H1N1 Flu Vaccine Shortage Frustrates Doctors...Lives Are At Stake!

(Doctors are becoming extremely frustrated with the H1N1 Flu vaccine shortages and delays. Lives are at stake!)

Visit msnbc.com for Breaking News, World News, and News about the Economy

(US Dept of HHS Kathleen Sebelius states that H1N1 Flu Production is picking up.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

Sources: MSNBC

Pres. Obama Declares H1N1 Flu National Emergency!

(National Emergency: President Obama signed a proclamation that would allow medical officials to bypass certain federal requirements. MSNBC's Alex Witt reports.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

Pres. Obama declares H1N1/ Swine Flu national emergency

President Barack Obama has signed a proclamation declaring swine flu a national emergency, the White House said Saturday.

"In keeping with the administration's proactive approach to H1N1 Flu, President Obama last night signed a proclamation declaring 2009-H1N1 Influenza a national emergency," it said in a statement. "The proclamation enhances the ability of our nation's medical treatment facilities to handle a surge in H1N1 patients by allowing, as needed, the waiver of certain standard federal requirements on a case-by-case basis."

Officials described the move as similar to a declaration ahead of a hurricane making landfall.

On Friday, federal health officials said more Americans have been vaccinated against seasonal flu this fall than ever before by this time of year.

Sixty million people have gotten the winter flu vaccine — probably because they're paying more attention to flu warnings in general, thanks to swine flu. It's an unprecedented number of seasonal flu shots for October; most usually aren't given until later in the fall.

Part of it is due to supply: There are already 85 million doses of seasonal flu vaccine available, a much larger amount than usual for this early in the fall. Most years, roughly 100 million doses are used during the season.

But a big factor probably is that swine flu is drawing attention to public health warnings that seasonal flu is also a deadly illness that can be prevented through vaccinations, said Joe Quimby, a spokesman for the U.S. Centers for Disease Control and Prevention.

"There's been a heightened awareness in the American public due to H1N1 this year," said Quimby.

More widespread than ever

Swine flu is also more widespread now than it's ever been, and has resulted in more than 1,000 U.S. deaths so far.

Flu illnesses are as widespread now as they are at the winter peak of normal flu seasons, CDC Director Dr. Thomas Frieden told reporters Friday. "To be basically in the peak of flu season in October is extremely unusual," he said.

"We expect that influenza will occur in waves and we can't predict how high, how far or how long the wave will go or when the next will come," he added.

"Many millions" of Americans have had swine flu so far, according to an estimate he gave at a Friday press conference. The government doesn't test everyone to confirm swine flu so it doesn't have an exact count.

Frieden updated some other estimates, too, saying there have been more than 20,000 hospitalizations.

Nearly 100 swine flu deaths in children have been reported, CDC officials also said.

Forty-six states now have widespread flu activity. The only states without widespread flu are Connecticut, Hawaii, New Jersey and South Carolina. There are at least two different types of flu causing illnesses; tests from about 5,000 patients suggest that nearly all the flu cases are swine flu.

Frustrating production delays

This year's seasonal flu vaccine won't protect against swine flu; a separate swine flu vaccine is needed. Vaccine production takes several months, and the work on seasonal vaccine was already well under way when swine flu was first identified in April. It was too late for the swine flu virus to be included in the seasonal doses.

Because of swine flu vaccine production delays, the government has backed off initial, optimistic estimates that as many as 120 million vaccine doses would be available by mid-October. As of Wednesday, only 11 million doses had been shipped to health departments, doctor's offices and other providers across the country, CDC officials said.

"It's frustrating to all of us. We wish there were more vaccine available," Frieden said.

The flu virus has to be grown in chicken eggs, and the yield hasn't been as high as was initially hoped, CDC officials explained. "Even if you yell at them, they don't grow faster," Frieden said.

He added that 5 million new doses became available in the past week, and vaccine should be more plentiful soon.

Much of the vaccine currently available is a nasal spray from AstraZeneca's unit MedImmune.

The Obama administration has ordered vaccine from five manufacturers: Sanofi-Aventis SA, CSL Ltd, Novartis AG, GlaxoSmithKline and AstraZeneca's MedImmune.

Global figures

Also Friday, the World Health Organization reported more than 414,000 laboratory confirmed cases of H1N1 worldwide, with nearly 5,000 deaths.

But the Geneva-based health agency noted that the figures were only the tip of the iceberg.

"As many countries have stopped counting individual cases, particularly of milder illness, the case count is significantly lower than the actual number of cases that have occurred," WHO said.

Sources: MSNBC

Florida's H1N1 Flu Death Panels...Deciding To Let Some Patients Die

(Florida Health Care Professionals are discussing that it may be wise to intentionally let some H1N1 Flu patients die if they are too sick. Isn't this a form of the "Death Panels" concept?)

