First, your numbers quote HOSPITALIZED patients. The mortality is even lower, across the board, since not everyone with flu gets put in the hospital.

A pandemic merely refers to geographic distribution, NOT mortality of a disease. In other words, swine flu is in many countries, around the world. But then, so is syphilis, TB, HIV... etc.

Yes, I know it's hospitalized patients, that's why I specified.

Okay, geographic distribution... so, what's all the excitement? From what I see, it isn't even as bad as the regular flu.

The panic is mostly media based, but I can tell you that at our hospital it is being watched very closely.

The main problem with this flu is that while it isn't any more lethal than other flu strains it is highly contagious, being twice as likely to be spread as previous flu. It simply becomes a numbers game, and when the numbers get large even small percentages become large populations of patients potentially hitting the hospitals.

Two seasons ago the regular flu taxed our particular facility to the limit, due to large numbers of flu patients and many ill staff members. If we see a large number of hospitalized patients from swine flu, it will hit the hospitals very hard, and limit our ability to care for other patients. I don't think most people realize how close to the limit most hospitals run at on a regular basis.

Plus, you never know when a virus is going to mutate into something nastier. So that is at least the concern amongst emergency management folks.

Greg

Which is exactly what worries me about the swine flu. Even without the strain mutating into something more lethal we could be in for a hellish ride if there is a real outbreak. And the damage is going to far exceed the actual number killed by the flu per se.

The words "epidemic" and "pandemic" do not convey the seriousness or communicability of a pathogen. I believe Swine Flu is at Level 6. This implies this pathogen is UNIQUE to humans and the particular strain is no longer present in other animals. The AIDS virus is an example of a pandemic. Everyone can get it. Not everyone has it.

For anyone medical out there, is there a better term to describe a "pandemic" that is very contagious like the 1918 Spanish Flu?

There is another social multiplier effect that will be a problem: past a certain threshold and parents will start bringing little Jonny straight to ER *every* time he gets the sniffles.

There was a fair amount of that this spring in South Texas.

I'm not medical people, but I finally thought to myself, "Look it up, dummy!"

PANDEMIC is defined as "universal".

CONTAGIOUS is defined as "communicable".

EPIDEMIC is defined as "a widespread outbreak of an infectious [or contagious] disease; many people are infected at the same time".

IMO, the media is trying to give people the impression that a pandemic is the same thing as an epidemic, which it is not, and may never be.

Also IMO, the American Public School System promotes ignorance. It is easier to confuse/control ignorant people than it is to confuse educated people. (And NO, I am not referring to anyone in particular.)

WHO has some very specific guidelines about how it classifies an infectious disease outbreak. A novel infection that demonstrates sustained human-to-human transmission in more than one region is their basic definition. Note that severity or lethality is not part of the definition, which turned out to be somewhat of a liability in the case of H1N1 since so far, it produces mild symptoms in most people it infects, and many people thought a Level 6 designation was crying wolf. The avian flu was novel to humans and highly lethal, but it never managed sustained human-to-human transmission, so it never got that far in the WHO scale.

There isn't really another alternative to the term "pandemic". Don't forget the term "endemic". Arguably, HIV could be endemic because it is well entrenched in many parts of the world, like malaria is. Only when the frequency of disease is higher than expected do we classify a disease as an "epidemic" or "pandemic".

I think that the WHO pandemic scale, like many other tools/guidelines used by planners, gets misused/misinterpreted when absorbed by the general public. Terms that have specific meanings to help make decisions could have very different meanings to the general public, like the word "pandemic". The average person may assume that any "pandemic" must be lethal, but from a public health planning/execution standpoint, that's not necessarily true.

Apparently with this virus it pays to be older....

In a report by the President’s Council of Advisers on Science and Technology, President SomePolitician PHRASECENSOREDPOSTERSHOULDKNOWBETTER. today was urged to speed vaccine production and name a senior member of the White House staff, preferably the homeland security adviser, to take responsibility for decision-making on the pandemic.


http://www.bloomberg.com/apps/news?pid=20601087&sid=a8_2nrwYD1kM

Aug. 24 (Bloomberg) -- Swine flu may infect half the U.S. population this year, hospitalize 1.8 million patients and lead to as many as 90,000 deaths, more than twice the number killed in a typical seasonal flu, White House advisers said.

The median age of those with the pandemic virus has been 12 to 17 years, the WHO said on July 24, citing data from Canada, Chile, Japan, U.K. and the U.S.

The H1N1 strain is genetically related to the 1918 Spanish Flu strain that killed an estimated 50 million people. Variations of the Spanish Flu strain circulated widely until around 1957, when they were pushed aside by other flu strains. People whose first exposure to a flu virus was one of those Spanish Flu relatives may have greater immunity to the current pandemic, Shaw said.