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/

“The last government shutdown — which lasted for 16 days in October 2013 — sheds light on just how far flung are the consequences of congressional inaction, especially for health companies and public health workers. STAT talked to former officials at the FDA, CDC, and NIH about how that shutdown affected the work they could do…
In 2013, the CDC shuttered most of its annual seasonal influenza program during the shutdown. It largely stopped tracking disease outbreaks across the country, ceasing communications with the local officials and clinicians who help the federal workers connect the dots when an outbreak might be growing. It stopped testing most incoming samples and specimens to ensure safety, and it largely stopped monitoring infections at airports around the country, according to documents and former agency staffers…” (A)

(A) How a government shutdown could affect drug safety, flu response, and more, by ERIN MERSHON and IKE SWETLITZ, https://www.statnews.com/2018/01/17/government-shutdown-cdc-fda-nih/

“In a press briefing on Friday, Dr. Dan Jernigan — director of the influenza division in the CDC’s National Center for Immunization and Respiratory Diseases — confirmed that the outbreak can legitimately be called an epidemic. “We have very specific criteria where we can say the epidemic is beginning and ending based on when flu activity goes above a certain baseline. So we’ve clearly passed that baseline back in November and we’re at the peak of it now,” he said.” (A)

Weekly US Map: Influenza Summary Update – highlight and click on
https://www.cdc.gov/flu/weekly/usmap.htm

During week 1 (December 31, 2017-January 6, 2018), influenza activity increased in the United States.
Geographic Spread of Influenza: The geographic spread of influenza in 49 states was reported as widespread; Guam and one state reported regional activity; the District of Columbia reported local activity; the U.S. Virgin Islands reported sporadic activity; and Puerto Rico did not report. (B)

“Think hospitals are under a strain now, from a slightly bad flu season? Wait until a really bad one hits.
Experts agree the U.S. is not ready for a bad epidemic, or even for some other disaster that would affect hospital supplies. And funding cuts mean even a little strain has a bigger impact than in years past…
“Each year, the healthcare system gets a thinner and thinner veneer of preparedness,” said Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
“It takes less and less impact for a healthcare system to go from routine to crisis.”..
Yet, every year, school systems and hospitals get caught short. There are spot shortages of drugs that fight flu such as Tamiflu and for the past three years, there’s been a shortage of certain preparations of saline solution — a hospital staple.
This year, the saline shortage has been made even worse by Hurricane Maria’s devastation in Puerto Rico, the U.S. territory where 40 percent of the saline supply is made…
Infectious disease experts have been urging the U.S. government to do more to keep the country prepared for outbreaks of diseases such as a new strain of flu, Ebola and severe acute respiratory syndrome, or SARS…
Influenza specialists say repeatedly that the chance of a new flu pandemic is 100 percent. Flu mutates constantly, and a major new strain emerges about every 20 years. The last one was H1N1 “swine” flu in 2009, which was fairly mild, but worse epidemics are probable.
No country can be ready without having stockpiles of drugs, vaccines and equipment, plans for deploying them and someone with the authority to make fast decisions…
Last year’s budget provides just $57 million for influenza pandemic planning.
“I think it is in part a sense that until it’s a downright crisis, everybody assumes everything is OK,” Osterholm said. “ (C)

“The huge numbers of sick people are also straining hospital staff who are confronting what could become California’s worst flu season in a decade.
Hospitals across the state are sending away ambulances, flying in nurses from out of state and not letting children visit their loved ones for fear they’ll spread the flu. Others are canceling surgeries and erecting tents in their parking lots so they can triage the hordes of flu patients…
Connie Cunningham and her staff at Loma Linda University Medical Center were triaging so many flu patients after New Year’s that they assembled what looks like a giant, brown camping tent in their emergency room parking lot. Several hospitals in California are treating flu patients in so-called “surge tents” intended for major disasters.
So many people are showing up sick with the flu that Loma Linda hospital put up this giant tent to treat patients in.
On a recent weekday morning, Cunningham walked through the tent, lined with folding chairs and patient beds that are separated by sheets hung from the ceiling.
Cunningham, executive director for the hospital’s emergency services, said she’d thought they would dismantle the tent after a few days, but staff are still treating 60 more patients each day than usual, she said.
“In my career, I’ve never seen anything like this,” she said…
Many hospitals also say they’re too full to accept any more patients or ambulances.
And when paramedics are allowed to drop off patients at a hospital, the emergency room is often so crowded that there aren’t available staff members to transfer care to. So the emergency responders can’t get back on the road to answer incoming 911 calls, said Kay Fruhwirth, L.A. County’s assistant director of emergency medical services.
“If there’s not a nurse available, and/or a bed — it’s usually an ‘and’ — they’re waiting there with the patient,” she said. (D)

