90,000 Swine Flu Deaths? Possible, Not Likely

but not likely, CDC officials say.

The numbers come from a report to the president from his science/technology
advisory panel. The report suggests that in a "plausible scenario," swine flu
would infect 40% of the U.S. population and overwhelm hospitals with 300,000
patients needing intensive care.

"PCAST [President's Council of Advisors on Science and Technology]
emphasizes that this is a planning scenario, not a prediction," states the
report, dated Aug. 7 but released only yesterday.

How likely a scenario is it? Not very, says Anne Schuchat, MD, director of
the CDC's Center for Immunization and Respiratory Diseases. Schuchat addressed
the issue during a two-day meeting held this week for top officials to discuss
the flu pandemic with journalists.

"We don't think that is necessarily the most likely scenario, but one we
must plan for and be ready for," Schuchat said, noting that it is the CDC's
policy to plan for the worst possible case.

Health and Human Services Secretary Kathleen Sebelius called the report
from the Presidential panel "quite helpful" in justifying the extensive
preparations being made for the fall flu season and in pointing out areas where
greater efforts are needed.

"We will not know until the middle of flu season how serious this is,"
Sebelius said at the meeting with journalists. "We think the novel H1N1 virus
will infect a lot of people. Even if we have mostly mild cases of novel H1N1,
we will have people hospitalized and we will have more deaths."

Sebelius noted that while H1N1 swine flu vaccinations will start around Oct.
15, it's expected that people will need two doses given three weeks apart. That
means a person who gets the vaccine won't be protected for five to eight weeks
after getting the first dose.

Schuchat estimated that most people who get the vaccine won't be protected
until Thanksgiving. Meanwhile, she said, most experts predict an upsurge of flu
cases will begin much earlier.

What this means, Schuchat and a parade of CDC officials stressed, is that
it's going to take more than a vaccine to fight the flu this fall. Public
health will depend at least as much on personal actions as on government
efforts.

"Hands and home" are the key tools, as Sebelius says. The message is as
important as it is simple:

• Hands: Wash or sanitize them often.


• Hands: Cough or sneeze into a tissue or sleeve, not bare hands.


• Home: If you're sick, stay home until you're better.

By Daniel DeNoon
Reviewed by Louise Chang
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