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.

Kylie Scott remembers the first clinic she visited with her two-year-old son Teagan “It was the 28th of October at the Ohio Historical Society and we waited about 4 hours,” Scott says. Scott brought Teagan for a second dose of the vaccine, the procedure that’s recommended for children under ten years of age. “He has had the first dose and just needs the second dose. At his age group it’s high risk if he does get the flu so we want to try to prevent that if at all possible,” Scott says. Since the Centers for Disease Control and Prevention began funneling H1N1 vaccine to Ohio, more than 2.5 million doses have been distributed statewide. Until now, the vaccine has been restricted to people in high risk groups. But the Ohio Department of Health says the vaccine will soon be available to anyone who wants it.

“In looking at the supply, in consulting with public health officials in other states we made the decision that this was a good time to open up the vaccine to anybody who’s interested in getting it,” says Kristopher Weiss.

Weiss is the state health department spokesman.

“What we’re hearing from our local health departments is that the clinics are not as full as they were,” Weiss says. “That’s part of the reason we want to try and open it up. We do understand that there are some people who just won’t seek out the vaccine.” According to the Columbus Health Department, there are a half-million people in the high risk category living in Franklin County. But as of the end of November only 140,000 had been vaccinated against Swine Flu. The number of people in Franklin County who’ve become ill with H1N1 is unknown says Columbus Public Health Commissioner Doctor Teresa Long. She does have figures on the number of people who’ve been admitted to hospitals with flu-like illnesses. “And that number is almost exactly 450 persons have been hospitalized,” Long says. “As far as the absolute diagnosis of H1N1 of influenza-like illnesses, it’s a smaller number; about 260 persons. And while we do know there have been deaths of adults, the only reportable condition has to do with pediatric deaths. And of those there have been 2.”

Swine flu first came to the world’s attention this spring with news of the outbreak and deaths in Mexico. In the weeks that followed, the CDC ordered mass production of H1N1 vaccine swine flu acquired the title pandemic; there were daily briefings from health officials; businesses began preparing for widespread employee illnesses. But has the disease been as serious as was predicted early on? Columbus Health Commissioner Teresa Long says officials acted on the information that they had. “You only get one chance in a pandemic to get it right so you have to come on strong and then back off and moderate as what makes sense with what you experience,” Long says. Predicting the course of the disease is made more complicated, say health officials, because influenza comes in waves. Last week the state health department downgraded swine flu activity in Ohio from “widespread” to “regional.” But officials say another widespread outbreak could be just around the corner. “History can also tell us that in the various subsequent waves often the severity of illness has increased so another reason to think about getting that vaccine now,” says Long. “But the important news is that so far the severity of illness is serious, but it hasn’t had that very, very high level of mortality that we were concerned about, whether the history of the pandemic of 1917/1918 or what we first thought was going on in Mexico.” Vaccinations at public health clinics will continue to be free of charge; the federal government is paying for the production of H1N1 vaccine and is not passing along the cost to the states. Providers such as drug stores and doctors offices are allowed to charge a small fee for administering the vaccine. The state health department has spent $1.5 million fighting the disease – the majority of that in personnel expenses. Meanwhile, health officials continue to urge all Ohioans to get vaccinated. The state health department’s Kristopher Weiss “This is not a time to be complacent, this is a time to seek out vaccine if you can find it and get it. The flu season in Ohio typically runs through mid-March; we’re here in mid-December. So I think that prevention steps remain very important,” Weiss says.

Columbus Health Department spokesman Jose Rodriguez cannot confirm the boy died from the swine flu – only that lab results show the boy was infected with the virus.

Officials say the boy died on November 13th. The lab results were reported to the Columbus Health Department December 2nd. No other information about the case is available.

Five-year-old Aden Hong died November 13 after spending nearly a month in the hospital. City of Columbus health officials say lab results received this week confirmed the boy was infected with the swine flu virus.

The boy’s mother, Ban-Yehn Chanthavong, said Aden’s immune system was suppressed because he was taking chemotherapy for a brain tumor. She said doctors told the family her son could not fight the virus. Four rounds of anti viral medication could not help him and he developed pneumonia.

Earlier this fall another Franklin county boy died from swine flu. 14-year-old Jon Fowler passed away in October due to complications from the virus.

“>View a remembrance of Aden Hong.

Ohio State Medical Center’s Dr. Stephen Hoffmann said about seven people are in intensive care with swine flu. Most of them, Hoffmann said, have a lung injury that causes poor breathing – or septic shock which makes blood pressure drop.

