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Wednesday, December 2, 2009

Swine Flu Cases Appear To Have Peaked

The Los Angeles Times:"The current wave of pandemic H1N1 appears to have peaked, with four weeks of declines in several key indicators, the Centers for Disease Control and Prevention said Monday. Despite the decrease, the outbreak is continuing to take a heavy toll of hospitalizations and deaths, especially among children. Widespread activity of H1N1, also called swine flu, was reported in 32 states ... in the week ending Nov. 21, down from 43 states the week before and 48 a month ago. Influenza-like illnesses accounted for 4.3% of all visits to doctors' offices during the week, down from nearly double that proportion in October. That is still well above the normal level, 2.3%, for this time of year, however" (Maugh, 12/1).

The Washington Post: "While officials warned that the number of people getting infected with the H1N1 virus remains high, and cases could surge again, the extended period of falling activity suggests that the intensity of the outbreak has reached a high. ... 'We're far from being out of the woods,' [Thomas Skinner, spokesman for the Centers for Disease Control and Prevention in Atlanta] said. 'There's still a lot of flu out there. And we wouldn't be surprised to see another uptick in activity as we approach the end of December and beginning of January, when kids come back from Christmas break.' But other experts said they thought the wave had peaked" (Stein, 12/1).

USA Today reports: "The steady decline in the USA and elsewhere prompted the World Health Organization to propose Friday that swine flu may have peaked in North America, the Caribbean and parts of Europe, though the 'winter influenza season continues to be intense.' U.S. officials challenged WHO's hopeful assessment, saying it is too soon to declare that swine flu is tapering off. ... As of Monday, 66 million doses of swine flu vaccine were available for states to order, and more were on the way, the CDC's Thomas Skinner says" (Sternberg, 11/30).

Meanwhile, The San Bernardino (Calif.) Sun reports that fewer blacks are receiving the vaccine: "San Bernardino County public health officials this week plan to make a special pitch to get more blacks to roll up their sleeves for the H1N1 vaccine. ... Alonzo Louis Plough, director of emergency preparedness and response at the Los Angeles County Department of Public Health, said last week that his agency had already made attempts at special outreach and participation in the H1N1 campaign, and participation is still lagging. ... Dr. Eric Frykman, health officer for Riverside County, said that he has asked clinic managers to informally start tracking participation by ethnic group" (Steinberg, 11/29).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at

Monday, November 2, 2009

Online Test Helps You Self-Diagnose H1N1 Flu

Feeling sick? Wondering if it's the H1N1 flu or just a regular old go-away-don't-come-near-me, flu?

Face it, your doctor may not be able to squeeze you right in. But you may be able to figure it out using a Web-based self-assessment tool developed by researchers at Emory University in Atlanta. The tool is now available on several national Web sites, including flu.gov , the Centers for Disease Control and Prevention (CDC), and Microsoft's H1N1 Response Center .

The online test includes questions like, do you have a fever? Have you been short of breath? Do you have a pain or pressure in your chest that you didn't have before? Were you feeling better and now a fever or cough is returning?

The online test includes questions like, do you have a fever? Have you been short of breath? Do you have a pain or pressure in your chest that you didn't have before? Were you feeling better and now a fever or cough is returning?

The H1N1 flu , also widely known as the swine flu, is a fairly new influenza virus that has spread around the world. The CDC reports that it first appeared in the United States this past April. By June 11, the World Health Organization categorized it as a pandemic . Because its extremely contagious, hospitals and health care workers have been bracing for the H1N1 to hit hard this fall.

With concerns about the new flu running high , health care providers expect to get slammed with a mounting wave of people rushing in to find out if they have the H1N1 virus.

The online test, dubbed the Strategy for Off-Site Rapid Triage, is designed to help a lot of people figure out if they need to see their doctor or go to a hospital.

"This Web site is carefully designed to encourage those who are severely ill, and those at increased risk for serious illness, to contact their doctor, while reassuring large numbers of people with a mild illness that it is safe to recover at home," Arthur Kellermann, professor of emergency medicine and an associate dean at the Emory School of Medicine, said in a statement. "Hopefully, providing easy-to-understand information to the public will reduce the number of people who are needlessly exposed to H1N1 influenza in crowded clinic and ER waiting rooms, and allow America's doctors and nurses to focus their attention on those who need us most."

Swine Flu Emergency Should Put IT on Alert

Though the H1N1 flu has been declared a national emergency by President Barack Obama, experts say that many companies remain ill-prepared for its potential consequences, which could include employee absentee rates of 40% or more.