“Still, the fact remains that every single year there is a flu epidemic. The principle behind these perennial epidemics is “persistence through plasticity,” said Dan Jernigan, MD, MPH, the director of the CDC’s Influenza Division. To put it simply, the influenza virus is always mutating to get around the vaccine and people’s natural immunities. “These constant changes do allow for adaptation,” he said. This adaptation makes it really hard to match a virus to the flu strain that’s circulating.
So with H3N2 as the major flu strain getting people sick this season, it’s possible you’ll get sick. And if you do, it’s likely you’ll receive antiviral drugs. The CDC recommends drugs belonging to the class called neuraminidase inhibitors, which block the enzyme that the influenza virus needs to reproduce. Clinical trials have shown that neuraminidase inhibitors are effective against both influenza A and influenza B, unlike the older M2 inhibitors. This is good for flu patients because you could still come down with one of the other common flu strains.
Here’s the thing, though: There haven’t been any double-blind placebo-controlled trials of these antiviral drugs on influenza cases, says Alicia Fry, MD, MPH, the chief of the CDC Influenza Division’s Epidemiology and Prevention Branch. They do show some significant positive results, though. According to Fry, early treatment with antiviral drugs does improve outcomes — something that can be seen even without placebo trials. It reduces mortality in adults, it reduces the severity of the illness in children, and it reduces the duration of sickness. (E)

“The most optimistic assumption among government experts is that the season peaked a few weeks ago, marking the apex of what was already an early and severe outbreak. However, such an outlook requires observers to ignore that outpatient doctor visits have continued to climb (albeit more slowly) in the first week of 2018, yielding the most flu cases ever for this time of the year.
Even if the hopeful assessment by the U.S. Centers for Disease Control and Prevention bears out, there will still be another 11 weeks to 13 weeks of flu circulating across the country. “In general, we see things peaking right about now, but that means there is still a whole lot more flu to go,” Jernigan said. “In addition, there are other strains of influenza still to show up that could be a major cause of disease.”
That may already be happening. The CDC is starting to see infections caused by the H1N1 strain of the virus in states grappling with high levels of the H3N2 strain, the predominant version this season. In addition, Jernigan said yet another type of flu, caused by the influenza B viruses, is still expected to show up later in the season.
H3N2 has compounded the damage usually wrought by the annual flu outbreak. It’s known for both its severity and ability to evade the protection provided by vaccinations that are typically more effective against the other types of flu…
The CDC’s latest method to categorize the severity of a flu outbreak, which takes into account indicators including hospitalizations, outpatient visits and deaths across an entire outbreak, already places the current season in the top three. During the 2014-2015 flu season, there were more than 700,000 hospitalizations. The current outbreak is matching the beginning of that period, though it’s unclear what the remainder of the season will look like, Jernigan said. Last year’s entire season saw more than 600,000 hospitalizations.
“You didn’t have this all-at-once phenomena that we’re getting now, where hospitals are having lots of cases all at once all across the U.S.,” he said. Jernigan was forthright about the agency’s inability to accurately predict the intensity of the influenza season.
“We are always expecting there to be an unusual season,” he said. “We are rather humbled by this virus. We are always preparing for a severe season and welcome a less severe season, but it’s difficult to predict what will happen.” (F)

“A modeling program called FluSurge developed by the Centers for Disease Control and Prevention to help hospitals plan generates some pretty sobering scenarios, he noted. In a bad pandemic, hospitals might have four times more people in need of a ventilator than they have ventilators, and far too few intensive care beds for the seriously ill.
“So there would be a big mismatch between demand for care, lifesaving care, and the ability to provide it,” Inglesby said. “We would have a huge problem in this country.”
The problem with influenza relates to the way it attacks, sickening large numbers of people in a relatively short period of time.
A hospital can plan for how much cancer care it will need to deliver based on the size of the nearby population and estimates of rates of various cancers. Affected people will seek care over the course of any given year.
But with flu, most of the severe illness happens in the space of a few weeks in any one location. The pressure that puts on a health system is exacerbated by the fact that some of the people needed to care for the sick fall ill themselves.
Getting help from elsewhere — as a community will often do in the case of a major medical disaster — isn’t really an option during flu epidemics, because other places are either dealing with their own or steeling themselves for a wave that’s about to hit. In the first week of this month, the entire continental United States was reporting widespread flu activity…
But the inability to predict the intervals between flu pandemics makes it easy for officials to shift preparedness efforts into the “should do” instead of the “must do” column.
There were nearly 40 years between the 1918 and 1957 pandemics; then the 1968 pandemic hit 11 years later. And then there was a 41-year interval before 2009. There is virtually no way to tell when the next will occur.
If anyone knew for sure that the next pandemic was coming soon, then society would begin planning aggressively, Inglesby said. “But since we have uncertainty about the timing and severity of the next pandemic, we’re kind of in this relatively modest national effort to prepare hospitals, which is doing what it can with the resources available.” “ (G)