Visit msnbc.com for Breaking News, World News, and News about the Economy

(The Center for Disease & Control warns citizens that the rapid H1N1 Flu test is not reliable.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

Florida plan advises hospitals to bar some patients in event of severe flu pandemic

Florida health officials are drawing up guidelines that recommend barring patients with incurable cancer, end-stage multiple sclerosis and other conditions from being admitted to hospitals if the state is overwhelmed by flu cases.

The plan, which would guide Florida hospitals on how to ration scarce medical care during a severe flu outbreak, also calls for doctors to remove patients with poor prognoses from ventilators to treat those who have better chances of surviving. That decision would be made by the hospital.

The flu causes severe respiratory illnesses in a small percentage of cases, and patients who need ventilators and are deprived of them could die without the breathing assistance the machines provide.

In June, Florida Surgeon General Ana M. Viamonte Ros sent the draft guidelines — which had already undergone a series of internal revisions — to 16 state medical organizations for their feedback.

But the state has not yet publicized the guidelines or solicited input from the general public. The Florida Department of Health released a copy of the draft plan at the request of ProPublica, a nonprofit news organization, which provided it to the Sun Sentinel.

The document addresses one of the most heart-rending issues in medicine: What to do if the number of people in need of ventilators and other treatment dramatically exceeds what is available.

The goal, the plan says, is to focus care on patients whose lives could be saved and who would be most likely to improve. While it says those decisions are not to be made based on patients' perceived social worth or role, the plan calls for different rules for some populations.

The list of conditions that disqualify hospital admission would be applied to most people only in the two most severe levels of a pandemic. However, they would also be applied in the first level ofa pandemic for patients transferred to hospitals from "other institutional facilities," such as nursing homes and mental health facilities.

Florida's planning effort reflects a growing acknowledgment that hospitals across the nation would be unable to cope with the flood of patients that a severe influenza pandemic, like the one that gripped the nation in 1918, would unleash. That resource gap is in the spotlight now, as the country is battered by a second wave of pandemic swine flu, also known as the H1N1 virus.

"What we have seen are real stresses, particularly on the emergency departments," Thomas Frieden, commissioner of the Centers for Disease Control and Prevention, said at a press conference last week.

The H1NI virus is much milder than the 1918 flu, but a small proportion of H1N1 patients, including some who have no risk factors and are young and healthy, develop severe breathing problems requiring mechanical ventilation and life support.

So far, intensive care units in the U.S. haven't been overwhelmed with people needing ventilators.

"That's something that we're tracking closely," Frieden said.

In Winnipeg, Canada, all regional critical care beds were full at the peak of the outbreak last spring, and in Mexico, patients experienced long delays before being admitted to ICUs. Four died before being transferred from the emergency room.

Florida health officials believe that the number of severely ill flu patients will likely remain at a manageable level, provided residents get vaccinated, that they know when to stay home and when to seek medical care (visit myflusafety.com or call 877-352-3581 for information), and that the existing flu strain does not mutate into a more virulent form.

In the case of a much severer scenario, Florida's draft guidelines call for hospitals to turn away anyone whose doctor has signed a "Do Not Resuscitate" order, which instructs rescuers not to revive a patient whose heartbeat or breathing stops.

A recent report from a panel of national experts convened by the Institute of Medicine urged states not to use DNR orders for this purpose, because they reflect preferences about end-of-life planning "more than an accurate estimate of survival."

The Florida plan also calls for intensive care unit patients and those using ventilators to be reassessed after 48 to 72 hours.

Those whose chances of survival have significantly worsened would be taken off the machines or discharged from critical care to make way for others who may have a better chance of survival. If needed, they would be given palliative care to keep them comfortable.

One goal of Florida's plan is to "reduce or eliminate" the legal liability of health care workers who, in good faith, deny or withdraw treatment from some patients in an emergency. The plan includes sample executive orders that the governor could issue to shield workers and authorize hospitals to implement the guidelines.

The draft document also outlines how the health care system should stretch critical resources before moving to ration care.

The guidelines suggest reusing supplies, canceling surgeries that are not absolutely necessary, training staff to perform additional tasks and drawing on stockpiles. The general public's responsibilities include treating certain sick family members at home and monitoring public health messages.

Florida's draft guidelines aim to provide the "greatest good for the greatest number" when doing the best for all patients is no longer possible.

That goal needs to be balanced with an effort to distribute scarce resources in the least discriminatory way, said professor Ken Goodman, who directs the University of Miami bioethics program and the Florida Bioethics Network.

"Among the ways we can do that is to somehow take the evidence about what we think works and bolt it to the values that I think are uncontroversially shared: Namely, life is good, suffering is bad."

He said that methods included in the draft are still imperfect: "It's a very difficult problem to figure out how the world of science can help ensure that our strategies for allocating resources are fair and effective."

Viamonte Ros will have final approval authority and the plan will remain voluntary and subject to review, according to Doc Kokol, the health department's information officer.

