Hike in H1N1 deaths expected because people at greatest risk aren’t seeking treatment

The head of the Centers for Disease Control said he expects to see increasing numbers of deaths from swine flu because those most at risk from the disease are not seeking treatment when they become ill.

That, said CDC Chief Dr. Thomas Frieden, makes inoculation for the highest risk Americans even more important.

CDC says 48 states have major flu outbreaks

CDC says 48 states have major flu outbreaks

But many people wanting protection are stymied because  manufacturers  of the H1N1 flu vaccine produced far fewer of the doses than promised. This comes as no surprise to the tens of thousands of people who waited hours for the medication this weekend.

Every community has its own story.  In my neck of the woods – the Pacific Northwest – people from as far away as Canada and Oregon lined up in eastern Washington and in counties north and south of Seattle long before dawn Saturday. Five hours in a line creeping at a snail’s pace was the norm.

Remember, these recipients of the first doses made available were supposed to be in high-priority groups, including health-care providers, children, and people with medical conditions that put them at risk.

With the exception of the needle, the process is relatively painless: a short form and a couple of questions. If your age, underlying medical condition or profession met the criteria, you were ready for the shot or the snort.

Police on both sides of Washington state said the crowds were orderly, but frustrated at the wait and concerned that the vaccine might be gone when their turn came.

David, Axelrod, President Obama’s senior advisor, admitted on the talk shows Sunday that the vaccine makers had missed their target of 40 million doses to be delivered by the end of October. However, he said that the U.S. will have all the vaccine it needs “soon.’’

The Centers for Disease Control said Friday that is has another 26.6 million doses of the vaccine available for shipment.

That’s not soon enough for some. Many state and county health departments  – the groups actually distributing the government-controlled supplies – have been forced to cancel or reschedule inoculation clinics. Clinics that were to distribute vaccine or nasal sprays by late October or early this month are being postponed until after Thanksgiving and even into early December.

While some people insist they will not take the vaccine because they fear sinister side effects, most people are anxious for it. A peek at the numbers may explain the basis of their concern.

Epidemiologists from the World Health Organization have calculated  the “clinical attack rate” — in this case, the proportion of a population affected by H1N1 — is far higher than the regular seasonal flu, which attacks 10 percent to 15 percent of the public.

WHO estimates that H1N1’s attack rate is as high as 50 percent. If correct, that means one out of two people may get the virus.

According to the CDC, 48 states are now reporting widespread influenza  activity. Remember, we’ve yet to hit the traditional flu season of February and March, when the weather drives people indoors and closer to one another.

What may get the attention of even more people is the death rate among children.

On Friday, CDC reported another 19 deaths among children, which is the largest one-week increase.

“This is a younger people’s flu,” said Frieden, the CDC director.

In a typical flu season, 90 percent of the deaths are among people over the age of 65,  he explained.  In H1N1, 90 percent of the deaths are in people under the age of 65.

Frieden described a “certain rhythm’’ of flu spread in a community:

First, there is an increase in the number of cases.

Children generally succumb first, then older people. As the ill develop complications, there is a marked increase in hospitalizations.

Then, “tragically,”  said Frieden, a peak in deaths occurs two or three weeks after the hospitalizations.

“So we are expecting to see, sadly, increasing numbers,’’ CDC’s top doc said. “And that’s one of the reasons we’ve emphasized that only half of the people who have underlying conditions have even sought care for their influenza-like illness.”

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