“A company making “smart thermometers” that upload body temperatures to its website claims to be tracking this year’s flu season faster and in greater geographic detail than public health authorities can.
This year’s flu season — which the Centers for Disease Control and Prevention considers “moderately severe” — has left Missouri and Iowa the “sickest states in the country,” said Inder Singh, the founder of Kinsahealth.com.
California has had its worst outbreak in five years, with nearly 1 percent of the state exhibiting flu symptoms on Jan. 2, he added. By contrast, New York, New England and the Southeast have had relatively mild seasons so far, but cases are rising and should peak in two weeks.
Mr. Singh’s data paints a different picture from that of the C.D.C., which held a news conference Friday to announce that flu activity was “widespread” across the continental United States, which is unusual. (Hawaii’s outbreak is smaller, the agency said.)…
The C.D.C. data comes from hospitals and clinics that report how many cases of “influenza-like illness” they treat. Delays can result if clinic statisticians are busy or if state health departments do not pass on the figures quickly.
Kinsa, by contrast, is able almost instantly to spot fever spikes in states — or even in cities and neighborhoods. More than 500,000 households now own its smartphone-connected oral and ear thermometers, Mr. Singh said, and the company gets about 25,000 readings each day.
(Of course, the company cannot measure hospitalizations, deaths, or which strains of flu are circulating, or consistently distinguish flu from other febrile illnesses.)
Kinsa’s technology was approved by the Food and Drug Administration in 2014 and gathered data in subsequent flu seasons; the company hopes to soon publish a study by outside experts assessing its accuracy in measuring the seasonal spread.
Those experts, Mr. Singh said, found the data to be more accurate than Google’s Flu Trends, which Google shut down three years ago after it missed the peak of the 2013-2014 season.
Google tracked internet searches for terms like “flu,” “fever” and so on, but could be misled by, for example, searches triggered by news coverage.” (H)

“One of the best defenses against the flu starts with tissue and hankerchiefs, two Northwest Indiana health professionals say.
For tissues, don’t use them twice. For hankies, don’t use them at all.
Donna E. Ricard, nurse practitioner with Franciscan Senior Health & Wellness at the Dyer Medical Pavilion, and Laura Matthys, manager at Franciscan Senior Health & Wellness, are emphatic about maintaining good hygiene to avoid spread of the virus. That means washing hands, using hand sanitizer, covering the cough and tossing tissues in the trash.
Some seniors need to break their habit of keeping tissues in their sleeves, according to Matthys. Matthys and Ricard both highly recommend everyone use a tissue once and throw it in the trash.
“And no hankies!” scolds Matthys. She’s not joking. Matthys recognizes there is a generation of men and women who still carry handkerchiefs in their purses and pockets.
Though many seniors have made it a lifelong habit to use a hanky instead of tissue, they may not realize how unsanitary it is — especially if they lend them to a friend, the health professionals said….
As the Indiana Department of Health reports widespread influenza-like illnesses, healthcare providers urge everyone to get a flu shot, be fastidious about washing their hands, covering their mouths when they cough and — as Ricard and Matthys said — remembering to throw away used tissues.” (I)

“In 2015, during an interview on the former Opie & Jim Norton radio show, Trump was asked if he gets the flu shot every year, and said no:
“I’ve never had one… Thus far I’ve never had the flu. I don’t like the idea of injecting bad stuff into [my] body, which is basically what they do…I’ve never had a flu shot, and I’ve never had the flu…I have friends that religiously get the flu shot and then they get the flu… I’ve seen a lot of reports that the last flu shot is virtually totally ineffective.”
He also said: “I’ve passed on it, but that doesn’t mean [other] people should.” “ (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) Watch how the flu became an epidemic, by SUSAN STEADE, https://www.mercurynews.com/2018/01/16/watch-how-the-flu-became-an-epidemic/
(B) 2017-2018 Influenza Season Week 1 ending January 6, 2018, https://www.cdc.gov/flu/weekly/index.htm
(C) Flu stresses hospitals, shows we’re not ready for emergencies, by MAGGIE FOX, https://www.nbcnews.com/health/health-news/flu-stresses-hospitals-shows-we-re-not-ready-emergencies-n838086
(D) California hospitals face a ‘war zone’ of flu patients — and are setting up tents to treat them, by Soumya Karlamangla, http://www.latimes.com/local/lanow/la-me-ln-flu-demand-20180116-htmlstory.html
(E) A Monster of a Flu Season Has the CDC Hunkering Down on Strategies, by Peter Hess, https://www.inverse.com/article/40232-glu-tamiflu-antivirals-h3n2-cdc-recommendations
(F) Why the Deadly 2018 Flu Season Could Get Even Worse , https://www.msn.com/en-us/health/medical/why-the-deadly-2018-flu-season-could-get-even-worse/ar-AAuLvdq?li=BBmkt5R&ocid=spartandhp
(G) A severe flu season is stretching hospitals thin. That is a very bad omen, By HELEN BRANSWELL, https://www.statnews.com/2018/01/15/flu-hospital-pandemics/?utm_source=STAT+Newsletters&utm_campaign=6a8b566307-On_Call&utm_medium=email&utm_term=0_8cab1d7961-6a8b566307-150519373
(H) ‘Smart Thermometers’ Track Flu Season in Real Time, by DONALD G. McNEIL Jr. , https://www.nytimes.com/2018/01/16/health/smart-thermometers-flu.html
(I) Don’t want to get the flu? Stop using hankies, experts say, by Nancy Coltun Webster, https://www.mercurynews.com/2018/01/16/watch-how-the-flu-became-an-epidemic/
(J) Did President Donald Trump Get the Flu Shot?, by ALEXANDRA SIFFERLIN, http://time.com/5093600/president-trump-flu-shot/