The Florida health department's original goal was to have a final draft of the plan ready by December.

But with public health workers scrambling to cope with other aspects of the H1N1 pandemic, that is now unlikely, state officials said.

"People would like to have that policy," said Goodman, who chaired an ethics meeting on these issues at Jackson Memorial Hospital in Miami last week. He said that staff at the hospital have drawn up their own draft plan to cope with a potential surge of patients needing care. Florida plans to accept public input after the guidelines are revised by health officials. Kokol wrote in an e-mail that that "will likely include regional meetings for public input as well as electronic receipt of comments."

In many states, that type of input has been largely absent. Groups of doctors, lawyers and ethicists have hammered out the plans with little engagement with the public or with groups that represent children, the elderly and those with chronic illnesses or disabilities.

When Utah tested a similar plan in late August, the drill revealed difficulties that Florida clinicians and patients are likely to encounter.

Utah family physician Pete DeWeerd had to tell a mock patient's mother that her 7-year-old daughter, who had cerebral palsy and was suffering from the flu, would be turned away from the hospital and likely die.

"I don't like to tell you this," he said he told her, "it feels unfair, but our list is our list is our list." He added: "It was awful. You get a huge lump in your throat."

Dr. Tom Kurrus, medical director of St. Mark's Hospital in Salt Lake City, called it "emotionally draining" when mock patients and family members yelled, screamed and took issue with who was denied treatment.

"The major weakness in our preparedness had to do with security," he said.

Kurrus said that although the exercise was covered widely in Utah's media, the public isn't aware that the disaster plans call for rationing.

"Even with the scenarios played out and the discussions entertained, they still don't understand," he said. "It's, 'Why can't I get into the hospital, why can't grandma get put on a respirator?'"

Goodman, the University of Miami ethicist, said open conversation about the complex, value-laden decisions that will determine who receives treatment in the most extreme circumstances is crucial, and that hospital, state or federal guidelines should always be subject to revision.

"This should be an ongoing process that includes new evidence as it becomes available and that includes, in an open society, the participation of citizens," he said.



View Larger Map

Sources: MSNBC, Politico, Sun Sentinel.com, CDC, Google Maps

H1N1 Flu Vaccine Shots Are Safe...Get Yours! Don't Delay!

(HHS Secretary Kathleen Sebelius: ‘Definitely is a safe vaccine. TODAY’s Meredith Vieira talks to Health and Human Services Secretary Kathleen Sebelius about how the U.S. is preparing for the seasonal flu and the H1N1 virus.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

(Drive-thru H1N1 Flu vaccine shots are being offered nationwide.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

Sebelius: Americans must get swine flu shot

Health and Human Services Secretary Kathleen Sebelius appealed anew Wednesday for widespread inoculation against a surging swine flu threat, calling the vaccine "safe and secure."

Sebelius unconditionally vouched for the safety of the vaccine, saying it "has been made exactly the same way seasonal vaccine has been made, year in and year out."

Appearing on morning news shows to step up the Obama administration's campaign for vaccinations, Sebelius said that "the adverse effects are minimal. ... We know it's safe and secure. ... This is definitely is a safe vaccine for people to get."

Sebelius was asked on CNN about surveys showing many parents were wary of getting their children vaccinated for fear the vaccine has been too hastily prepared and wasn't safe. She replied that it was targeted specifically at the H1N1 virus and was "right on target with an immune response."

The HHS secretary appeared as new cases of the flu, particularly among younger people, have been appearing recently. Some 600 people have died so far from the flu in this country, and the government has targeted roughly 90,000 sites to receive the swine flu vaccine by the end of this month.

"This flu is a younger person's flu," Sebelius said on NBC's "Today" show. "Kids have no immunity to the flu ... children are great carriers of bugs and viruses."

Because of the danger of easy transmission, especially in school and day-care settings, Sebelius said, "We strongly urge parents to take precautionary steps. Flu kills every year ... and we've got a great vaccine to deal with it."

"There's going to be plenty of vaccine," the secretary said. "It's rolling off the production lines right now ... ahead of schedule, and that's good news... By the end of October we should have a substantial amount available and begin to vaccinate a wider population of folks."

Said Sebelius: "There's no question the disease is out there, which is why today we're rolling out PSAs (public service announcements) ... to make sure people take steps to help prevent the spread of the disease, and in the meantime we will push the vaccine out as quickly as we get it off the production lines."

Appearing on CBS's "The Early Show," she said the Centers for Disease Control and Prevention and the President's Advisory Committee on Immunizations have identified five target populations: pregnant women, health care workers, children with underlying health conditions ages 6 months to 24 years, older Americans with underlying health conditions.

"That's a lot of people," Sebelius said. "That's about half the population."

