School study reported that 25% of businesses in their study do not offer paid sick leave, 65% do not offer paid time off to care for sick family members and 79% do not offer paid leave to care for children home fro school. These results are slightly improved from US Department of Labor statistics from several years ago that pointed to 48% of paid workers without paid sick leave. On a conference call for clinicians last week, the CDC spoke about revised guidance for treatment which stresses early treatment for people who are hospitalized even if flu is only suspected but not confirmed. In these cases, physicians should not wait for laboratory confirmation but should start Tamiflu or other antiviral treatment immediately. This should also be done in sick high risk persons including children less than 5, elderly adults, pregnant women and people under 19 years old on chronic aspirin therapy. On the conference call it was recommended that physicians also be very proactive with patients who have neuromuscular disease perhaps giving them a prescription in advance to be filled immediately if they have any symptoms of the flu. They also discouraged routine preventative use of antiviral medications at this time except in specific circumstances (healthcare workers without personal protective equipment, persons at high risk in households with a sick person). On a lighter note, civility may be a casualty of the new H1N1 flu. Last week, the French Health Ministry began recommending that "la bise", the French cheek to cheek little kiss that is used to say hello and goodbye, should be discouraged. And today, USA Today is reporting that the NCAA has suspended the mandatory pre and post match handshakes required in Volleyball matches (the other college sport with required handshakes is wrestling and no decision has been made there yet).   HOUSEKEEPING ITEM:  If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to me at sweiss@MedPrepGroup.com       ANALYSIS:    Its good news that single dose vaccination is producing good immune results for several reasons. First, if only one dose of vaccine is necessary, more people can get the shot, there will be more to go around. Second, from a public health perspective, it is much easier to get people in for one shot than to get them in for a first shot and a second one 3 weeks later. This is especially true with young adult, college age people.   The rise in case numbers in some parts of the country to almost maximal levels normally seen only during the height of flu season is very concerning. This may lead to a severe strain on our healthcare system and much anxiety and concern within society.   One of the national experts on the behavioral aspects of disease, Steven Crimando, is part of our team. He often reminds business planners that the psychological effects of an event may greatly overshadow the effects caused by the actual disease. If we look back over past disasters with a disease or medical component, there can be hundreds of psychologically affected people for every one person actually affected by the illness. These psychologically affected people or "worried well" show up in emergency departments and utilize resources. Their bodies may be reacting to stress and producing symptoms similar to common flu symptoms (fatigue, not feeling well, diarrhea, chest tightness, etc.) Some of these people will be your employees so it is important to consider the psychological aspects of the pandemic when designing your pandemic plans. Steven is available to assist you in this area.   As the temperature continues to drop across the US and conditions favoring viral survival and spread continue to improve (influenza viruses survive longer in colder weather), we will continue to see increasing numbers of flu cases across the country. We will see large numbers of people getting sick and if the southern hemisphere gives us any clue, we will see disruptions in production and supply chains due to worker absenteeism. New models have been recently reported on worker absenteeism. The British have moved their estimate of worker absenteeism down to about 15%, folks at the CDC speak about 20-25%. We are recommending that businesses plan that 20% of their workforce will be absent for 3-5 days over the course of the next 6 months. That's a good starting place to do planning with the caveat that this number may rise or fall depending on what the virus does.     ADVICE: If you are a small business, you must do some pandemic planning or at least pandemic thinking now. Recent media reports suggest that large numbers of small businesses have done little to no pandemic planning. Small businesses with a single person in a critical job, and no redundancy, face significant issues if those critical people become ill and there has been no planning. Look at your H.R. policies and how you create a culture of worker health. Do you enable workers to make good choices and stay home if they are sick or do they get penalized for making a good choice? The statistics on paid sick time are not particularly encouraging in this area. It will serve you well to enable sick employees to choose to stay home and not come to work but this may require tough decisions that have financial impact. Pay attention to your high risk employees. Early data clearly links pregnancy, obesity and diabetes to severe illness and death. Focus employee education program on this high risk group. Plan for the psychological effects of this disease outbreak. Review your plans from this point of view. If you need assistance, we have experts in this area that can help. If you find yourself desperately trying to catch up with pandemic planning for your company, call us. We can help bring you up to speed quickly. Look at our tools listed below.   TOOLS: Virtual Medical Director - If you don't have a corporate medical director, our Virtual Medical Director program may be a good solution for you. Our Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. We have affordable decision support plans that you can enroll in.   DC3 Expert Trigger Assessment and Readiness Analysis tool will be available next week. This software replaces the old non-helpful WHO Pandemic phases and will analyze your current H1N1 situation from several key perspectives and give you intelligent Organizational Levels to link your trigger based action plan to. DC3 incorporates expert medical opinion that is updated regularly into the logic and will advise you on actions you should be taking and help you assess your readiness.    Global Disease Surveillance - MedPrep has teamed with a global surveillance company to provide geomapped specific surveillance for corporations who want site specific news and information. Through this system, we monitor over 30,000 information sources and provide you with intelligence and analysis on influenza and 259 other infectious diseases.   Pandemic Planning Assistance - We have a policy matrix, policy toolkits, FAQ's, posters, employee educational materials, a trigger based action plan template . We can help you jumpstart your planning or take a look at your current plans with a fresh set of eyes.         Not preparing now would be a serious mistake.       If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com       MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program.   Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com   Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC