H1N1: A Year Later

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It was a year ago this week that America learned about a new strain of flu that was killing people in Mexico and some parts of the southwestern United States. Later, some health leaders predicted swine flu, as it was called then, had the potential to kill close to 100,000 people in the U.S. alone. The numbers of deaths, though, related to H1N1 are radically lower than foretasted. WOSU talked with health officials about swine flu a year later.

The public service announcements last fall were ubiquitous.

“Health officials are concerned about 2009 H1N1 flu, spreading from person-to -person. Officials are acting to combat this threat but the outbreak could grown…”

Thousands heard the warnings and lined up to get swine flu shots.

“It was like a three-hour wait.”

“We waited about 4 hours.”

Long vaccination lines snaked around buildings and down streets…some people arrived the night before to get in line…The scenes led TV news each night and appeared on the front page each morning. Officials predicted the virus could kill up to 100,000 Americans.

Vaccinating all those people cost a lot of money.

The Ohio Department of Health received more than $51 million dollars from the federal government to help local health department and hospitals vaccinate the healthy and treat the sick.

As it turns out, 100,000 Americans did not die.

In Ohio, 51 deaths were linked to H1N1 – seven of them were children. Across the country, about 2,100 deaths were connected to H1N1 and seasonal flu – 13 percent were children who died because of swine flu.

The numbers were not as bad as health officials predicted. In fact, the entire flu season was not act bad as some expected.

At a news conference in May of last year, the Ohio Department of Health’s assistant epidemiologist, Mary DiOrio, said that health officials were unsure how powerful this strain of flu would be.

“The seasonal viruses that we see every year, there is a proportion of the population that is immune. This new virus presents the whole new challenge of a virus that no one has immunity to,” she said.

A year later, DiOrio has the answer.

“We did find out that the virus probably is similar to other viruses that have circulated in the past because older individuals, a lot of older individuals, seemed to have some immunity. So we didn’t see a huge number of those individuals getting sick,” DiOrio said.

Some health officials early on likened this year’s pandemic to the 1918 flu pandemic that killed as many as 100 million around the world.

Philip Alcabes is professor of Urban Public Health in the School of Health Sciences Hunter College in New York. He was convinced from the start that the H1N1 virus would not be any more serious than season flu. And Alcabes thinks health officials created a crisis.

“And the creation of a crisis by kind of, I’m not alleging conspiracy here, but a sort of informal, maybe unwitting collusion between media and public officials and particularly the corporations that benefit by selling vaccine and Tamiflu and other products,” he said.

Alcabis agreed there was a pandemic, but only by definition – that one strain of flu was in lots of different parts of the world.

“It was certainly not mild if you think about people who got extremely sick or died from it. But it was not really very extensive and it was not really very severe in terms of the kind of great history of epidemic outbreaks,” he said.

The ODH’s DiOrio admits she thought the flu would linger longer than it did. “I was somewhat surprised that we didn’t see a continuing level of flu activity into the winter. I expected there to be more flu activity. But flu viruses are very unpredictable, and this one surprised us this way,” DiOrio said.

The state ordered more than 4.1 million doses of vaccine. It was distributed to health departments, hospitals, doctors’ offices and health clinics. So far only 40 percent has been used. About 14 percent of Ohioans were vaccinated.

The flu season dropped off after November, and so did the number of people getting vaccinated.

DiOrio thinks the number of people becoming ill and developing a natural immunity to the virus in combination with people getting vaccinated staved off what could have been a more lengthy flu season.

Columbus Public Health Commissioner Teresa Long says health officials were prepared for what could have been much worse. The city spent about two-thirds of the more than $3 million it got from the state to staff, plan and implement vaccination clinics. Long said the city was faced with a pandemic, and in her words “you only get one chance to get it right.” “Frankly, the good news is we did not have as high a death rate. We actually had a lot of illness in this community, but we did not have as high a mortality rate,” Long said.

There were a lot of flu-related hospitalizations – more than 3,200 in Ohio. In Franklin County 532 people were hospitalized for the flu.

Neither DiOrio nor Long say health officials went overboard in efforts to educate the public about H1N1 or its severity. Long said health officials acted sensibly.

“Influenza, is very unpredictable, it can change. And so to come on strong and then back off or adjust as we learn about the virus is exactly what is the responsible action. And I believe that’s what happened nationally, and I believe that’s what happened in the state and in Central Ohio as well,” Long said.

But Alcabes still maintains, health officials did go overboard.

“To talk about nobody has immunity. Tens of millions of people might get infected, there could be, as the president’s council and scientific advisers crazily forecasted it could be 90,000 deaths in America, to say those things has no role other than to promote a fear narrative, to create a crisis,” he said.

Health officials say H1N1 is still around. It’s still circulating but not at high levels. And they still urge people to get their flu shot.