“Most of our patients are on mechanical ventilation,” he said.

Hoffmann said lung injuries are very common in people who have pneumonia or the flu. There’s a 20 to 30 percent mortality rate, Hoffman says, associated with sepsis and acute respiratory distress syndrome.

“Whether there’s additional mortality impact of the flu itself I don’t think we know. The prognosis is hopeful but still a very unstable and sick population with great risk,” Hoffman said.

Hoffmann said those hospitalized with swine flu at the OSU Med Center have ranged in age from their 20s to mid-50s.

“Which we would consider younger. While some have had significant co-morbid diseases, things like renal failure or cancer or a number of other diseases, we’ve had other folks who really haven’t had those co-morbid diseases which is a little bit different than what we frequently see during flu season,” Hoffman said.

Unlike the seasonal flu, which typically affects the elderly or those with underlying health problems, the H1N1 virus continues to strike healthy young adults. Health officials are unsure why the virus is attacking the younger population.

The Ohio Department of Health’s Kristopher Weiss said so far the virus has not mutated.

“We are however seeing increased flu activity in the state of Ohio. And with the increased activity we have seen an increase in the number of hospitalizations,” he said.

Weiss said flu is unpredictable and it’s unknown if the H1N1 outbreak has peaked of if the worse is yet to come.

“We are however getting into the time of year where we typically start seeing seasonal flu circulate in the state of Ohio,” Weiss said.

Other local hospitals say they will not release swine flu hospitalization counts. Children’s Hospital said it’s emergency room and urgent care visits are 40 percent higher than normal. The Ohio Department of Health reports 1,235 people have been hospitalized around the state with the H1N1 virus since August. Two people in Franklin County – a 20-year-old mother and a 14-year-old boy – have died from the disease.

Parishioners at Saint Joseph’s Cathedral in downtown Columbus shook hands during the sign of the peace at noon mass. They also drank from the same challis during communion. While these practices are still in place at Saint Joseph’s a few other Catholic Churches around the city have suspended the rituals.

Beginning Sunday Saint Peter in Northwest Columbus will forgo the sign of the peace and the distribution of wine during mass for the month of November.

Deacon Joseph Schermer is making decisions for the parish while the church’s pastor is in Israel. Schermer said he’s prepared to get some flak from parishioners.

“I’m sure there are some who will consider we’re overreacting. And that’s probably true in a sense that it’s probably overreacting in just to be more cautious,” he said.

Schermer said there have been several cases of swine flu at the church and thinks the decision will lessen parishioners chances of getting sick.

Deacon Tom Berg in the chancery office said some have suggested suspending part of the liturgy while the swine flu is widespread, but so far the diocese is leaving it up to individual parishes to decide how to handle the issue.

“We continue to monitor the situation and rather than point to any specific benchmark we want to see how things are going from week to week,” Berg said.

Catholic Dioceses in New England and New York have gone further than Columbus. They’ve recommended churches suspend sharing cups and shaking hands.

Edward Achaab attended the noon mass at Saint Joseph’s downtown. He said the challis is optional.

“We’ve been advised that if you’re sick don’t take it,” Achaab said.

Paul Pennino said he doesn’t think there’s anything to be worried about.

“And we do have instituted at our mass that any of the extraordinary Eucharistic ministers do use the Purell hand sanitizers before they distribute the communion,” Pennino said. The Columbus diocese has directed priests and anyone who hands out communion should wash or sanitize their hands.

Parents pushing strollers arrived at the Historical Society up to 5 hours early to have their young children vaccinated against swine flu. By about 1:30, the line wrapped part of the way around the facility. The H1N1 vaccine clinic, held by Columbus Public Health, targeted children from 6 months to 4 years and pregnant women.

Liza Paul and her 18 month old son Dominic arrived around 11:30 to wait in line for the vaccine. She says the whole process moved smoothly.

“I think they did a great job, they were organized. It was really fast once they opened the clinic, and it seems to be moving along. The nurses know what they’re doing and the staff is pretty reassuring,” says Paul.

The clinic was open from 2 to 5, but parents who did NOT get in line early were turned away. Liza Kane, whose daughter Zophia is 11 months old, was one of those parents. She arrived at the Historical Society just before 2pm.

“I figured it would be really crowded and I would have to stand in line a long time, but I didn’t imagine coming here and them already saying, Bye,’” says Kane.