“The emergency room at Good Samaritan Hospital has been so packed with patients suffering from miserable flu symptoms the past few weeks, with incoming ambulances lined up outside and hospital rooms jammed, the staff has gone to its “Code Green” nearly every day.
“It’s all hands on deck,” said Dr. David Feldman, chairman of Good Samaritan’s Emergency Department.
Hospital CEO Joe DeSchryver has picked up a broom to sweep out emergency rooms for the stream of patients. Grace Ibe, a vice president, has wheeled patients in gurneys upstairs. And CFO Jody Dial has come in at midnight to troubleshoot and bring pizza…
At hospitals around the Bay Area and across the country, those on the front lines of what is shaping up to be the worst flu season in a decade are struggling to keep up — and wondering whether it will get worse.
Doctors and nurses are working overtime and double shifts. Some have become sick themselves, causing staff shortages when they are needed most. As one doctor put it, in emergency departments where misery is often hidden behind ubiquitous blue masks, “there’s a lot of coughing, sneezing, crying and fever.”” (B)

“Because the flu is so common, we tend to minimize its importance. Consider the contrast with how the United States responded to Ebola a few years ago. We had a handful of infections, almost none of them contracted here. One person died. Yet some states considered travel bans, and others started quarantining people.
Worldwide, just over 10,000 people died in the 2014-15 West African outbreak of Ebola: a relatively new, frighteningly contagious illness that people feared could become a global pandemic. It’s not surprising that it got a lot of attention. Yet the tens of thousands who died of influenza in the United States the same year barely made the news.”
The C.D.C. estimated that in the 2015-2016 flu season, the flu shot prevented more than five million cases of the flu, about 2.5 million medical visits and more than 70,000 hospitalizations. It was also estimated that it prevented 3,000 deaths.” (C)

“Influenza activity is widespread in all states except Hawaii (and the District of Columbia), according to the weekly flu report released Friday by the US Centers for Disease Control and Prevention.
“Flu is everywhere in the US right now,” said Dr. Dan Jernigan, director of the CDC’s influenza branch. “This is the first year we’ve had the entire continental US at the same level (of flu activity) at the same time.” It has been an early flu season that seems to be peaking now, he said, with a 5.8% increase in laboratory-confirmed cases this week over last.
There were 11,718 new laboratory-confirmed cases during the week ending January 6, bringing the season total to 60,161. These numbers do not include all people who have had the flu, as many do not see a doctor when sick.
Seven additional pediatric deaths were reported during the week ending January 6, bringing the total for the season to 20…
Different states, different responses
Alabama Gov. Kay Ivey declared a state public health emergency because of the flu on Thursday.
Scott Harris, acting state health officer at the Alabama Department of Public Health, said the influenza outbreak includes high activity throughout the state but particularly in metropolitan areas. This “crush” means some hospitals are operating over capacity, leaving some patients sitting in ERs. The public health emergency order helps health care professionals manage resources more efficiently and provides leeway so alternative care can be provided when personnel are unable to offer standard care…
Texas, which laboratory-confirmed 5,585 cases of the flu as of that date, is seeing activity levels “at the highest level — widespread — for a few weeks,” said Lara M. Anton, a press officer for the Department of State Health Services….
“There are reports of hospitals throughout the state that have needed to divert non-emergency ambulances for periods of time because of overcrowding in their ER,” Anton said. With most hospitals coming off “divert status” within the same day, the state’s hospital system has been managing the increased number of patients. The department continues to monitor the situation closely and “will step in with support when it is requested,” she said.
Texas is encouraging “anyone with symptoms to stay home and to see their health care provider, as antiviral medications may shorten the duration of their illness..” (D)

“Big-city hospitals in Texas have been overwhelmed this week by an influx of flu patients, and state health officials say influenza activity is widespread across the state.
At Parkland Memorial Hospital in Dallas, waiting rooms turned into exam areas as a medical tent was built in order to deal with the surge of patients. A Houston doctor said local hospital beds were at capacity, telling flu sufferers they might be better off staying at home. Austin’s emergency rooms have also seen an influx of flu patients.
But high emergency room volumes and filled hospital beds are “not uncommon” for this point during flu season, which runs from October to May, said Lara Anton of the Texas Department of State Health Services.
“We definitely know it’s widespread,” Anton said this week. “We have been at widespread for the past three weeks.” But she added that it’s too early in the season to know whether this year’s flu impact is extraordinary.
On Monday alone, Parkland’s emergency department had seen 930 patients — double what the hospital typically sees for people with flu symptoms by this time of year, Dr. Joseph Chang, associate chief medical officer for Parkland, told CBS11.” (E)

