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Recent severe cases of H1N1 flu worry health officials

In a teleconference with reporters this afternoon, federal health officials provided an update on the current state of the Canadian government's response to the H1N1 flu pandemic.

Health Minister Leona Aglukkaq -- who has kept a fairly low profile in her time at the helm of Health Canada throughout the H1N1 response as well as the radioisotope shortage crisis -- was in attendance but said little besides mentioning that she'd be traveling to Mexico soon alongside foreign governments' delegates to discuss at a World Health Organization meeting how to deal with the expected resurgence of the H1N1 virus this fall.

Dr David Butler-Jones, the government's Chief Public Health Officer (above right), said that although the vast majority of the 7,775 cases detected in Canada so far (see the map below for a breakdown by province or visit the Public Health Agency's surveillance website) have been mild and have resulted in full recoveries, the anticipated "second wave" of infections this fall has been preceded already by the mysterious appearance in recent weeks of a small number of "severe" infections.


According to Dr Butler-Jones, the reason or reasons for the emergence of this new set of "severe" cases in Canada has not been determined, though epidemiologists with Health Canada and the Public Health Agency of Canada have been dispatched to study the matter. Possible explanations, he explained, could include: genetic variations that result in either too little or too great an immune response in infected patients, a mutation in the H1N1 virus (which would augur potentially very serious consequences in the general population over the months to come, it would seem), or some combination of factors. He warned that we should expect to see more cases in Canada over the coming months, including more severe cases, and more deaths.

At the top of the news lately have been accusations that the federal government's response to the rapid spread of the H1N1 flu virus in aboriginal communities, particularly in Manitoba, has been insufficient. Health Canada's regional director of First Nations and Inuit Health, Valerie Gideon, endeavored to convince reporters that was not the case. The shipments of hand sanitizer, which had been delayed because of concerns that the alcohol-based gels might be abused by First Nations patients, have now been delivered, she said, and nursing stations are open on the reserves 24 hours per day and are stocked with necessary medical supplies.

One interesting item to note about Monday's news conference was the tone that Dr Butler-Jones employed when discussing recommended precautionary measures for pregnant women and people with preexisting health conditions, both of which groups of patients may be at higher risk of experiencing dangerous complications if they are infected with the H1N1 flu. Whereas US Vice-President Joe Biden was mocked not long ago for warning people to avoid crowded places like buses and trains for fear of catching the virus, Dr Butler-Jones said very seriously that pregnant women in Canada should consider staying out of crowds. He refused, however, to cite specific crowded places pregnant women should avoid; he demurred when asked by one reporter if he meant women should avoid shopping malls and public transportation, only mentioning for certain (and this is where things took a brief turn for the surreal) that pregnant women should avoid mosh pits.

Photo: Public Health Agency of Canada

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70 comments:

  1. sharonJune 30, 2009 at 2:38 PM

    RE: H1N1

    Time for the frog story:

    There were two frogs in a pond and the population of frogs doubled every five days.

    On day 90 the pond is full of frogs........ on what day was the pond half full?

    Delete
  2. Sam SolomonJune 30, 2009 at 2:48 PM

    Day 85! That is, assuming the frogs lack access to hand sanitizer and their ghettoized pond has perpetually unsafe housing and sanitation conditions. If our metaphorical frog pond weren't so egregiously neglected, that kind of exponential growth pattern might not come into play.

    Delete
  3. sharonJune 30, 2009 at 3:01 PM

    egregiously neglected?

    by those whom "provide" the means( information, gelled alcohol, aseptic techniques, etc)

    .... or those who do or do not apply the means?

    Delete
  4. Sam SolomonJune 30, 2009 at 3:26 PM

    Neglect is neglect is neglect, of course, but certainly a very major portion of the burden for protecting First Nations communities' health falls on the federal health ministry, which is explicitly responsible for that task. Casting aspersions on members and even leaders of those communities for behaviour that may appear to some to be some sort of "self-neglect" seems to me to be nothing more than blaming the victims.

    Delete
  5. sharonJune 30, 2009 at 9:00 PM

    Well Sam... this might be an "ethnocentricity " thing..... depending on who is reading it.

    [If this was 1943 someone would think I was addressing the "Quebecois"... not Aboriginals]

    In reality I am addressing a generic failing in the "safe" societies we think we have ( regardless of ethnic origin ).
    We are not alert.
    We are not prepared.
    We are not self sufficient.
    We are not skilled.


    We think "deductively" because it comes easier to mind........even when we have the ability to think inductively.

    To pursue that line of thinking would any one of us have been alerted on the 75th day...when the pond was only 1/8 full?

    I think not.

    Delete
  6. snakeoilbaronJuly 7, 2009 at 11:27 PM

    Are not terms such as "neglect" and "burden of responsibility" meant for discussing children and the parental relationship to them? Maybe you can extend the term to include the elderly and the severly disabled but why do natives as a community require guardianship?

    Delete
  7. Sam SolomonJuly 8, 2009 at 9:38 AM

    Snakeoilbaron: Your premise is misleading. The parent-child relationship is not a reasonable parallel. Quite simply, government has the responsibility to provide sufficient services for citizens. Failure to do so qualifies as neglect in my book.

    Delete
  8. AnonymousSeptember 17, 2009 at 10:44 AM

    Sam, I think you mean that exponential growth is expected if there IS access to hand sanitizer and aseptic techniques.

    The pond would not grow ie dying of of disease if there WASN'T access to those things.