While last month's emergency declaration is targeted mostly at helping health care providers and government agencies bypass regulatory requirements to provide critical care, experts say it should also be a red flag for the IT and business communities.

Organizations probably have not allocated enough resources for virtual private networks nor tested VPNs for the fact that 80% of their staff could be working from home," said Al Berman, executive director of DRI International, a training institute that focuses on helping businesses prepare for emergencies. "We ran some tests with companies, and they ran out of TCP/IP addresses in five minutes."

Berman said that many businesses are probably delaying VPN upgrades because of increasing bandwidth costs. For example, he said, DRI recently met with officials of a large insurance provider and found that it would cost the company $1 million to boost bandwidth enough to support 40% of its staff working from home.

The federal government's Flu.gov Web site, managed by the U.S. Department of Health and Human Services, offers guidance to businesses about what to do in the event of a pandemic. Its suggestions range from making sure sick employees stay home to appointing a pandemic coordinator or team to oversee the preparation and implementation of a disaster plan.

Employers should "send a very strong message to employees to stay home if they're sick. No one is that essential," said Kim Elliott, deputy director of Trust for America's Health, a public health advocacy group. "You don't want employees coming in and infecting others to the point where your business shuts down."

The pandemic coordinator or team should monitor employees to ensure that they follow basic rules of hygiene, such as washing their hands, and make sure that face masks are available, according to the Flu.gov Web site.

Elliott said that the planning process should also include an assessment of how the absence of a large number of employees would affect operations, with recommendations on how to keep things running under such circumstances.

"That may mean cross-training employees in some key business functions," Elliott said, citing IT infrastructure maintenance, bookkeeping and accounting duties, and some customer-facing activities.

Businesses should also develop a plan to communicate with municipal agencies, which determine whether bus routes, schools or even businesses need to be shut down, Berman said.
The national emergency declaration came after a weekly U.S. Centers for Disease Control and Prevention report called FluView noted that 43 states are now reporting widespread influenza activity and that H1N1 has caused 1,000 deaths in the U.S.

elevating its health emergency alert status to Phase 6 -- its highest level. At that time, the number of influenza cases was close to 30,000 worldwide. The WHO now says there are 414,000 confirmed cases of H1N1 and that there have been nearly 5,000 H1N1-related deaths.

iPhone App Tracks Swine Flu

A new, free iPhone app from the creators of HealthMap shows the outbreaks of the H1N1 swine flu in your area and elsewhere. The app, called Outbreaks Near Me, finds your location and shows a map with red pins indicating recent outbreaks.

The app updates every hour using reports from more than 30,000 sources. Users can report updates such as school closings through the app. The app was launched last month and now has been downloaded 81,000 times.

Red pins dot the state of California, with heavy concentrations in Los Angeles and the San Francisco Bay Area. Perhaps one of those red pins includes my friend (and many in his East Bay company) who came down with the swine flu a couple of weeks ago.

There are no warning signs, he says. One day you're happily working in your cubicle, and the next you're fighting a fever, vomiting and worse. He lost eight pounds in only a few days after losing his appetite for food and liquids. Luckily, I hadn't caught up with him in a while.

John Brownstein, an assistant professor at Children's Hospital Boston and one of HealthMap's creators, told the Wall Street Journal that the goal of the free app isn't to spark panic, rather to spread the word. To this end, he says, an app solely running on the iPhone isn't ideal. HealthMap is currently developing an app for Google's Android and, later, for RIM's BlackBerry.

Thursday, October 29, 2009

Work instructions if you become ill or exposed

Individuals who pose a risk of infecting others as a result of personal illness with H1N1 Flu (Swine Flu) or who have been exposed through direct caregiving may not enter IBM work environments until the risk ceases.

Please be sure Integrated Health Services receives notification as soon as possible about an illness or exposure concern. Immediate action may be needed to evaluate next steps associated with these issues. If you are unable to notify IHS yourself, please contact your manager to handle in your behalf. To reach an IHS representative, please refer to the local IHS team to whom you would report workplace health concerns. Please see below for specific instructions:

Illness
If you have been diagnosed with H1N1 Flu or have symptoms of this illness including fever and cough, sore throat or body aches you are not permitted to come into any IBM work environment (including customer). This restriction applies for a minimum of seven calendar days following the onset of symptoms or at least 24 hours after symptoms have resolved, whichever is longer.

For all other (non-influenza) illnesses and symptoms, the above requirement does not apply. Contact your manager or Integrated Health Services (for IBM employees) and follow the normal return to work practices.