The clinic was to administer up to 15 hundred doses of vaccine. Columbus Public Health spokesperson Jose Rodriguez says he wasn’t surprised by how early or how many people arrived. Rodriguez says they’re doing the best with what they have.

“We have a system in place that works, so once people get to our clinics, we move them fairly fast – we can do several hundred and hour. The challenge is having the vaccine – the supply – to protect them.”

Future clinics are planned, but as to when, Columbus officials won’t know until they get word of the timing and size of the next vaccine shipment from the federal government.

Customers at Debby’s Wigs and Fashions in Mount Vernon Plaza expressed a lot of concern about the swine flu vaccine. 39 year old Kyra Scales says she is healthy and doesn’t want to take a chance on any side effects from the vaccine.

“I actually feel that if you expose me to it than I’ll eventually catch it.”

Shopper Stephanie Scales has a grand-daughter who goes to school where a student came down with swine flu. She’s skeptical about getting a flu shot for herself and wants to know more.

“With anything we need to be educated on it so we can make a decision because right now we’re kind of going in the blind and it all sounds like conspiracy.” Says Scales.

Those fears have roots because of past research that included the infamous syphilis studies conducted by the federal government at Tuskegee Institute in Alabama.

However, Doctor Augustus Parker says the swine flu vaccine is safe. He and a group of more than a dozen minority physicians in Central Ohio are trying to stop the disease from spreading. Members of the group rolled up their own sleeves to get the H-1-N-1 flu vaccine and to encourage others in minority communities to do the same.

“We feel as physicians we’ve done our research. We’ve done our due diligence to make sure that as is humanly possible this is going to be a safe and effective vaccine for those particularly at risk.” Says Parker.

Parker adds that because of higher rates of diabetes, asthma,other lung diseases, and hypertension, minorities may be more at risk.

“There’s a likelihood that there’s a four times higher incidence that minorities will be hospitalized than they’re white counterparts, and that’s African Americans, Hispanics and Asians.”

Parker says the physician’s group is also working with local churches to boost swine flu vaccinations as they become available.

Debbie Holmes WOSU News.

Franklin County’s Health Commissioner Susan Tilgner says that school clinics are the most logical way to inoculate one of the largest at-risk populations for swine flu. “We’re seeing younger and school age children being more affected by H1N1 than we do seasonal flu,” Tilgner says. “So given that, we look at what’s the best way to get a lot of vaccine out to a lot of kids in a short period of time, and the most efficient way is to work with the school systems.” School nurses already work to detect communicable diseases among the 150,000 public school students in Franklin County. Since the swine flu outbreak, they’ve been keeping the health department apprised of changes in absenteeism. Deborah Strauss is a registered nurse who works for the Columbus City Schools. She’s also president of the Ohio Association of School Nurses. “If we find a student with a fever over a hundred, also if we find a student who has fever like symptoms, perhaps some dizziness, some nausea, perhaps some other issues, those are some of the things that a professional school nurse is able to do in an assessment,” Strauss says. “And determine that it does include flu-like symptoms.” Statewide the ratio of students to nurses is about 1300 students per nurse. That ranks Ohio 43rd in the nurse to student ratio.

On average Franklin County districts have more nurses per students says Strauss. But it depends on the district. Reynoldsburg, with 11 buildings and 6300 students has two full-time nurses and several part-time. The Upper Arlington school district has seven full or part time nurses for eight schools. One of Upper Arlington’s nurses is Nancy Kimnach, who says preparations for the clinics have already begun.

“Most of us have just had a refresher training on the flu shots and administering and that kind of thing,” Kimnach says. Kimnach says parents will be asked to sign a consent form so that their child can be vaccinated. She also says there’s some anxiety about the swine flu among parents and children. “Yes there’s some fear and some panic,” Kimnach says. “Obviously nobody wants to get the flu. And of course the concern is that the H1N1 is going to hit young people more and make them more sick.” While the planning for school based inoculation clinics is on-going, health officials have not set dates yet. That’s because they don’t know when sufficient quantities of the vaccine will arrive. Franklin County Health Commissioner Susan Tilgner:

“When we get enough vaccine for the elementary school students, we will start there and vaccinate all the elementary school students,” Tilgner says. “Then hopefully we will be able to do another round to reach the middle school and high school students. And then we will have to go back to the elementary school students because children nine years and under have to have two doses of the vaccine. Our goal is to start the very first week in November.” Tilgner says information about the clinics will be posted on the website: Columbuspandemicflu-dot-org.