Archive for October, 2009

What’s scarier, the swine flu or Halloween?

Tuesday, October 20th, 2009

OK- I need to be writing an article about Halloween for my column in Manhattan Times News, but what feels a lot scarier than Halloween is The Swine Flu.  Is it the symptoms, the death talks or the hysteria fueling my fear.  Recently the New Yorker did a good piece on the science and the fear: Oinking aside, how much purell can I buy? My apartment is littered with it.  I have decided to get the shot, my kids have asthma, my mother has COPD and cancer and I work with pregnant women and babies. I have gotten the flu vaccine yearly since having children.  When my kids developed asthma the doctor encouraged us to get the vaccine and they tolerated it and did not get the flu.

My kids have gotten really pretty good about washing their  hands when they first come into the apartment .  I send handi wipes to school with them but is there anything else, short of wearing a protective mask?

How do we protect our selves and others and not become obsessed? Our government regulating the vaccines add to the controversies that will arise as a result of a new vaccine on the market.  It’s hard to keep in all straight and clear.  There was a good NPR (National Public Radio) piece done about a month ago that addressed questions and concerns

Juliet LeBien wrote an “editorial” while pregnant, lat month.  She is a social worker who works in infectious disease: She highlights the “higher risk” groups, such as pregnant women and young people.

In NY, there have been about 81 deaths attributed to swine flu; nationwide, over 600, putting the death rate at.04%. That’s the rate of death for seasonal flu, too. But here’s a contrast: the death rate for pregnant women who have contracted the swine flu jumps dramatically, and severe disease is far more likely. Mortality occurred mostly in the second and third trimester, with the third being seen as “more dangerous”, probably because the immune system is compromised for quite a while AND the lungs are “squished” allowing for the virus to overtake the lungs easily, pneumonias to set in, etc. Six percent of ALL deaths-around the world-are pregnant women. This constitutes, to those of us in stats, “unacceptable” rate. The Infectious Disease net noted early on in this pandemic that this particular flu seems to hit pregnant women very hard, with the theory being that maybe the deep penetration of the lungs causes severe disease.

NYC stopped publishing the “underlying conditions” of people who died of swine flu, unfortunately there have been some tragic cases of pregnant women in NYC and around the country and globe. These cases are very difficult for health-care workers. Many of the New Yorkers hospitalized for in “wave 1″ were pregnant women. I also know there were stories of amazing recovery! One woman (not in NYC) was put in a medically induced coma, C-sectioned, and aggressively treated. She did recover, after about 30 days post C-section and is now home with her child. Other women were successfully treated and could carry to full term, although they were women who caught the infection early on and took medication withing 48 hours of first noting symptoms. There is also a new therapy for severely ill people that involves IV administration of medication.

Just so you know, the flu shot is always a crap shoot, no matter what formulation of virus it has in it, so the risks are always the same. The flu is constantly mutating, so every year you’re getting a new, rather untested formulation. I’m heartened that this H1N1 shot is actually being tested on pregnant women shows me that people are serious about making sure it’s safe. The fact that this disease is really striking down younger people is troublesome. And while in most cases, people are fine, I can let you know that my 16 year old nephew in Louisiana who had it earlier this month was quite ill for a good 5 days (over 103 degree fever), with a cough that’s still lingering.
-Juliet Keeler LeBien, LCSW

The decision to inoculate is only part of  the battle, getting the vaccine is the other. Schools in NYC are supposed to be dispensing the H1N1 nose spray (not good for those with asthma).  Pediatricians are to receive it, but that’s a daily call to your doctor, so who knows when. The following site is the NY Gov site on flu vaccine and treatment:
City clinics aren’t due to distribute until November.

Alternatives to the vaccine, I just don’t know. I think no matter what, boosting our immune system, eating well, sleeping well, washing hands- are common sense actions to take. I wonder if Depok Chopra or Andrew Weil would suggest their grandchildren or pregnant family members get the H1N1 vaccine. I wonder if any of those individuals had  underlying conditions if that would influence their decision. I wonder if living in NY, riding the subway, going to a public school, being pregnant, having and underlying condition would influence anyone’s decision- in either direction.

And what about our childcare providers? In one of my groups yesterday, a mom asked if she could “make” her babysitter get the flu shot (her baby was under 6 months of age). I know at hospitals, right now, staff is required to receive a flu shot.  If your childcare worker is “on the books”  this might hold a greater influence for them.  The mom decided to pay for her babysitter’s vaccine and search for a convenient place for her to get it.  To get this shot is a personal decision, to ask your employee to get the shot and offer options for her, might be helpful. Forcing your provider to get the vaccine, I don’t see how that is possible.  You might want to review with your employee some calling in sick guidelines.  If your babysitter comes to work with a bad cold because she doesn’t want to “stand you up” this isn’t always helpful.  Decide what the parameters of coming to work when not feeling well are for you and your babysitter.

What are your thoughts about the swine flu and the swine flu shot? How are you addressing this issue? I’d love to know.
momsupport: Identifying the power to embrace the journey

Overview of flu trends in NYC