"By the end of this week," she added,"we'll begin to have injectable vaccine also available. We're dealing with five production companies. That's very good news. But the vaccine will become available as the lines clear up. So as soon as we have any vaccine available, we're pushing it out to 90,000 sites around the country. The early going is a little bumpy but we'll have a good supply by October."




Charlotte-Mecklenburg County gets shipment of swine flu vaccine

The Charlotte-Mecklenburg County Health Department on Tuesday received its first shipment of a nasal spray vaccine for the H1N1 flu, but it's too early to know when it will be available to the general public.

Health Department Director Wynn Mabry said the office now has 3,600 doses of the FluMist vaccine with more - including an injection form - expected to arrive in the future.

The health department requested 160,000 vaccine doses.

N.C. officials said Tuesday they ordered 52,000 vaccine doses last week, which will be sent to 102 providers statewide, including counties and hospital systems.

Mabry told county commissioners the health department is reaching out to other medical providers to learn how much of the vaccine is available in the community and how the doses will be distributed.

The nasal spray is recommended for healthy people between the ages of 2 and 49. Pregnant women and those with chronic medical conditions would need the injected vaccine.

Among those to be first in line for the nasal spray, Mabry said, are medical personnel and some child-care providers under 50. He also said the health department wants to be able to serve clients of the federal program that serves low-income women and children.

Mabry said he doesn't know yet when the health department will be able to offer the vaccine to the broader public. He encouraged people to contact their doctors to see whether they have the vaccine. It also may be available to pharmacies in the future.

The county also is working with Charlotte-Mecklenburg Schools and private schools to offer vaccinations to students once more doses arrive.

People with questions about the vaccine can call 311



View Larger Map

Sources: MSNBC, US Dept of HHS, CNN, CDC, AP, McClatchy Newspapers, Charlotte Observer, Google Maps

H1N1 Flu Vaccinations: Is It Safe To Skip Them?

Swine Flu: To Vaccinate or Not to Vaccinate?

With news that the FDA has approved a swine flu vaccine, more and more parents are faced with a dilemma… to vaccinate or not to vaccinate.?

Tammy Reed, of Menifee, California says there's nothing she wouldn't do to protect her one year old daughter Corral but she's beginning to question the protection being offered against the swine flu.

She is worried that the new vaccine hasn't been tested enough and she doesn't want her daughter to be a guinea pig. I spoke with pediatrician Dr. Danelle Fisher, at the St. Johns health center. She understands that some people are skeptical, especially since the vaccine has been manufactured very quickly and many people don't know about it. But she strongly recommends that all children between the ages of 6 months and 5 years get the swine flu vaccine.

Dr. Fisher doesn't think there will be any significant side affects with the vaccine and that it's too great a risk to not get it. But Tammy Reed and more and more parents like her are going against doctor's orders. Tammy says perhaps in the future when there's more research about the vaccine she may change her mind and give it to her daughter.

But right now she's going with her gut which is telling her not to get it. Experts in disease control are concerned that if more and more parents decide not to give the vaccine to their kids this could cause an even bigger crisis and possibly slow the efforts of government officials and medical experts to prevent the spread of another contagious outbreak.

For more info on the H1N1 virus and the new vaccine go to www. cdc.gov



View Larger Map

Sources: KTLA, CDC, MSNBC, Google Maps

H1N1 Flu Seems To Strike Kids 5 Yrs & Older Hardest...Wash Your Hands!

MSNBC----

CDC: Swine flu deaths higher in older kids

80 percent of children who died were age 5 or older, government says.


(Starting a new school year is stressful enough, but now there’s the added worry that your kids could be walking into ground zero for swine flu. What can parents and schools do to ease these concerns.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

ATLANTA - About one in 13 U.S. swine flu deaths have been children and most of the kids have been of school age, the federal government said Thursday in its first study of the new flu's youngest victims.

More than 40 U.S. children have died from the virus since it was first identified in this country in April. The report from the U.S. Centers for Disease Control and Prevention takes a comprehensive look at the first 36 deaths, and found some important differences in the pediatric death toll from swine flu as compared to seasonal flu:

* Normally, half or more of the children who die from flu are age 4 and younger. But more than 80 percent of the kids who died with swine flu were 5 or older.

* Almost two-thirds of the children who died with swine flu had epilepsy, cerebral palsy or other neurodevelopmental conditions. In a previous flu season, only a third of pediatric deaths had those conditions.

* Bacterial co-infections were a big danger, and were blamed in most of the deaths of otherwise healthy children. Co-infections usually occur when a patient, weakened by a virus, then gets hit by a bacterial bug.

The CDC released the report through one of its publications, Morbidity and Mortality Weekly Report.

More than 1 million in U.S. infected

Swine flu has caused more than 1 million illnesses in the United States, the CDC estimates. More than 550 deaths and 8,800 hospitalizations have been reported to date.

