“..in a severe (flu) pandemic, the U.S. healthcare system could be overwhelmed in just weeks.

Hospitals and clinics would be forced to turn away millions of patients. Critical medications and care would not reach people in time. Millions of people in every state would be felled by the virus, and hundreds of thousands—including newborn babies, toddlers and older adults—would die in the weeks and months following the initial outbreak. The GDP in the United States would plummet as much as $2 billion, if not more.
Inadequate preparedness programs—and the investments required to fund and sustain them—mean that even with some of the best available healthcare there is, the United States remains woefully susceptible to a major future flu epidemic that might make this year’s widespread lethal outbreak look mild in comparison. Over the last decade, the federal government has cut upwards of 50% of its funding for the U.S. Public Health Emergency Preparedness program that it created in the aftermath of the 9/11 attack to protect against bioterror, pandemics and other public health emergencies. This has cost state and local health departments some 45,000 jobs. And the Trump administration is now calling for even more draconian budget cuts…
Why do we as a nation continue to leave ourselves vulnerable? The shockingly simple answer lies in our collective complacency. As soon as headlines about the flu are gone, hospitals are emptied of flu patients, schools are back in session and workplace absenteeism declines, we go back to business as usual. Pandemic preparedness plans are put back on the shelf. Funding for public health preparedness and flu R&D disappears into a haze of competing demands.” (A)

“With a nasty flu season underway across the country, businesses can expect to see billions of dollars in lost productivity, according to global outplacement consultancy Challenger, Gray & Christmas.
“We’re predicting about 11 million Americans will fall ill over the flu season and that’s going to cost employers over $9 billion in wages being paid to employees that are staying home sick,” Andy Challenger, the firm’s vice president, told CNBC’s “Closing Bell” on Friday.
That estimate does not take into account those workers who need to stay home to care for a sick family member…
Challenger said it’s important that workers don’t try to tough it out and go into the office and that employers discourage sick employees from coming in. Limiting meetings and expanding remote work options are two ways to help prevent the spread of the illness, he noted.
“It’s better to make sure an entire department doesn’t fall ill and cost the company a lot of money over the flu season,” Challenger said.
As for when to return to the office, Schaffner said, “After you’ve started to get better, two, three days after the onset of disease, if you’re adult you can come on back to work.”
If the worker has a fever, the CDC recommends staying home for at least 24 hours until the fever subsides.” (B)

“Keyboards, especially within a work environment, can harbour flu germs, experts say.
“At any given time the human body is emitting anywhere from one to tens of millions of microbes every hour,” Canadian microbiologist Jason Tetro says. “Normally that’s not a problem – however, if you happen to be sick then that microbial cloud starts to incorporate a number of these pathogens that you happen to be infected with.”
Those pathogens, Tetro says, land on people and surfaces and end up posing a risk.
“That poses a risk because you’re not going to get sick by picking up somebody’s skin or hair bacteria from a keyboard, but you may get sick if you happen to pick up dry droplets from someone who had the cough or flu,” he says.
And those droplets can end up on what are called “high touch surfaces.”
These are surfaces that have a higher likelihood of leading to infection, Tetro says. That likelihood essentially comes down to the number of times something is touched.
Flu germs (and cold germs for that matter) live on surfaces between two to eight hours at a time. The higher the number of high-touch surfaces you come into contact with everyday, the greater your chances of picking up those germs.
So what are some of those high touch surfaces? Water coolers, taps and water fountains. Photo copiers and printers in offices. Bathroom surfaces. Door handles. Soap dispensers that require pumping. Subway poles. Mobile devices. Keyboards. Flight check-in kiosks at airports. Shopping carts.” (C)

“It is easier to spread the influenza virus (flu) than previously thought, according to a new University of Maryland-led study released today. People commonly believe that they can catch the flu by exposure to droplets from an infected person’s coughs or sneezes or by touching contaminated surfaces. But, new information about flu transmission reveals that we may pass the flu to others just by breathing…
“We found that flu cases contaminated the air around them with infectious virus just by breathing, without coughing or sneezing,” explained Dr. Donald Milton, M.D., MPH, professor of environmental health in the University of Maryland School of Public Health and lead researcher of this study. “People with flu generate infectious aerosols (tiny droplets that stay suspended in the air for a long time) even when they are not coughing, and especially during the first days of illness. So when someone is coming down with influenza, they should go home and not remain in the workplace and infect others.”…
“The study findings suggest that keeping surfaces clean, washing our hands all the time, and avoiding people who are coughing does not provide complete protection from getting the flu,” said Sheryl Ehrman, Don Beall Dean of the Charles W. Davidson College of Engineering at San José State University. “Staying home and out of public spaces could make a difference in the spread of the influenza virus.” (D)

“Lost in the flurry of news stories is the startling and alarming report from the CDC in December that only about one-third of pregnant women are getting flu shots. A startling 64 percent of pregnant women had not been vaccinated against the flu, despite recommendations from the CDC, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists.
While 98 percent of pregnant women reported visiting a doctor or other medical professional at least once before or during pregnancy, the CDC found that only about 59 percent reported receiving a recommendation for and offer of flu vaccination from a doctor or other medical professional, while 16 percent received only a recommendation for — but no offer of — the vaccine. A whopping 26 percent received neither a recommendation for nor an offer of flu vaccination…
Pregnant women and their unborn babies are especially vulnerable to influenza and are more likely to develop serious complications from it. About one-third of cases of pneumonia are caused by respiratory viruses, the most common of which is influenza. Pneumonia and other complications increase the risk of preterm labor. Babies in utero are also at risk of complications: Pregnant women who develop the flu are more likely to give birth to children with birth defects of the brain and spine.” (E)