“A shortage of the plastic bags used to deliver fluids and medicine to sick and dehydrated patients is spurring area hospitals to find alternative delivery methods in the midst of a nasty flu season.
Hospitals in Michigan and nationwide have resorted to jury-rigging solutions and even reverting to labor-intensive methods rarely used since the advent of the IV bags that have become indispensable in modern medicine. Those alternatives have increased the workload for pharmacists and nurses, and are forcing some hospitals to beef up staffing to keep pace with the need.
The problem comes in the wake of Hurricane Maria, which devastated operations in Puerto Rico at the major manufacturing plants for the bags.
Hardest hit have been the small-volume IV bags of 100 milliliters or less that are used to infuse antibiotics, cancer medicines and other critical drugs. Prior to the shortage, the five-hospital Beaumont Health system reportedly went through about 50,000 per month. Beaumont gets its small IV bags from Baxter, the nation’s largest supplier of the mini-bags, whose manufacturing facilities in Puerto Rico were idled by the storm. Their operations are expected to be back to full production by the end of January, but experts say it will take time to replenish supplies…
The shortage has been exacerbated by the flu outbreak, which has spiked emergency room visits and hospital admissions across the country. Beaumont Health announced Friday it was imposing visitation restrictions at its hospitals due to high volumes of patients with upper respiratory infections, predominantly the flu.”..
“Some days we’re able to get saline solution, other days we can get dextrose,” he said. “We have to work very closely with our nursing staff and providers to make sure whatever changes we’re making are safe for the patients.”
Some of the alternatives implemented include using portable pumps instead to administer some medicines. Supportive medicines, like those for nausea or to calm anxiety, are given orally when possible. And nurses can hand-push medications into IV lines at the bedside as another alternative.
Communication among staff is critical to ensure patient safety, Smith emphasized. Karmanos uses its internal online communications system, tip-sheets and other methods to keep all staff informed of up-to-the-minute changes.
“Everybody has to be on the same page on what we’re doing,” Smith said. “The nurse at the bedside (needs to know) exactly what you’re doing.” (F)

“According to the numbers, this year’s flu season is in fact worse than usual. It got started early, and it’s been more severe. Twenty kids have died of the flu since October. And in the week ending January 6, 22.7 out of every 100,000 hospitalizations in the U.S. were for flu—twice the number of the previous week.
“Flu is everywhere in the U.S. right now,” Dan Jernigan, director of the Center for Disease Control and Prevention’s influenza branch, said during a Friday press briefing. “This is the first year we’ve had the entire continental U.S. be the same same color”—referring to a map of state-by-state estimate of flu activity. That color is brown, meaning the flu is “widespread” everywhere in the U.S. except for Hawaii and the District of Columbia.
Several factors have come together make this year’s flu worse for patients who get sick and for hospitals trying to treat them.
First, the virus. Fears of a bad flu season first began in the early fall, after public health officials noticed a worse-than-average flu season in the southern hemisphere. The dominant circulating strain this year is H3N2, which hits humans harder than other strains. Scientists don’t really know why, but flu seasons where H3N2 have dominated in the past have tended to be worse. STAT reporter Helen Branswell called it the “problem child of seasonal flu.”
H3N2 (red) makes up the majority of lab-confirmed cases of flu this season. (CDC)
Second, the vaccine. This year’s vaccine was only 10 percent effective against the problematic H3N2 strain in Australia…
In recent years, researchers have tried to stop relying on chicken eggs. This flu season, for the first time, the H3N2 component of one type of vaccine, Flucelvax, was made in dog cells rather than chicken eggs. However, Flucelvax is more expensive and less widely available; most people who got the vaccine this year likely got the ones grown in chicken eggs. Researchers also are pursuing a universal flu vaccine that works against all strains.” (G)

“If you experience flu-like symptoms, you should first call or visit your primary care provider, who can quickly assess your health needs. By taking this step, you can avoid potentially long wait times at your nearby emergency department.
Your physician can also determine whether you need additional care because of the severity of symptoms or other risk factors, such as age (under 2 or over 65), pregnancy, a compromised immune system, or a chronic disease such as diabetes, heart disease or neurological disorders.
Each year, millions of children get sick with the flu and thousands are hospitalized. Some kids are at higher risk of serious complications: those younger than five, and any child who has a chronic medical condition such as asthma, diabetes, or disorders of the brain or nervous system. However, even healthy children can develop complications.
The best way to protect children is a yearly, injectable flu vaccine. It is not too late to get a shot. The vaccine protects your child against flu illnesses, which can reduce visits to the doctor and missed school days, and can prevent hospitalizations.
Symptoms of the flu typically begin one to four days after exposure to the virus and, in children, last one to two weeks. In addition to the typical fever, cough, aches and fatigue, children are more likely than adults to suffer vomiting and diarrhea – which can lead to dehydration.
Call the pediatrician if your child develops a fever; starts breathing rapidly or has trouble breathing; is not drinking enough; is less responsive than normal; or has the flu, gets better, and then relapses with fever or cough.” (H)

“The C.D.C. recommends people who are hospitalized or at high risk for complications of the flu, such as older patients, pregnant women and those who are otherwise immunocompromised, take the antiviral drug oseltamivir, sold under the brand name Tamiflu, because observational data indicate it might reduce the likelihood of death.
Other researchers, including those at the Cochrane Collaboration, disagree, saying that there’s not enough evidence to support taking oseltamivir or its chemical cousin zanamivir (brand name Relenza). They question the wisdom of spending billions stockpiling them as many countries, including the United States, began doing during the swine flu scare in the mid 2000s. Indeed, the World Health Organization last year downgraded oseltamivir from its list of essential medicines. It may or may not help, depending on which study you look at.
For healthy people who get the flu, most researchers agree the data indicates oseltamivir taken within 48 hours of onset can reduce the duration by about two-thirds of a day. But at around $154 for a course of the medication, that may not be worth it, given that the side effects include nausea and vomiting.
“We wish we had better drugs that could wipe out flu,” said Angela Campbell, a medical officer with the C.D.C.’s Influenza Division. But she said oseltamivir is “what we have right now” and in outpatient situations “it’s really the clinician’s decision with the patient based on a number of factors,” including cost and effectiveness, whether it should be prescribed or not.
The C.D.C. also still recommends getting this season’s flu shot, despite its questionable prophylactic value, because it might reduce the severity of the flu should you contract it. In previous years, against strains other than H3N2, flu shots have had reported effectiveness of about 40 percent to 60 percent. (I)

