Watch how Kingston Frontenac Lennox & Addington (KFL&A) Public Health used Infection Watch Live to monitor and manage the 2nd wave of H1N1 in their community.

H1N1 pandemic ending with a whimper, not a bang

With H1N1 poised to enter history as the least deadly of four global flu pandemics, some experts are calling for an end to Canada’s mass vaccination program.

Nature is already achieving what we would hope to achieve by vaccinating, they say.

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The drop in cases suggests Canada has hit the critical fraction of the population that needs to be vaccinated to control the pandemic, says Dr. David Fisman, a University of Toronto expert in infectious disease dynamics.

Fisman can’t understand the rational for continuing mass vaccinations. He said that for a virus as contagious as H1N1, fewer than 30 per cent of the population needed vaccination to reach a critical level of immunity.

“I’m sure that the vaccine has prevented some deaths. I’m sure that there are people who are alive right now who would not have been alive if we hadn’t vaccinated,” he says. But the pandemic was already peaking, and then subsiding before the vaccination was rolling out in force.

Full Article: here.

Only 30 per cent of Ontario residents have received H1N1 shot, says top official

Ontario’s top medical official says only 30 per cent of the province’s population has received the H1N1 shot.

The target had been to vaccinate 70 per cent of the population, and Chief Medical Officer of Health Dr. Arlene King repeated her message Friday that people should not become complacent.

Full Article: here.

Public Health Agency says 48 cases of anaphylaxis reported after H1N1 shots

The Public Health Agency of Canada says there have been 48 cases of a severe allergic reaction reported in people who have had H1N1 shots.

The agency says that was as of the week of Nov. 20, when nearly 12.3 million doses of vaccine had been distributed across the country. The rate of anaphylactic reactions is 0.39 per 100,000 doses, which the agency says doesn’t exceed the normal rate seen for the administration of vaccines.
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One lot of GlaxoSmithKline’s pandemic vaccine was put on hold because it was linked to a higher-than-normal number of cases of anaphylaxis.

The agency says seven of the cases of anaphylaxis were in people who received shots from that batch of vaccine.

Full Article: here.

Kenya to introduce H1N1 vaccine

Kenya will introduce vaccination against the H1N1 influenza virus commonly known as Swine Flu in January after the World Health Organisation (WHO) offered 730,000 doses of the vaccine.

In an exclusive interview with Capital News, the Director of Public Health Dr Shahnaaz Shariff said that Kenya and Togo would be the first African countries to receive the vaccine from WHO which are enough to vaccinate 10 percent of the population.

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“The United States, United Kingdom, Australia, Canada have actually started immunising their citizens against H1N1 and they are also targeting the high risk groups. The difference is they are paying it from their own tax payers’ money but we are getting from the WHO stockpile,” he said.

Full Article: here.

WHO Defends Flu Response Amid Exaggeration Claims

Mortality from the new H1N1 strain is “unquestionably higher” than the death toll reported by national authorities, the Geneva-based agency said in a report seen by Bloomberg News before its scheduled publication today. Deaths totaled more than 7,820 as of Nov. 22, said WHO, which estimates as many as 500,000 people die each year from seasonal strains.

Health authorities worldwide are assessing whether their response to swine flu is justified by its threat as cases of flu-like illness retreat in the U.S. and U.K. While a majority of patients recover within days and reported fatalities are a fraction of the seasonal flu toll, these figures mask the full impact of swine flu on society, WHO said.

“Compared with seasonal influenza, the H1N1 virus affects a much younger age group in all categories — those most frequently infected, hospitalized, requiring intensive care, and dying,” WHO said in the report.

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“If you look at years of personal life lost, it’s much higher, and that’s the point we have to get across,” Osterholm said in a telephone interview today. “A death in an otherwise healthy 24-year-old, to me, is a major defeat for society.”

Full Article: here.

Still too early to declare swine flu pandemic over: WHO

It is too soon to decide whether to declare the H1N1 pandemic over, World Health Organization officials said Thursday.

While the number of infections and deaths are falling in Canada and the U.S., “that’s still not true for the entire Northern Hemisphere,” and it is impossible to know now whether the spring will bring a third wave of infection, Dr. Feiji Fukuda, special adviser to the WHO director-general on pandemic influenza said in a press briefing.

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“Overall, it’s too early to say whether activity is peaking in the Northern Hemisphere, and, at this point, it is also not possible to predict what we are going to be seeing in the spring time.”