“The Department of Health and Human Services doesn’t have the funding it needs to prepare for a public health emergency, according to an official at the agency.
The Senate Health, Education, Labor and Pensions Committee held a hearing on Wednesday that focused on the reauthorization of the Pandemic and All Hazards Preparedness Act. At the hearing Robert Kadlec, M.D., HHS assistant secretary for preparedness and response, said that the agency is “working with half an aircraft carrier” to address the needs of 320 million people in the event of a public health emergency.
“We can’t do more things with limited resources,” he told senators.” (F)

“Confirmed cases of the flu are growing at a faster pace than the past two seasons in New Jersey, and with the worst months yet to come, it might be the nastiest year in a while.
There were 1,166 confirmed cases in the past week, as compared to 697 for the same period last season and 24 for 2015-16, according to state Department of Health data.
Why is this year’s flu season shaping up to be a serious threat? The type of flu strain spreading throughout the state — the dreaded H3N2 virus, a form of influenza A — is typically associated with more severe illness than other strains.
“What we’re seeing now is a lot of H3N2 (and) that is the predominant risk of more severe cases,” said Dr. David J. Cennimo, an epidemiologist at University Hospital in Newark and an assistant professor of medicine-pediatrics infectious disease at Rutgers Medical School.
The H3N2 virus has been particularly notable in California, overwhelming hospitals and medical professionals.
In total, there are 3,189 confirmed cases of the flu so far this year in the Garden State. The virus is now at high flu levels in all parts of the state, according to the health department.” (G)

“The flu was so bad last week in New York, it was the worst since the state started recording the data 14 years ago.
The Department of Health reported the number of lab-confirmed influenza cases last week was 6,083, an increase of more than 50 percent from the week before.
There were 1,606 people hospitalized with confirmed cases of the flu in New York last week. That was the highest weekly number of cases reported since the Department of Health began reporting the data in 2004.” (H)

“The current flu epidemic wreaking havoc across the nation was in part fanned by so many people spreading germs while traveling over the holidays, according to the U.S. Centers for Disease Control and prevention.
As 49 states are reporting widespread flu activity, “Good Morning America” spoke with a flight attendant and a doctor to get some expert tips on how to prevent the spread of flu germs while traveling on airplanes or passing through major airports.
Why this year’s flu season is so bad and what you can do about it
1. Wipe down communal surfaces such as tray tables and armrests
2. Turn on your air vent
3. Let other passengers board first
4. Choose a window seat
5. Avoid caffeine, alcohol while aboard
6. Use a nasal spray. (I)

“The Centers for Disease Control and Prevention may be able to continue its immediate response to seasonal influenza in the event the government shuts down, a senior administration official said Friday night on a call with reporters.
“CDC will specifically be continuing their ongoing influenza surveillance,” the official said. “They’ll be collecting data reported by states, hospitals, [and] others and they’ll be reporting that critical information needed for state and local health authorities.”
Those remarks stand in direct contrast to the fiscal year 2018 contingency plan posted by the Department of Health and Human Services Friday morning, which specifically lists the agency’s seasonal flu work as one of the activities that will not continue in the case of a shutdown.” (J)

Note: This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.

(A) Our Complacency About the Flu Is Killing Us, by JONATHAN D. QUICK, http://time.com/5107964/flu-2018-epidemic/
(B) Andy Challenger told CNBC the firm predicts 11 million Americans will fall ill, costing employers more than $9 billion in wages being paid to employees who are staying home sick, Michelle Fox, https://www.cnbc.com/2018/01/19/2018-flu-season-could-cost-employers-more-than-9-billion.html
(C) Don’t touch these surfaces if you want to avoid the flu, by Dani-Elle Dubé, https://jumpradio.ca/news/3973361/dont-touch-these-surfaces-if-you-want-to-avoid-the-flu/
(D) Flu may be spread just by breathing, new study shows; coughing and sneezing not required, https://sph.umd.edu/news-item/flu-may-be-spread-just-breathing-new-study-shows-coughing-and-sneezing-not-required
(E) Two-thirds of pregnant women aren’t getting the flu vaccine. That needs to change, by MARK N. SIMON, https://www.statnews.com/2018/01/18/flu-vaccine-pregnant-women/
(F) HHS’ Robert Kadlec, M.D.: Agency needs more funding to prepare for public health emergencies, by Paige Minemyer, https://www.fiercehealthcare.com/healthcare/department-health-and-human-services-public-health-emergencies-funding-senate?mkt_tok=eyJpIjoiWVdVMU5qVm1ORGd6WVdaaiIsInQiOiJYYUE2UG5FWEhNdnpIOVY4WHRHelFya2greEdhcmVheXYyNGxpSzJJT0srdFM1SThRdUNteVlzRjRUSkxPUlwvY2pCVUFJZWJZT083SUZweDgzbVpKV0E1ZWQzQk5ZN0ltYjJocmtNOEV4b3E1eWY4Z1luMFF2THVaUkQ0YlNCclUifQ%3D%3D&mrkid=654508
(G) Flu season in N.J. could be worst in recent years, new data shows, by Erin Petenko and Spencer Kent, http://www.nj.com/news/index.ssf/2018/01/flu_season_in_nj_could_be_worst_in_recent_years_ne.html#incart_river_index
(H) Flu everywhere: NY had worst week ever, by Natasha Vaughn, https://www.democratandchronicle.com/story/news/politics/albany/2018/01/22/flu-everywhere-ny-had-worst-week-ever/1054647001/
(I) Planes and the flu: 6 things to know to help you stay healthy while flying, http://abcnews.go.com/Health/planes-flu-things-stay-healthy-flying/story?id=52418032
(J) Flu response will be maintained during shutdown, officials say, contrary to previous plan, by ERIN MERSHON, https://www.statnews.com/2018/01/19/flu-response-government-shutdown/

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