Friday, August 28, 2009
A recent report from the White House estimates that up to 90,000 Americans could die from the swine flu this flu season. The report also estimates that 2 million people could be hospitalized, and 20 to 40 percent of the population could be infected by the H1N1 influenza pandemic.
GLORIA PENNER (Host): Okay, well, let's move on because we sure don’t want to stop before we get to this subject and we sure don't want to add to the swine flu fear either that's building up as schools begin to open. But the Centers for Disease Control and Prevention are predicting a sizeable increase in flu cases when school starts, and it's just about started in San Diego in some of the districts. CDC further estimates that 40% of the U.S. population—40%—will get the new H1N1 or swine flu strain. So, Tony, with those warnings clear and concerning, how prepared is our medical community for dealing with this pandemic?
TONY PERRY (San Diego Bureau Chief, Los Angeles Times): If, indeed, it gets to that kind of numbers and the head of Public Health in California is saying one out of four Californians may come down with swine flu, if we reach those kind of large numbers, we're not well prepared. We don't have enough swine flu vaccination to get even the most vulnerable people, small children, pregnant women, old people, let alone the big demographic there in the middle. We don't have enough of that. We don't even have enough of those masks, those surgical masks. For some reason, that industry's fallen apart. There's talk that emergency rooms will be clogged. Now I don't know if a lot of this talk isn't post-Katrina safeguard, bureaucratic safeguard, where the feds, in particular, want – don't want to get caught short underestimating the gravity of the situation. But it's bad and it's going to get worse. Here in San Diego, what have we got, nearly 1200 cases we've had. Had the first case here, you may remember. We've had 18 deaths, three more you could add, they were visitors passing through. It's going to hit and it's going to hit hard come just in a few weeks, and it's going to hit differently than our – and that's on top of the usual flu. The usual flu's bad enough, 36,000 deaths a year. We've got a vaccine for it but that vaccine isn't seen as good enough for the swine flu. The swine flu may motate so that even the vaccines that we do have won't be much good. It could get a lot worse before it gets at all better.
PENNER: Well, here's something kind of scary. The LA Times, that's your paper, reports that nearly 2 million Americans could be hospitalized this winter with H1N1 but yesterday, Andrew, our health reporter, Kenny Goldberg at KPBS, filed a story reporting that the California Nurses Association says many hospitals aren't prepared for the outbreak and that, as Tony said, a number of hospitals don't have the proper masks, they don't have isolation rooms. What's it going to take to get the hospitals equipped in time?
ANDREW DONOHUE (Editor, voiceofsandiego.com): I don't know that I have the answer for that one, Gloria, but I think…
PENNER: Well, I mean, I was thinking maybe a huge infusion from the federal government, maybe…
PENNER: …there's going to have to be a financial stimulus package of some sort.
PERRY: What there needs to be is a public education campaign which is underway. Pretty basic stuff. Wash your hands. Don't sneeze on other people. Don't go to work or school when you're not feeling well. Don't run to the emergency room. Don't touch things like the guardrails at the moving escalator in – at the airport. Common sense. Public education, I think is our best bet. Remember, I've covered these matters. The Russian Army was in Afghanistan for a decade fighting various people. It lost more people to bad sanitation than to combat. Germs can kill you faster than bullets.
DONOHUE: And I think a problem with a public awareness campaign is I think a lot of people thought that the first wave of…
PERRY: Was it…
DONOHUE: …public awareness was crying wolf.
PERRY: Yes, soon.
DONOHUE: I mean, we were prepared for a complete and total Armageddon and so when it didn't hit that level, now I think people are still hearing this swine flu thing and they're wondering, really, how credible some of these large warnings are.
PENNER: Well, let me get, you know, sort of basic here. With so many parents working and so many people worried about keeping their jobs, Tom, do you expect that some will be resistant to keeping their kids out of school if these symptoms mimic a bad cold that, to a parent's eye, might be indistinguishable from H1N1.
TOM YORK (Editor, San Diego Business Journal): I think that's already happening with the opening of school here in the last week or so. We're seeing incidents of swine flu and the, you know, the school authorities are having trouble telling parents to – or, having trouble with parents keeping their kids at home to keep them from being exposed to this virus.
PERRY: Mom and dad both working…
PERRY: …who's – and there's a shortage of babysitters? The school becomes a babysitter and then becomes an incubator for viruses.
PENNER: We have time for one call and let's take it from Simon in Rancho Bernardo. Simon, you're on with the editors.
SIMON (Caller, Rancho Bernardo): Yes, I called back again. This is Simon from Rancho Bernardo. I called earlier. It's hygienic. People need to wash their hands. I work in hospitality and you'd be surprised. I would say 95% of my customers don't wash their hands before they eat. If you just simply wash your hands, better hygiene, you'd be surprised how healthcare relieves…
SIMON: Just wash your hands for God's sake.
PENNER: Thank you. For God sakes wash your hands, you heard what Simon said.
DONOHUE: We got to get him on the show next week.
PENNER: Yeah, gentlemen, go out and wash your hands. Go ahead, Tom York.
