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Fear spreads faster than flu pandemic

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By MARY SHEDDEN

mshedden@tampatrib.com

Published: November 1, 2009

Updated: 11/01/2009 12:33 am

TAMPA - Dire predictions about swine flu are feeding fears about the global pandemic despite emerging evidence it is mostly mild.

It has been six months since people who are trained to ponder the worst possible public health emergencies first warned of tragic deaths, overwhelmed hospitals, school closures and excessive absenteeism at companies across the country.

Swine flu is serious, a factor in the deaths of 140 people statewide. But it didn't prove particularly lethal as it passed through winter in the Southern Hemisphere, and the pattern seems to be holding to the north.

Still, doctors' offices and hospital emergency rooms are seeing a surge in patients reporting flu-like symptoms, a number of whom don't need serious medical care. A few of the ill, mostly children and their parents, fear that a flu diagnosis is a death sentence.

Frightening people is not what public health agencies intended, said Ryan Pedigo, Hillsborough County's director of public health preparedness.

"I don't want them scared," Pedigo said, "I want them washing their hands."

But it may be hard to ratchet back from a campaign that's been so long in the making, against a disease that, unlike traditional flu, pops up mainly in young people.

"Some parents are just terrified," said Stephen Dickey, chief executive and medical director for eight local Doctor's Walk-In Clinics. He has noted a big increase in flu cases recently: 20 percent to 25 percent of the 500 patients seen each day think they have the flu.

The preparations emerged long before swine flu was declared a global pandemic, a new virus against which humans have no immunity. Though widespread, swine flu is mostly mild, characterized by three to five days of fever and aches.

Still, public health departments on national, state and local levels laid plans for everything from a small increase in the number of normal flu illnesses to a scourge that overwhelms hospitals and causes catastrophic loss of life.

Worst-case scenarios, widely reported, projected 90,000 dead nationwide and 3,500 in Hillsborough County. So far, swine flu has been blamed in the deaths of nine people in Hillsborough, all adults.

Hillsborough health department director Doug Holt calls the disaster plans a necessary "framework about how you would approach decisions that nobody wants to make." It's his agency's job to be transparent in that kind of planning, he said.

But he's also mindful of the need for public health officials to avoid creating anxiety over a virus from which 80 percent of those infected won't need medical care.

"It's the unknown and the unpredictability that I think creates understandable fear," Holt said.

Most of the plans, including Hillsborough's, were developed in reaction to previous outbreak threats and reflect the grim routine of 35,000 deaths each year from seasonal flu in the United States. A draft plan for Florida pandemic influenza drew criticism for suggesting that hospitals turn away patients with terminal cancers and other incurable conditions to make room for flu patients.

Florida Surgeon General Ana Viamonte Ros cautioned that the draft, started in 2006, is not a plan for dealing with the current pandemic. Swine flu is officially considered a mild outbreak, responsible for 140 deaths statewide, according to weekly state Department of Health epidemiology reports.

An expected increase in real flu cases, coupled with heightened awareness, is the reason emergency rooms have seen the number of people complaining of flu-like symptoms double in the past six weeks, health officials said. Nearly 7 percent of all trips to Florida emergency rooms are related to the flu. In the Bay area, the number is closer to 8 percent.

Dickey said 100 or more of his walk-in clinic patients are complaining of flu each day. In reality, some simply have a cold, while others do need anti-viral medication to control serious flu symptoms.

Also, some people are showing up because schools and businesses are reacting swiftly when anyone coughs. Some people believed to have the flu must see a doctor before they're allowed to return.

"People are just shunned now if they sneeze," said Dickey, who attributes a lot of the fear to news stories highlighting that 100 of the 1,000 Americans killed by swine flu are children. "Everyone's very sensitive to this."

News reports aren't the only source of fear, though, said public health officials, including Pedigo of the Hillsborough health department. There's also the mountain of information about the flu that people are having trouble absorbing.

"I think the media is being fair, but the problem is that's all there is out there," Dickey said. "It's all they're talking about."

The latest swine flu news isn't helping calm concerns.

The government's predictions about when the swine flu vaccine would be available fell short, as doses are now trickling to communities. Doctors and patients are frustrated as they await the chance of protection through the voluntary program.

Centers for Disease Control and Prevention officials estimated that as many as 120 million doses of the vaccine would have arrived by now. This past week, just 14 million had been delivered to local health departments, physicians and other providers.

The Hillsborough health department and local providers had expected 244,500 doses by now, Holt said. By Friday, 59,500 doses had arrived and been distributed.

Pinellas County's health department on Friday announced its diminished supply of H1N1 vaccine was behind a decision to suspend clinic vaccinations temporarily.

Dickey said his clinics are getting 25 calls a day for swine flu vaccines, but he has used the 300 shots he received. Signs are posted at the clinics advising of the shortage, and some people are growing more anxious.

"It erodes our confidence," Dickey said. "You assume it's going to be done right."

Public health officials admit the delays and frustrations are hurting the public's view of the vaccination program.

It won't matter much if swine flu's toll remains mostly mild because a healthy public is the ultimate goal, Pedigo said. But it would be tragic if communications miscues leave people with no time to protect themselves.

"Whether it's a hurricane or a pandemic," Pedigo said, "at some point, something traumatic will happen if we're not prepared."

Reporter Mary Shedden can be reached at (813) 259-7365.

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