It's hard to say whether children have accounted for a higher proportion of deaths from swine flu than they normally do from seasonal flu, though CDC officials say that seems to be true. The CDC doesn't monitor seasonal flu deaths as closely as it does swine flu, and it has no comprehensive count of annual seasonal flu deaths to enable such a comparison.

The new report focuses on lab-confirmed swine flu deaths reported through Aug. 8. The CDC hasn't been able to do as complete an analysis of cases that have come in since then, said Dr. Cynthia Moore, a CDC medical officer who was one of the study's co-authors.

Through Aug. 8, there were 477 total swine flu deaths, including 36 in children.

Only about 20 percent of those children were age 4 or younger. That's unusual: Often 50 percent or more of seasonal flu deaths are in infants and toddlers, who have less mature immune systems and smaller air passages and are generally in more danger from respiratory infections.

"There's a lot of school-aged children" in the death count, said Dr. Beth Bell, a CDC epidemiologist who is a leader in the agency's swine flu response efforts.

Older kids may be more likely to be exposed to virus

It's not clear why such a large percentage of the swine flu pediatric deaths are in kids aged 5 and older. It simply may be because older children were more likely to encounter the virus — at schools, summer camps — than very young children who spend more time at home, Bell said.

The initial numbers in the report are small and the CDC will need to look at more reports to see if the trends hold up, CDC officials said.

Two-thirds of the children who died had high-risk medical conditions. Nearly all of them had an illness related to the nervous system, including mental retardation, cerebral palsy and epilepsy and other seizure disorders.

Years ago experts recognized that children with Neuro-developmental conditions are at higher risk of serious complications from the flu. But the proportion of swine flu victims with that kind of underlying condition was swine flu percentages are high compared to a previous flu season, CDC officials said.

It's not clear how significant that finding is, because many of the children had other medical problems that had weakened their bodies, CDC officials said.

Of the children who were healthy before they got swine flu, many were probably killed by a one-two punch of swine flu working with a bacterial co-infection, CDC officials said.

Bacterial co-infections have been an increasingly noticed danger since the government started tracking pediatric flu deaths in 2004. So their occurrence with swine flu was not a surprise, but emphasized the needs for parents and doctors to be alert to the danger and give the child antibiotics when appropriate, CDC officials said.


View Larger Map

Sources: MSNBC, Day Life, Google Maps

H1N1 Flu Alert: 40% Of Hospitals Not Fully Prepared For Pandemic...Health Care Reform Watch

Huffington Post----

When health facilities ignore the quality-of-care concerns of nurses, whether involving nurse-patient staffing ratios or infection control practices, people die or get ill needlessly.

Now, as reported by the AFL-CIO Now blog, those dangers now face patients who are expected to seek treatment for swine flu/H1N1 virus at many health care facilities, as shown by a new survey of 190 hospital in nine states from California to Maine. The study was done by by the California Nursing Association/National Nurses Organizing Committee.

And now there are early signs that hospitals are starting to fire some nurses who complain about dangerous conditions, the labor group says.

All this comes on top of a disturbing new report by a White House Science Advisory Panel, which last week reported that up to 50 percent of the public could become infected, with as many as 90,000 people potentially dying from the disease.

That adds to as many as 200,000 patients a year who already die from medical mistakes and infections in hospitals each year, according a new series by The San Francisco Chronicle and Hearst Corporation, "Dead by Mistake"

So, given the threat of the pandemic and the ongoing crisis in safe hospital care, it's especially disturbing to see how widespread the lack of an effective response is in the nation's front-line facilities, endangering both patients and staff:

As we approach flu season, a survey of 190 health care facilities in nine states finds a

"disturbing number of our nation's healthcare facilities are not prepared for the coming H1N1/swine flu pandemic."

The survey...found wide gaps in safety gear, infection control training and post-exposure procedures.

* At more than one-fourth of the hospitals, nurses cite inadequate isolation of swine flu patients, increasing the risk of infection to others.

* Nurses at 15 percent of hospitals do not have access to the proper respirator masks, exposing nurses and patients to infection.
* At up to 40 percent of the hospitals, nurses are expected to re-use masks, in violation of Centers for Disease Control and Prevention guidelines.

Instead of responding to these vital concerns, healthcare facilities seem to be ignoring them or, in some cases, firing those bearing the bad news. As a result, according to the AFL-CIO Now blog and other news accounts, nurses took to the street in protest earlier in August in San Francisco:

More than 100 nurses, wearing surgical masks and carrying signs that read "Nurses and Patients Demand Swine Flu Protection," rallied Wednesday at the University of California at San Francisco (UCSF) Medical Center to spotlight unsafe practices in treating H1N1 (swine) flu patients and protecting health care workers and other patients.

The nurses, members of the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC), also protested the recent firing by UCSF of an RN who blew the whistle on unsafe patient care involving swine flu at the facility.

You can learn more about this crisis and the feeble health care industry's response to it at the new In These Times blog on workplace and labor issues.