YORK: I just want to say that we talked earlier about the economy and about whether or not we're in recovery and what's on the horizon that could disrupt what little recovery we've seen, and I think the swine flu is certainly one of those four horsemen of the apocalypse, which would be a pestilence in this case. And I think that we have to be very cautious here. I know that business is not fully prepared for this, the absences and that kind of thing. So this is a cause for concern.
PENNER: Well, aren't we being told, Tom, that businesses really need to draw up some plans…
PENNER: …so that if they do have an absentee rate they don't suffer inordinately.
YORK: Yes, and the swine flu does hit younger people more than it does the older people, especially the elderly. And so that would be a concern, too, because most of the people that are younger are the ones that are filling important positions in the workplace.
PENNER: Now, Tony, that brings us to the whole tier idea of who's going to get the vaccination when it comes out in end of October or the beginning of November. Meanwhile, I understand that there are three tiers? And that it starts, really, with very young people and pregnant women and those who provide care for other people, healthcare personnel.
PERRY: Sure, and there's talk that you'll need not one shot, as we usually do each flu season, but three shots and maybe those second two will be kind of duds because the virus will have changed. The enemy will have changed its tactics. Yeah, it's – it's almost a microcosm of the whole healthcare debate that we're having. When you have a shortage, who gets helped and who is sort of SOL?
DONOHUE: Are we going to have swine flu death panels?
PENNER: Well, you know, I'm reading a transcript of an interview we did with Wilma Wooten. It's going to be on tonight when we do San Diego Week on TV at 7:00 and the second tier would include 24 to 64 years of age that don't have underlying medical. And the third tier would be those who are 65 years or older.
PERRY: The most vulnerable people are the last…
PERRY: …to get help.
PENNER: Now, you know, that really interests me because when you talk about death panels, there are those people who are going to take a look at that and say, you mean to say if I'm over 65 I may not even get the vaccination? Tom.
YORK: Well, I think that in this particular go around of swine flu, that the elderly are the ones that are the best protected against the flu because they've gone through life being exposed to different viruses and they have some immunity to this.
PENNER: So you're…
PERRY: One of our swine flu victims, just the other day, fit that demographic so we really…
YORK: But she had secondary considerations.
PERRY: Who – who doesn't at that age, frankly. Who – who…
YORK: Well, I don't. I'm in my sixties…
PERRY: …who at that age…
YORK: I don't. I'm in pretty good health.
PERRY: Yes, indeed.
PERRY: We know that you're a marvel. But…
YORK: I am.
PERRY: …but the average person is going to have something, so this idea of, oh, they had secondary, yeah, but the secondary, they'd have lived for 20 more years.
PENNER: All right, so let's wrap this up, though, with some final comments here. There have been suggestions of clustering kids with symptoms, let's say, in one classroom so put – put college students into one temporary dorm. Just how disruptive will this disease be? We have to assume that it's coming in some form or another whether it be light or medium or heavy. How disruptive? Start with you, Tony.
PERRY: Ever seen what happens at schools when there's rain and the kids can't go out to recess? The whole place turns into a zoo. It could be very, very disruptive. Let's hope it does not get to that point and that parents start doing the right thing and keeping the kids home rather than shipping them off to ABC elementary school.
PENNER: And what about the school sit – I mean, the workplace? I mean, are you saying the same thing at the…
PERRY: Same thing. Let's get that telecommuting idea that was all the rage some years ago and then kind of fell away, let's get that working and let's also get people actually using their slick – sick leave rather than somehow bundling it up and afraid to miss a day for fear they'll get laid off somewhere down the line.
PENNER: And what's going to motivate this kind of action that Tony is suggesting?
YORK: Well, I would say fear…
YORK: …fear of death, you know. If you're getting really sick, I think people are going to be frightened by what they see around them and they're going to take action. And I think that's when we're going to get really serious about, you know, combating the effects of swine flu.
PENNER: But don't you need some kind of leadership, Tom York? I mean, where will the leadership come from to effect this kind of a major change?
YORK: Well, we – you know, the business leaders, business owners, school superintendents, mayors, city council and boards of trustees, everybody's going to have to man up and, you know, take charge here.
PERRY: Wilma Wooten.
PERRY: Wilma Wooten has done a marvelous job. She's been a poster for how to handle this thing in terms of public information, get the information out quick, straight, don't scare people needlessly but tell them the truth and move on.
PENNER: And – and she…
PERRY: I – I'm glad Wilma's in control.
PENNER: And she's the County Public Health officer. You have 15 seconds to give us your comment. Make it pithy and to the point, please, Andrew.
DONOHUE: You know, let's see what CNN does. I think last time they went a little bit crazy on it for four days and so people might be a little bit turned off by it.
PENNER: Well, thank you very much.
PENNER: That's Andrew Donohue, voiceofsandiego.org, Tom York from the San Diego Business Journal, Tony Perry from the LA Times. I want to thank them. I want to thank our listeners and our callers. You can see us at our – on our web page KPBS.org/Editors Roundtable. This is the Editors Roundtable. I'm Gloria Penner.