H1N1 Up Close: Death of New Colleague's Wife Raises "Hazard Watch"

I met Steve three times at a local business networking meeting. On Tuesday, October 27 at about 9:00 am I bade him farewell along with others after we did our usual round of business. One week later (November 3) Steve sent out an email that his wife had “a raging case of pneumonia and possibly H1N1” and was in hospital. On November 5 Steve’s wife of 14 years passed away from H1N1 flu at Credit Valley Hospital in Mississauga.

This is not supposed to happen, although public health officials are saying: “There will be deaths”. We are between a rock and a hard place. So is public health---the available supply and the inoculation system is out-of-synch with the real demand and the timing of the flu pathway through the population.

I know nothing of Steve’s wife’s background. Perhaps she was among the “at risk”. She was likely in her forties judging from my guesstimate of Steve’s age. Could she have been saved by more readily available vaccine?

The lock-step nature of the roll-out of the vaccine puts to the test our self-control (to be patient and wait our turn) and our sense of fairness (stories abound on people jumping the queue). Besides, how does one divide up a family according to a rather rough risk measure (some get it, some don’t in the first parts of the roll-out) and still maintain a sense of calm? So, aside from the evolving science of the disease which researchers and practitioners are working hard at keeping up with, how does an everyday person manage risk when the safety net has holes in it?

One of my dear friends who is a biochemist claims the flu is already everywhere, as it usually is during this time of year. She counsels: “Stop worrying about the rigmarole over the vaccine and just get on with life” as it’s somewhat late to get a shot. The best risk management actions remain the same—adhere to healthy living practices including the frequent washing of hands, etc.” The statistics are on our side as this is a mild flu.

Underlying our conversation, however, is not concern for ourselves. If truth be told, it’s for our families. My friend has six grandchildren ranging in age from four months to 12 years old. My children are young adults. As whole families cannot be inoculated at the same time, our “hazard watch” escalates.

Brain science reveals that we use up a tremendous amount of brain energy (glucose) to manage the uncertainties in our environment. The stress can be exhausting and leaves less energy for tackling other important parts of our professional and personal lives. The functioning of our pre-frontal cortex ramps up as it communicates with and tries to sort out and guide the emotional turmoil buried in deeper brain regions. With the H1N1 situation running at high uncertainty, calming our minds daily with good thoughts, exercise, fellowship, fun and other means of relaxing is an antidote for survival.

We shape our brains daily. This can be used to our advantage. Since 9/11 it feels as if we have lived in a chronically uncertain world. Each segment of any one year has its “signature” threats. We are learning through no choice of our own to adapt as if we are running a marathon most of the time. Anyone who has trained for a marathon knows it can be done. In a sense, we are all getting stronger and more resilient.

H1N1 Vaccine Chaos: Business Process Screw-Up

Our family doc led us to believe a couple of months ago that he’d vaccinate us against the H1N1 flu virus. He’s still waiting for his supply. In the meantime, we are being encouraged to join three to six hour line-ups coming to our “town” shortly. Someone has skipped a beat here in common sense planning.

Few if any of us pictured that we’d have to line up en masse on the basis of first come first serve for this vaccination. Make an extra visit to our local walk-in clinic or family physician—yes. According to one of our local clinics, the medical staff does not expect to be receiving any vaccine. How assumptions can be so wrong! Maybe things will change.

We are envious that Sault St. Marie has managed the process by having people book an appointment largely on line and I presume also by telephone. The real story might not be quite as streamlined as not everyone has access to the internet and many shut-ins cannot venture out to a clinic. Plus, the vastness of the north has accelerated the transition to e-records and e-communications ahead of more southerly cities and communities giving Sault Ste. Marie an advantage to start with. However, at this point in the roll-out in Southern Ontario, it is mystifying why the gap in “user-friendliness” is so huge between the north and south.

Understandably a mass vaccination of this type has never happened in anyone’s lifetime. The closest comparator is the polio epidemic in the 1950s where schools were the chief locations for inoculation. The target groups were school-age children not the general population. That then was relatively easy. However, there’s a lesson: implementation was highly de-centralized.

We are being funneled into too few spots as in a traffic jam on highway 401 when the on-ramps feed into narrower parts. I can understand that to take the pressure off the normal conduits for health care like emergency rooms, walk in clinics and primary physicians public health is providing temporary alternatives. Unfortunately, the timing is off as public health is the only source right now.

Where were the computer-modelers when we needed them?

This will get sorted out. The first time is always full of lessons learned. On the side of public health, it is likely hampered by uncertainty about vaccine supplies---how much and when available. Resources too are thin at the best of times.

Nevertheless, why some synergy has not been created at this stage with personnel at easy to access locations where there would be minimal line-ups still makes me scratch my head.