    But has the government or will the government withhold the H1N1 vaccine that is going to provide the surest way to prevent the virus?

    Withholding sanitizer that does not contain alcohol but having provided a similar product in its place that is just as effective (is it?) to reduce transmission of infection isn't in itself going to reduce the frog pond numbers.

    What about plain 'ol washing of the hands? Do elders not know this is an option? Have proper techniques to prevent the spread of H1N1 been withheld from the government by proper education to the native communities in question? Or has proper education on how H1N1 spreads within the community been withheld by elders/chiefs of the community itself?

    If you tell me that the vaccine is being withheld by the government to delay vaccinating vulnerable communities - perhaps because Health Canada wants to hold back providing the vaccine to Canadians because it wants to keep testing the vaccine - then that is suspect to me.

    Withholding the means to prevent death - especially in a community that is experiencing higher than normal incidences of H1N1 - is tantamount to extermination as far as I'm concerned.

    I don't know if withholding hand sanitizer with alcohol as opposed to hand sanitizer sans alcohol is enough to trigger the extermination by omission argument.

    Delete
  9. AnonymousSeptember 17, 2009 at 10:49 AM

    p.s. correction. I should have written: "perhaps because Health Canada wants to hold back providing the vaccine in a timely manner...

    Delete
  10. AnonymousSeptember 17, 2009 at 11:27 AM

    Using the frog pond analogy to characterize the spread of the H1N1 virus in terms of infected people (frog pop), then not providing the vaccine in a timely manner could cause large numbers of frogs to die.

    For example, if Health Canada left providing the vaccine to day 85 - then on day 85 the virus has infected 131,072 individuals. If Health Canada provides the vaccine on lets say, day 15, timelier than delaying it to day 90 (or till the end of the year when it is supposed to be ready)- only 16 individuals (frogs) are infected by the H1N1 virus.

    It's easier to control the spread of the virus in 16 frogs than 131,072, which according to the analogy, the disease (pop. of frogs) will spread 2x its size every 5 days.

    The next question is, how many people does a person with H1N1 infect? Is it 2x every 5 days, 3x?; 4x?

    Think about it

    Delete
  11. Purley Quirt (aka Sharon)September 17, 2009 at 11:33 AM

    Actually anonymous...

    By day 15......13,408 frogs would be infected.

    Exponential growth of " unchecked" states grow geometrically.

    Delete
  12. AnonymousSeptember 18, 2009 at 1:54 AM

    The point is still the same no matter the numbers

    BTY how many doctors sat on the death panel to decide the priorities on who gets the vaccine?

    Delete
  13. AnonymousSeptember 18, 2009 at 2:25 AM

    Auggh! Do lawyers study stats? Actually, Sharon did not mention exponential growth rate, Sam Soloman did. Or is that Sharon too? With those rates there is less time to save the pond from lily pads...(or frogs, or rice...)

    Delete
  14. Purley Quirt (aka Sharon )September 18, 2009 at 9:49 AM

    It is valuable to know that "exponential growth" CAN be halted.

    http://www.youtube.com/watch?v=hM1x4RljmnE&NR=1

    The point is............. will it be in time?

    We are not likely to ACT with appropriate alterations if we do not recognize our own intellectual limitations and capacities.

    I have read "for lack of knowledge, my people perish" ... and knowledge
    is best used to "start" something good .......while simultaneously "stopping" something bad.

    "For lack of motivation people fail to do the work of acquiring " knowledge".

    What motivations work?...... may be the most important question:

    Health? ( not to mindsets that believe they are invulnerable)

    Wealth? ( this is why " carbon offsets" will slow eco- destruction )

    Fame? ( 15 minutes promised is not a good enough goal for most)

    And in the panic stage where survival issues are recognized .... we find there is no comfort in finally "knowing".

    Delete
  15. AnonymousSeptember 24, 2009 at 5:10 PM

    Update: Canada's first death panel - Hamilton Health Sciences run by the Deputy Minister of Health Ron Sapsford and Barbara Sullivan, former Liberal MP & Chair of the Health Professions Regulatory Advisory Council - the body that oversees the safety of patients in Ontario - announces who they will allow to die and to live. (is it another scheme to obtain money from government?)

    Health Canada will not have the H1N1 vaccine available until late December contrary to best practices observed by Australia's public health experiences with their H1N1. Best practice is to have the vaccine available as soon as possible.

    The euthanasia panel at HGH death panel is leaving the elderly for last to receive the vaccine just after the disabled. Hamilton media is presenting the 'news' as if it were something to be proud of.

    Hamilton's physicians in private practice and in the hospitals, routinely maltreat their disabled patients including medical discrimination and refusal to treat those they perceive with mental illness. If this isn't a case for Nazi-like euthanasia with ties to the Ontario government, I don't know what is.

    All Canadians are guaranteed security of the person and are to be treated equally no matter the disability under the Constitution/Charter. But this supreme law Canada does not appear to be recognized by the lawyers who are providing the legal advice to HGH. (are they government lawyers?)

    Despite close ties of hospital CEO's to the current Liberal government, even the NDP representatives in the City have been silent on the euthanasia as well as a complete refusal of the office of the leader of the Ontario's Conservative Party to make a statement such death panels.

    http://www.thespec.com/article/640626

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  16. Sam SolomonSeptember 25, 2009 at 11:39 AM

    Thank you for posting the link to the article from The Spectator.

    Delete
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