Exposure
Management of H1N1 Flu exposure situations can vary based on the nature of exposure, country requirements and business considerations. In some circumstances, individual risk assessments may be required. Integrated Health Services should participate in those risk assessments.

Travel from an H1N1 Flu affected community/country:
IBM is not requiring anyone to self quarantine at this time as a result of travel.
NOTE: Self quarantine means restricting entry to IBM work environments for 7 calendar days from the last date of exposure (including offices, meetings, customer locations, etc.)
Some countries may impose a period of self quarantine. In such cases, country regulations apply.
Some customers may require a period of self quarantine. In such cases, a business unit decision along with IHS consultation is appropriate.

Caregiver Exposure
If you are directly caring for someone who is ill with H1N1 flu (such as a small child or incapacitated adult) and have had prolonged periods of close face to face contact such as during feeding or bathing the person, it may be possible for you to transmit the illness to someone else just prior to becoming ill yourself. Because of this, you are restricted from coming into an IBM work environment (including customer) for seven days from the date you stop providing direct care. During this time period, you should conduct daily self screening for illness symptoms and fever.
In all other circumstances, exposed individuals may come into the workplace unless otherwise directed by the local/country health department or customer/client instructions. The exposed individual should conduct self screening for illness symptoms and fever daily for seven days from the last date of exposure.

Self screening
Individuals are asked to perform H1N1 Flu illness self screening following exposure to a confirmed or suspected case.

To conduct self screening, please perform the following steps:

Step One: Check whether you have symptoms of illness including fever and cough, sore throat or body aches.

Step Two: Check your temperature using a standard, good quality thermometer following the manufacturer’s instructions.

Step Three: If you have symptoms as described in Step One or you have a temperature greater than 100.4o F or 38o C, you must not go into the workplace.

You should:

Notify your manager that you are unable to report to work.
Contact an IHS representative; please refer to the local IHS team to whom you would report workplace health concerns.
Contact your health care provider for further health instructions, especially if you are at higher risk for complications.
Refer to the guidance in Work Instructions if You Become Ill or Exposed.

Stop the spread of H1N1 Flu

This virus spreads from person-to-person, probably in much the same way that seasonal influenza viruses spread, through coughing and sneezing. Cough etiquette and hand washing are essential to stopping the spread and preventing exposure to the virus.

Wash Hands:

Before eating or preparing food.
After coughing, sneezing, or blowing your nose.
After using restroom facilities.

Handwashing Technique
Wash your hands with soap and water for 20 seconds. Rinse well, with hands held downward. Dry with a paper towel, then use the towel to turn off the faucet.
For health reasons, IBM is only recommending hand sanitizers be present in work areas when soap and water are not available. Though hand sanitizers can be effective in killing some germs, they are less effective than soap and water for removal of germ containing debris on the hands that can be deposited when coughing and sneezing.

Avoid touching your eyes, nose or mouth.
Germs often spread when a person touches something contaminated and then touches their eyes, nose or mouth.

Go home if you get sick at work
Ill individuals should leave the work environment immediately or as soon as possible. Inform your manager or lead that you are ill and need to leave the workplace. Keep at least 1 meter/3 feet from others to protect them from getting sick. Practice cough etiquette. Cover your mouth and nose if coughing or sneezing, using tissues and disposing of them properly. Wash your hands afterward.


For tips on how to stay healthy while traveling, please check the Online Swine Flu Help. For country specific advisories and mandatory quarantine or restrictions on community movement for those who exhibit H1N1 illness symptoms or were exposed to ill travelers, please refer to International SOS Country Guides (see Closures & Quarantine, Airport Screening or Travel Restrictions) or country government agencies such as embassies and state departments.

H1N1 Flu Facts from the World Health Organization (WHO)

H1N1 is now the dominant flu strain in most parts of the world. Studies have detected no signs that the virus has mutated to a more virulent or lethal form.
The pandemic will persist in the coming months as the virus continues to move through susceptible populations.
The symptoms of H1N1 flu are similar to the symptoms of seasonal flu and may include fever, cough, headache, body aches, chills, fatigue, sneezing, sore throat and runny nose. A significant number of people who have been infected with this new H1N1 virus also have reported diarrhea and vomiting.
The overwhelming majority of patients continue to experience mild illness.
At higher risk of serious complications from H1N1 flu are people age 65 years and older, children younger than 5 years old, pregnant women, and people of any age with chronic medical conditions (such as asthma, diabetes, heart disease or immunosuppressed).

While this is a new health problem that may cause concern, there are many actions you can take to protect yourself, your family and the workplace.