The Swine Flu Paradox

indigo girl · Aug 21, 2009

http://www.bloomberg.com/apps/news?pid=20601081&sid=a9vKlznnyeQ4

Swine flu filled up Geoff Shaw’s intensive care unit in Christchurch, New Zealand, last month, forcing some surgeries to be canceled as the hospital struggled to cope. As winter moves to the Northern Hemisphere, health officials from Chicago to London brace for a similar overload.
“We have run out of bed space, we have run out of nurses,” Shaw, 47, said after working in the ICU and being on- call for 185 hours over 11 days. “There will be people who die because they were denied access to other treatments.”
Health officials call it the swine flu paradox. As the new H1N1 strain spreads, the majority of patients recover within days and the number of deaths is a fraction of the seasonal flu toll. Those statistics mask an alarming reality: the pandemic has strained intensive care units and a resurgence of the virus in the fall could bring a public health disaster, experts say.
“We have largely been fortunate,” said Simon Towler, an intensive care specialist at the Royal Perth Hospital and Western Australia’s chief medical officer. “If we had a severe flu of a different type we would be in massive trouble. The systems really don’t have the capacity to cope with a surge.”
Last weekend, a quarter of Western Australia’s 105 adult intensive care beds were occupied by swine flu patients who needed ventilators to breathe, according to Towler.
The experience in Australia and New Zealand offers clues about what North America, Europe and Japan may see when winter moves in.
“The Northern Hemisphere medical care requirements for the next six months are a train wreck waiting to happen,” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy in Minneapolis. “In the fall, even if nothing else changes in terms of the virus’s severity and our preparedness, it’s going to be a real challenge.”
Studies in the U.S. show that the group of patients requiring mechanical ventilation for at least four days is growing six times faster than the rest of hospitalizations, said Marya Zilberberg, a scientist with the Amherst EviMed Research Group at the University of Massachusetts.
“It’s striking young people down,” said Shaw, the intensive care specialist in Christchurch. “We are seeing people largely between the ages of 20 and 50. That really is quite different from anything else we have ever had.”
“There is something very different about this virus,” said Heath Kelly, head of epidemiology at Victoria state’s infectious diseases reference laboratory in Melbourne. “In ICUs, it looks worse” than expected, he said. “But everywhere else you look, it looks better. That’s the interesting paradox.”

(hat tip PFI/Monotreme)