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.

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

Swine flu pandemic peaks in Ukraine

After three weeks of panic, pandemonium and politics, the initial swine flu pandemic in Ukraine has peaked.

Today the government is expected to end a nationwide ban on public gatherings, lift travel restrictions and order the reopening of parliament, schools and universities in all but 11 regions.

But the country, with its anemic health-care system, is still reeling from having 1.6 million people fall sick with the flu, resulting in the hospitalization of 97,000 people and the deaths of 388 in three weeks.

Full Article: here.

As of yesterday, Ontario has expanded its H1N1 priority list to include frontline responders (e.g. police, firefighters, correctional workers) as well as seniors over the age 65 who have chronic conditions and live in long-term care institutions. This shortly after Montreal’s The Gazette ran a story wondering why seniors weren’t considered a priority group for the vaccine (see excerpt below).

Why aren’t seniors an H1N1 priority? critics ask

Senior citizens left off the government’s swine-flu vaccination priority list say they are victims of discrimination.

With the average age of those dying from H1N1 complication in Quebec being 63.9, many seniors have called The Gazette to say the vaccine priorities are “criminal” and one person suggested it was “Canada’s new pension plan.”

Most of those who have succumbed to swine flu have had underlying health issues, yet seniors over 65 – a group known to have multiple health problems – have been left off the roster until the end of the campaign.

Full Article: here.