“If ever there was a case where familiarity bred contempt, and that contempt represented grave danger, it is the flu. Our casual references to “cold and flu” epitomize that perilous mindset. We seemingly think of the flu, likely due to its predictably annual impositions and its long familiarity, as a nuisance on par with the common cold. In my years of patient care, this mentality has been confirmed by the frequent, popular conflation of the two conditions; patients who merely have colds routinely self-diagnose the flu…
There is a case to make, and one that has been made, that we are more vulnerable now than in 1918. The global population of humans is vastly greater; the global population of domestic animals is greater; the co-habitation of the two in much of Asia persists; and global travel means that an outbreak anywhere can be everywhere else far more expeditiously now than a century ago. That is all legitimate cause for serious concern.
There are, however, reasons to think we may be less prone to catastrophe than our early 20th century forebears. They experienced a flu pandemic during a grueling world war. While current posturing about nuclear arms and buttons on desks is far from comforting, we may hope to avoid a recurrence of that dire confluence.
There is much less abject global poverty now than in 1918. We have antiviral drugs that are at least often and partially effective against flu. The world’s population is better nourished. And, of course, we have monumental advances in medical care overall that allow for far more effective management of flu complications, such as pneumonia.
That’s all reassuring. But it is by no means a case for complacency. Nor does any resource we have defend against the pernicious corrosion of Internet conspiracy theories and anti-vaccination sentiment run amok. No, vaccines are not perfectly, unfailingly safe, and they are certainly not perfectively effective. But they need be neither to be monumentally safer than and preferable to the diseases they help prevent. That is true of influenza, as it is true of polio, and was true of smallpox. I favor natural approaches to health and medicine when they are known to work, but there is no alternative ever shown to do what vaccines do; arguments to the contrary simply abandon epidemiology for ideology…
That we were catastrophically unprepared to be “flu’d” in 1918 was a surprise for which we may blame the virus. If we are so “flu’d” again, however, then we will need to hold ourselves accountable, and suffer the shame of tragic complacency along with the inevitable cost in lives. We are forewarned; whether or not we choose to be forearmed is up to us.” (J)

“You’ve no doubt heard the saying “feed a cold; starve a fever.” However, the healing power of nourishment and energy through foods is vital when you’re battling an intestinal virus or common cold in order to boost your immunity and give your body the energy it needs to fight off whatever illness is ailing you, particularly if you’re dealing with flu symptoms for several days or weeks.
Here are eight foods that are gentle on your body yet will help you overcome the flu…
Chicken Soup. There’s obviously some truth to the “Chicken Soup for the Soul” phenomenon. Not only is a steaming hot bowl of chicken soup comforting at time when you’re not feeling you’re best—each bowl contains vitamins, nourishment, minerals, and hydration benefits that you can’t get from starving a cold.
According to research from Mount Sinai, in Miami, Florida, chicken soup has the ability to improve air flow and flush out mucus in the nasal passages thanks to the copious amount of hot, steamy liquid within. A 1998 research report entitled “Coping With Allergies and Asthma” also found that a bowl of chicken soup actually contains anti-inflammatory properties that boost the tiny hairs-like follicles (known as cilia) in your nasal passages, which filter and stop the transportation of viruses, fungus, and bacteria from entering the body and causing nasty infections.” (K)

Hospital Pandemic Influenza Planning Checklist (L)
Planning for pandemic influenza is critical for ensuring a sustainable healthcare response. The Centers for Disease Control and Prevention (CDC), with input from other Federal partners, have developed this checklist to help hospitals assess and improve their preparedness for responding to pandemic influenza. Because of differences among hospitals (e.g., characteristics of the patient population, size of the hospital/community, scope of services), each hospital will need to adapt this checklist to meet its unique needs and circumstances.1 This checklist should be used as one of several tools for evaluating current plans or in developing a comprehensive pandemic influenza plan.