And while new estimates suggest H1N1 is, overall, no more deadly than regular seasonal influenza, Dr. Fukuda warned that it is premature to declare how H1N1 will stack up against past pandemics.

The WHO says swine flu pandemic is milder than expected, may be nearing peak

Fukuda acknowledged that the virus has proved less lethal than authorities originally feared. “It is possible there could be unexpected events which occur as we go through” the pandemic, he said. But “it is quite possible to have a pandemic on the milder side and if we are experiencing that, and if the number of serious cases is kept down … this is something for which we should all be thankful.”

Fukuda said that more than 150 million doses of swine flu vaccine have now been distributed in about 40 countries. The United States, with at least 70 million doses, represents nearly half that total.

He also said that, so far, researchers have identified 96 patients with strains of the swine flu virus that are resistant to the most commonly used antiviral agent, Tamiflu, known generically as oseltamivir.

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New data from college campuses support the idea that swine flu may have passed its peak in the United States. For the week ending Nov. 27, there were only 1,076 new cases of influenza-like illnesses, generally presumed to be swine flu, among the nearly 3 million students covered in the survey, a 69% drop from the previous week.

Top doctor pleads for Canadians to get H1N1 vaccine

H1N1 may have hit its peak but the risk of transmission remains high and millions of Canadians could still be infected, Canada’s top doctor warned Wednesday in pleading for Canadians to get vaccinated.

“Even if you are not personally worried about getting H1N1, for the sake of others around you, as well as your loved ones, please get your H1N1 flu shot,” said Dr. David Butler-Jones, Canada’s chief public health officer.

Full Article: here.

From the most recent issue of Strategic Change’s newsletter, Michael Schiel on “What the H1N1 Panic Can Teach Us“:

“As the public panic begins to subside over the H1N1 vaccination response by Federal and Provincial governments, there is a good chance that calmer heads will prevail. If one takes a systemic point of view, some important organizational, policy or process lessons can be garnered.

When you filter through the hype, some of the important aspects include:

• Challenges with Estimating Demand – Although much of the reporting in the media has been hyperbolic, it is clear that the provinces have had some trouble in figuring out in advance how much supply was required.
• Challenges with Supply Side – The Federal Government was somewhat hamstrung as there was only one supplier of the vaccine, and they had issues meeting the changing needs of the government and the populace.
• Supply Logistics – There were many indicators that public health organizations had some trouble determining the best approach to supplying the vaccine, as evidenced by mixed messages, the allowance of queue jumping at many places, and the inability of some clinics to realistically handle the crowds.

What does all of this mean?

• Leadership is Complex - In a recent report, the Auditor General found that “defining a leadership role when each department responds to its own ministerial direction, and coordinating that direction with other departments can be a challenge”. I have seen this before on other large multi-ministry or inter-jurisdictional projects too. From a change management perspective, it is important to determine clear leadership links in advance, or at least to widely declare them if they need to be created on the fly.
• Roles and Responsibility – Thee Auditor General also found that “…while Public Safety Canada played a coordination role in some emergencies it has yet to establish the policies and programs that would help define its leadership and coordination role for emergency management in an all-hazards environment”. More thought and effort will need to go into planning for coordination across different jurisdictions.
• Communication is Key - One of the biggest challenges has been conflicting and changing messages from the government. It would be wise in future events for a calm, strategic approach to communication to be used. People resist change naturally, and one of the best ways to overcome that resistance is a more effective communication strategy.
• Forecasting – A key lesson here is that when planning for future external events like pandemics, public sector organizations will need to continue to find better ways to estimate what the public response will be.
• Need for Engaged and Experienced Staff – The area of Public Safety Canada that was responsible for planning and responding to the pandemic had an employee vacancy rate of 39 percent in the 2008-09 fiscal year, and a vacancy rate of 50 percent the previous year. Numerous studies exist on the difficulties that the Federal Government has faced in engaging staff during the 1990s and 2000s, and several reform efforts during that time have only partially eased some of the issues. Clearly it is hard to expect top level service delivery with low levels of staff, and one can imagine the existing staff are also overworked and somewhat stressed.
• Flexibility – It must be remembered though, that no amount of planning would be able to accurately foretell what the public reaction would be. The public changed its mind dramatically as the pandemic unfolded, and the various levels of government did their best to adjust their vaccination program rollout accordingly. Patience, openness and flexibility are key characteristics to achieve success during events like this.”

CDC warns: Holiday could bring more swine flu