Sources: Huffington Post, Whitehouse.gov, MSNBC

U.S. Schools Prepare Early For H1N1 Flu Outbreaks

MSNBC----


(US School Districts and Colleges prepare for possible H1N1 Flu outbreaks.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

(The CDC recommends that School Districts screen schools for the H1N1 Flu Virus.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

Hundreds of U.S. schools are heeding the government's call to set up flu-shot clinics this fall, preparing for what could be the most widespread school vaccinations since the days of polio.

On Sunday, the head of the World Health Organization said the world must remain on its guard against swine flu, which has been mild so far but could become more serious as the northern hemisphere heads into winter.

Margaret Chan, on a visit to Tanzania, noted that most people infected with the H1N1 virus had suffered only mild symptoms but it affected certain groups such as pregnant women and people with underlying medical conditions much more severely.

"Looking ahead in the weeks and months ahead, especially for countries in the northern hemisphere, when they will be going into the winter, we need to maintain our vigilance and see how the disease will evolve," Chan told reporters.

In the U.S., an Associated Press review of swine flu planning suggests there are nearly 3 million students in districts where officials want to offer the vaccine once federal health officials begin shipping it in mid-October.

Many more may get involved: The National Schools Boards Association told the AP three-quarters of the districts in a recent survey agreed to allow vaccinations in school buildings.

In South Carolina, "there will be a massive attempt to use schools as vaccination centers," said state Superintendent Jim Rex. He plans at least one vaccination clinic in each of the state's 85 school districts.

South Dakota started offering free children's vaccination against regular winter flu in 2007, and this year it plans to offer both kinds in many schools, said state Health Secretary Doneen Hollingsworth.

Now come the difficult details: figuring out all the logistics in giving squirmy youngsters a shot in the arm or a squirt in the nose.

That's in addition to measures being taken to keep the swine flu virus from spreading inside schools and to keep sick kids at home.

Already, Lee County, Mississippi, schools have reported a few cases of swine flu during the first week of school, and a Louisiana high school football team reported 20 players sick or recovering from it.

To make sure students wash their hands, Minneapolis schools have outfitted every restroom with tamperproof soap dispensers.

Bismarck, North Dakota, is insisting that parents keep feverish children home. "We're going to have to be a little firmer on that this year than in the past," superintendent Paul Johnson said.

Keep schools open

It can be hard to tell if a child has a bad cold or flu — and swine flu and regular flu share the same symptoms. For many schools, a 100-degree Fahrenheit (38-degree Celsius) temperature automatically means sending a child home.

The goal is to keep schools open; federal officials said last week schools should close only as a last resort. The emergence of the never-before-seen flu strain last spring prompted more than 700 schools to temporarily close, giving students an unexpected vacation as parents scrambled to find child care.

The government is urging parents to have a backup plan for caring for their kids in case they are hit by swine flu once the new school year begins.

Health and Human Services Secretary Kathleen Sebelius says parents need to consider alternative strategies for caring for kids who are sick with swine flu.

School officials are already taking preparations to minimize the spread of the flu at schools. One strategy is frequent hand washing. Sebelius endorses the idea that kids should wash their hands for as long as it takes them to sing "Happy Birthday to You" to themselves.

Sebelius spoke Sunday on ABC's "This Week."

Some big states, like California, Ohio and Massachusetts, are focusing on stopping spread and not on vaccinations, because they don't know how much vaccine the federal government will send or when it will arrive. Boston has decided against in-school vaccinations because an attempt at regular winter flu inoculations at a middle school last year flopped, and Dallas officials also have decided against school shots.

But hundreds of districts are preparing for vaccinations. At least 700 health and school officials joined an online seminar last week by the National Association of County & City Health Officials on how to run school flu vaccinations.

The government is awaiting results of vaccine studies that began last week before making a final decision on whether and how to offer swine-flu inoculations. If vaccinations go forward, children are to be among the first in line. They could get vaccine at a variety of places, but federal officials want schools to play a starring role.

"The vaccine over time will be available to every child," Education Secretary Arne Duncan said in an interview with the AP. "And I personally think the best place for them to have access would be at their local school or at a school in their neighborhood."

An AP-GfK poll last month found parents like that convenience: Nearly two-thirds said they were likely to give permission if their child's school offered vaccinations.

The school setting is attractive for many reasons, said Dr. Anne Schuchat of the Centers for Disease Control and Prevention.

Swine flu seems to strike the young most often, and it's particularly easy to spread from child to child. Moreover, school-age children "don't see doctors very often," Schuchat told the AP, after they have accumulated the list of vaccinations required for school entry.

She added that it should be relatively easy for schools to offer flu-shot clinics because the federal government would be buying swine flu vaccine and sending it free to states.

There is plenty of experience with vaccinating school kids for regular flu, and there is plenty of evidence it works.