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) CDC quietly postpones nuclear war prep briefing to focus on the flu epidemic instead, by Ilene MacDonald, https://www.fiercehealthcare.com/healthcare/cdc-quietly-postpones-nuclear-war-prep-briefing-to-focus-flu-epidemic-instead?mkt_tok=eyJpIjoiT0RjMk56UXpZMlUwT0RnMCIsInQiOiJOSG9PSVk1XC9IZ0JuR3N3eEFwbElmSXlWZkQ0aHprVVFTbTNkVjBIVmNKUGpKcXROZDV3cTdZXC90TDFqVCt2RFBUeUFodDhsS3QwMER2bktyWmNCUU5hdno5ZndKVjdBUXBoU1l2bUhXcitjN2M1S09mbE9aWmc2d3ZaOGRYOGVoIn0%3D&mrkid=654508
(B) Flu deaths rise, patients pack Bay Area emergency rooms: ‘All hands on deck,’ doctor, by Julia Prodis Sulek, https://www.mercurynews.com/2018/01/14/flu-deaths-rise-patients-pack-bay-area-emergency-rooms-all-hands-on-deck-doctor-says/
(C) Still Not Convinced You Need a Flu Shot? First, It’s Not All About You, by Aaron E. Carroll, https://www.nytimes.com/2018/01/15/upshot/flu-shot-deaths-herd-immunity.html?_r=0
(D) Flu stomps the nation, overwhelming ERs and leaving 20 children dead, by Susan Scutti, http://www.cnn.com/2018/01/12/health/flu-surveillance-cdc/index.html
(E) Flu patients leave Texas hospitals strapped, by SYDNEY GREENE, https://www.texastribune.org/2018/01/11/flu-levels-rise-texas-officials-advise-public-be-aware/
(F) Detroit area hospitals’ IV bags drying up in flu season, by Karen Bouffard, http://www.detroitnews.com/story/life/wellness/2018/01/12/detroit-area-hospitals-iv-bags/109411668/
(G) The Perfect Storm Behind This Year’s Nasty Flu Season, by SARAH ZHANG, https://www.theatlantic.com/health/archive/2018/01/the-perfect-storm-behind-this-years-nasty-flu-season/550469/
(H) 2018 Flu Treatment, Prevention and How to Care for Others with the flu, https://www.lifespan.org/centers-services/primary-care-services/2018-flu-treatment-prevention-and-how-care-others
(I) In the Flu Battle, Hydration and Elevation May Be Your Best Weapons, by KATE MURPHY, https://www.nytimes.com/2018/01/12/well/live/flu-h3n2-virus-care-remedy.html
(J) Flu Us Twice?, by David L. Katz, https://www.huffingtonpost.com/entry/flu-us-twice_us_5a58b6f5e4b0d3efcf695772
(K) 8 Foods to Eat When Fighting the Flu, by Emily Lockhart, http://www.activebeat.co/diet-nutrition/8-foods-to-eat-when-fighting-the-flu/
(L) https://www.cdc.gov/flu/pandemic-resources/pdf/hospitalchecklist.pdf

“This winter’s flu season is turning into a “moderately severe” one that might get worse because of an imperfect vaccine and steady cold weather, flu experts and public health officials said this week…
About 80 percent of cases are of the H3N2 strain, which caused many hospitalizations and deaths this year in Australia, where winter comes in July and August.
“H3N2 is a bad virus,” Dr. Jernigan said. “We hate H3N2.”
Compared to H1N1, the other seasonal Type A strain, and to B strains that usually arrive late in the season, H3N2 tends to kill more of the very young and very old, he said…
The H3N2 component of Australia’s flu shot was reported to be only 10 percent effective at preventing infection and is the same as in North American shots. But both Dr. Jernigan and Dr. Fauci said they expected to see roughly 30 percent effectiveness when data is collected at season’s end, in part because more healthy people get their shots.
The vaccine mismatch was not caused by a genetic shift in the circulating flu, as happens in some years, but by changes in the “seed virus” used in the vaccine; as it grew in eggs, it picked up mutations foreign to human flu.” (A)

“The flu season is straining resources at hospitals nationwide with the Centers for Disease Control and Prevention reporting the flu is widespread in 46 states. Some hospitals are setting up emergency tents to handle the high volume of patients while others are dealing with a shortage of IV bags after Hurricane Maria cut power to manufacturing plants in Puerto Rico.
IV bags hold the medicines and fluids administered by IV and now nurses and doctors are being forced to find other ways to care for their patients, reports CBS News’ Michelle Miller.
In the intensive care unit at Massachusetts General Hospital, nurse Hannah Owens-Pike uses Gatorade to combat dehydration. It now takes her four times as long to administer treatment that would normally be delivered intravenously. Hospital staffers are forced to conserve supplies. (B)

Here is what you should know about this flu season:
1. It’s shaping up to be one of the worst in recent years
2. This season’s flu vaccine is likely to be less effective than in previous years
3. You should get the flu shot anyway
4. Basic precautions may spare you and your family from days in bed
5. Don’t mistake flu symptoms for those of a common cold (C)

“You’re going to be really annoyed, if after spending 12 hours waiting in the ER, we just say “you have the flu, go home.” But that’s all we’ll be able to say to you. Because we cannot cure the flu. It is a virus. We can try to make you feel better. But lots of the things we do for the flu, you can do at home. Flu care mostly consists of supportive measures like fluids and rest and over-the-counter medications.
Ibuprofen (like Motrin) usually makes people feel better than Tylenol. “Prescription strength” ibuprofen is 800 mg (four over-the-counter 200 mg tablets) taken every eight hours, and that’s the best thing to take, unless you have an ulcer. Take with food or milk or an antacid.
If you cannot hold anything down, we can give you IV fluids and anti-nausea medicine.
You may have heard of Tamiflu, the flu medicine. Tamiflu reduces symptoms by an average of one to one and a half days and can have side effects. It is also ineffective after 24 to 48 hours of symptom onset. We will give it to you if we think you really need it, but if we don’t give it, trust us that it’s because it’s not going to help you.
Do not request a Z-Pack. Antibiotics do not help a virus and risk giving you antibiotic-associated diarrhea, and you don’t want that…
There are other ways to get help beyond an unsatisfying trip to the emergency department. Here are our best suggestions:
Call your primary care doctor. Often your primary care doctor can offer advice over the phone or get you in her office. Give your doctor a chance to take care of you!
Urgent care centers: Wait times are considerably less at urgent care centers than emergency departments, and they’re usually able to estimate times over the phone. Many can administer all the treatments described above, even the IV fluids and X-rays.
Telemedicine: Consider finding out if your insurance pays for telemedicine services. This is a perfect use of telemedicine, and you won’t be exposing anyone else to the flu.” (D)