For the fourth year running, Knox County, Tennessee, vaccinated 30,000 children for free in schools and daycare centers last year. The county often closed schools because of winter flu outbreaks in the past, but it has not since vaccinations began.

There is an important difference with this year's swine-flu inoculations: Health officials think two separate doses, about three weeks apart, will be needed. Studies are under way now to confirm that. If so, it means any school that offers the first shot must set up for each recipient to get the second dose.

Different school districts handle vaccinations differently. Some will offer only vaccine against the regular winter flu — also important, as both types are expected to hit this year. That could be confusing for parents trying to remember which vaccine their child is getting.

Chicago probably will have swine-flu shot clinics at select high schools, not elementary schools, saying it simply doesn't have the workers to send teams to more than 600 schools.

Taking advantage of lead time

In New York City, swine flu exploded in the spring at Saint Francis Preparatory School, which sent home 102 sick kids in one day. Today, City Health Commissioner Dr. Thomas Farley's first choice is for kids to get vaccinated by their own family doctors, but he's looking into clinics at schools or other locations.

"There's an awful lot of children who need to be vaccinated," Farley said.

Once the decision is made to offer flu shots at school, there are still issues to be worked out. Health professionals will need to administer shots and also check kids for reaction to the vaccine.

While educators and health officials decide how best to ward off a stronger strain of the virus in the fall, St. Francis Assistant Principal Patrick McLaughlin said his students may have already learned from experience to be vigilant.

He already noticed the changes: Sharing water bottles at school suddenly became a major transgression. And in 25 years of teaching health class, McLaughlin had never seen students get so excited about communicable diseases.

"I don't want them to come to school being afraid," McLaughlin says, standing by neat rows of empty classroom chairs. "But I do want that awareness ... that knowledge, that it's out there. It could come back. Be ready for it."

No one wants to call the city's outbreak a blessing, but the spring's out-of-season flu invasion did provide a peculiar kind of gift. Now New York City's Health Department and schools are trying to take advantage of the lead time — preparing for a fall season that is expected to be even worse.

The details of the city's swine flu plan are still being finalized by a Health Department panel.

Sources: MSNBC, CDC

WHO Raises H1N1 Flu Pandemic To Phase 6....First Time In 41 Years!...Vaccine

(MSNBC reports on this story.)

Visit msnbc.com for Breaking News, World News, and News about the Economy

MSNBC----

GENEVA - Swine flu is now formally a pandemic, a declaration by U.N. health officials that will speed vaccine production and spur government spending to combat the first global flu epidemic in 41 years.

Thursday's announcement by the World Health Organization doesn't mean the virus is any more lethal — only that its spread is considered unstoppable.

Since it was first detected in late April in Mexico and the United States, swine flu has reached 74 countries, infecting nearly 29,000 people. Most who catch the bug have only mild symptoms and don't need medical treatment.

WHO chief Dr. Margaret Chan made the long-awaited declaration after the U.N. agency held an emergency meeting with flu experts and said she was moving to phase 6 — the agency's highest alert level — which means a pandemic is under way.

"The world is moving into the early days of its first influenza pandemic in the 21st century," Chan said in Geneva.

Dr. Thomas Frieden, the new head of the U.S. Centers for Disease Control and Prevention, said in Atlanta that he does not expect widespread public anxiety in the United States as a result of the declaration, noting it came nearly two months after the virus was identified.

For many weeks, U.S. health officials have been treating it as a pandemic, increasing the availability of anti-viral flu medicines and pouring money into a possible vaccination program. And scientists have grown to understand that the virus is generally not much more severe than the seasonal flu.

"That helps to tamp down any fears that may be excessive," Frieden said at a news conference — his first as CDC director.

Virus spreading rapidly:

But the virus can still be deadly and may change into a more frightening form in the near future, and so people should not be complacent, he added.

So far, swine flu has caused 144 deaths, compared with ordinary flu that kills up to 500,000 people a year.

The pandemic decision might have been made much earlier if WHO had more accurate information about swine flu's rising sweep through Europe. Chan said she called the emergency meeting with flu experts after concerns were raised that some countries, such as Britain, were not accurately reporting their cases.

Chan said the experts unanimously agreed there was a wider spread of swine flu than was being reported.

She would not say which country tipped the world into the pandemic, but WHO flu chief Keiji Fukuda said the situation from Australia seemed to indicate the virus was spreading rapidly there — more than 1,300 cases were reported by Thursday.

In Chile, authorities have identified almost 1,700 cases to WHO.

Many health experts said the world has been in a pandemic for weeks but WHO became too bogged down by politics to declare one. In May, several countries urged WHO not to declare a pandemic, fearing it would cause social and economic turmoil. At the time, WHO said it would rewrite its pandemic definition to avoid announcing one.

But with the recent surge in cases across Europe, Chile, Australia and Japan, the agency was under increasing pressure to acknowledge a pandemic.