““What should you do if you have the flu?
Often the only response required for treating the flu is rest and staying hydrated, according to the CDC, since most people who get the flu do not need medical care or medication. Infected individuals should not go to the emergency room unless they have very severe symptoms, including being unable to eat, having trouble breathing, and severe vomiting.
Alas, Antibiotics are only helpful for treating bacterial infections, but influenza is caused by a virus.
People who are at high risk for complications — young children, people 65 and older, pregnant women and people with certain medical conditions — may consider taking an antiviral treatment to shorten the length of the illness. If you are in that group, contact your health care provider, the CDC suggests.
Should you go to work if you feel up to it?
Another important measure to take if you have the flu is staying home. More than one-quarter of American workers admit to going to work when they are sick, largely because of their work load, according to a survey released Tuesday by the public health nonprofit organization NSF International.
Being a martyr at work is highly discouraged by the CDC. “Stay away from others as much as possible to keep from infecting them,” the CDC said. “If you must leave home, for example to get medical care, wear a face mask if you have one, or cover coughs and sneezes with a tissue.” (E)

“At the Palomar Medical Center near San Diego, the new year ushered in a brutal flu season.
“The day came when we had extended waits in the emergency department up to eight or nine hours for a patient to be seen,” said Michelle Gunnett, emergency room nursing director. “We need to figure out other space to see patients.”
That space ended up being a triage tent set up right outside the ER.” (F)

“We are not prepared. Our current vaccines are based on 1940s research. Deploying them against a severe global pandemic would be equivalent to trying to stop an advancing battle tank with a single rifle. Limited global manufacturing capacity combined with the five to six months it takes to make these vaccines mean many people would never even have a chance to be vaccinated. Little is being done to aggressively change this unacceptable situation. We will have worldwide flu pandemics. Only their severity is unknown.
The only real solution is a universal vaccine that effectively attacks all influenza A strains, with reliable protection lasting for years, like other modern vaccines. Although the National Institutes of Health has publicly declared developing a vaccine a priority, it has only about $32 million this year specifically for such research. The Biomedical Advanced Research and Development Authority, the other federal agency responsible for developing and making available new vaccines for emergency response, has in fiscal year 2017 only a single project for $43 million supporting game-changing influenza vaccines….
The next few weeks will highlight how ill prepared we are for even “ordinary” flu. A worldwide influenza pandemic is literally the worst-case scenario in public health — yet far from an unthinkable occurrence. Unless we make changes, the question is not if but when it will come.” (G)

“In 2009, former President Barack Obama released a photo getting his H1N1 (swine flu) vaccine. President Gerald Ford got his swine flu vaccine back in 1976 on television. Plenty of governors and senators also release photos of their influenza vaccinations. In 2010, Obama officially declared Dec. 5-11 as National Influenza Vaccination Week. “I encourage Americans to get vaccinated this week if they have not yet done so, and to urge their families, friends, and co workers to do the same,” he wrote.” (H)

“Did President Donald Trump Get the Flu Shot? Some public health experts are hopeful that he will—and that he’ll talk about it” (I)

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) Already ‘Moderately Severe,’ Flu Season in U.S. Could Get Worse, by DONALD G. McNEIL Jr., https://www.nytimes.com/2018/01/08/health/flu-season-cdc.html
(B) Hospitals struggle to battle peak flu season amid widespread IV bag shortage, https://www.cbsnews.com/pictures/notable-deaths-in-2017/
(C) What You Need To Know About This Year’s Flu Season, by BARBARA FEDER OSTROV, https://www.npr.org/sections/health-shots/2018/01/09/576772534/facing-down-flu-5-things-to-know-now
(D) What to Do if You Have the Flu, by Dara Kass and Brian Thomas Fletcher, http://www.slate.com/articles/health_and_science/medical_examiner/2018/01/how_to_handle_the_flu.html
(E) The flu costs Americans $10.4 billion in medical expenses and another $7 billion in lost productivity, by Kari Paul, https://www.marketwatch.com/topics/journalists/kari-paul
(F) Hospitals grapple with brutal flu season that could get even worse, by JONATHAN LAPOOK, https://www.cbsnews.com/news/hospitals-grapple-with-brutal-flu-season-that-could-get-even-worse/
(G) We’re Not Ready for a Flu Pandemic, MICHAEL T. OSTERHOLM and MARK OLSHAKERJAN, https://www.nytimes.com/2018/01/08/opinion/flu-pandemic-universal-vaccine.html?_r=0
(H) Did President Donald Trump Get the Flu Shot?, by Alexandra Sifferlin, http://time.com/5093600/president-trump-flu-shot/
(I) Did President Donald Trump Get the Flu Shot?, http://global.breaking.quwa.org/news/did-president-donald-trump-get-the-flu-shot