"This is WHO finally catching up with the facts," said Michael Osterholm, a flu expert at the University of Minnesota.

David Ropeik, an expert in risk perception and communication at Harvard University, says the word pandemic is less frightening than when emerged during worries about bird flu a few years ago.

He said the "soft buildup" to declaring swine flu a pandemic has been helpful.

"That allows people to get used to what is otherwise a scary word, understand the particulars of the disease, and that should mean reaction will be a little more information-based and a little less emotional," Ropeik said in an e-mail.



Pandemic vaccine

WHO will now recommend that pharmaceutical companies make swine flu vaccine. The agency typically recommends which flu strains drug companies should use in the vaccines. In a global outbreak, WHO also advises whether companies should make pandemic vaccine.

The decision to make pandemic vaccine is a gamble. Most flu vaccine makers cannot make both regular seasonal flu vaccine and pandemic vaccine at the same time. That means they must decide which one the world will need more.

Drug giant GlaxoSmithKline PLC said it could start commercial production of pandemic vaccine in July but that it would take months before large quantities are available.

Glaxo spokesman Stephen Rea said the company's first doses of vaccine would be reserved for countries who had ordered it in advance, including Belgium, Britain and France. He said Glaxo would also donate 50 million doses to WHO for poor countries.

Pascal Barollier, a spokesman for Sanofi-Aventis, said they were also working on a pandemic vaccine but WHO had not yet asked them to start making mass quantities of it.

WHO described the pandemic as "moderate." Fukuda said people should not get overly anxious about the virus. "Understand it, put it in context, and then you get on with things," he said.

Still, about half of the people who have died from swine flu were previously young and healthy — people who are not usually susceptible to flu. Swine flu is also crowding out regular flu viruses. Both features are typical of pandemic flu viruses.

Virus proving to be resilient:

Swine flu is also continuing to spread during the start of summer in the northern hemisphere. Normally, flu viruses disappear with warm weather, but swine flu is proving to be resilient.

"What this declaration does do is remind the world that flu viruses like H1N1 need to be taken seriously," said U.S. Secretary of Health and Human Services Kathleen Sebelius, warning that more cases could crop up in the fall.

Now that a pandemic has been declared, some countries might be prompted to devote more money to containing the virus. Many developed countries have pandemic preparedness plans that link spending to a WHO declaration.

The U.N. is keen to avoid panic. "We must guard against rash and discriminatory action, such as travel bans or trade restrictions," said U.N. Secretary-General Ban Ki-moon.

Fear has already gripped Argentina, where thousands have flooded hospitals this week, bringing emergency health services in Buenos Aires to the brink of collapse during winter weather. Last month, a bus arriving in Argentina from Chile was stoned by people who thought a passenger had swine flu.

China has quarantined travelers, including New Orleans Mayor Ray Nagin, on the slightest suspicion of contact with an infected person.

The U.S. government has already increased the availability of flu-fighting medicines and authorized $1 billion for developing a new swine flu vaccine. In addition, new cases seem to be declining in many parts of the country, U.S. health officials say, as North America moves out of its traditional winter flu season.

Still, New York City reported three more swine flu deaths Thursday, including a child under 2, a teenager and a person in their 30s.

"Countries where outbreaks appear to have peaked should prepare for a second wave of infection," Chan warned.

Sources: MSNBC, Day Life, The Canadian Press, Yahoo News

President Obama's Weekly Address Explains U.S. Government's Role In Controlling H1N1 Virus

"This H1N1 flu has had its biggest impact in Mexico, where it has claimed a number of lives and infected hundreds more. Thus far, the strain in this country that has infected people in at least nineteen states has not been as potent or as deadly. We cannot know for certain why that is, which is why we are taking all necessary precautions in the event that the virus does turn into something worse."

"This is also why the Centers for Disease Control has recommended that schools and child care facilities with confirmed cases of the virus close for up to fourteen days. It is why we urge employers to allow infected employees to take as many sick days as necessary. If more schools are forced to close, we’ve also recommended that both parents and businesses think about contingency plans if children do have to stay home. We have asked every American to take the same steps you would take to prevent any other flu: keep your hands washed; cover your mouth when you cough; stay home from work if you’re sick; and keep your children home from school if they’re sick. And the White House has launched pages in Facebook, MySpace and Twitter to support the ongoing efforts by the CDC to update the public as quickly and effectively as possible."



Sources: Whitehouse.gov, TIME, Youtube

Joe Biden Educates The World On Containing H1N1 Flu Pandemic....You Gotta Love Him

During an interview with Today Show's Matt Lauer "Dr. Joe Biden" educates the world on how to best contain the H1N1 Flu Pandemic.



Afterward White House Press Secretary Robert Gibbs tactfully and ever so politely interprets what "Dr. Joe" really meant to say.



Sources: Today Show, Whitehouse.gov, Huffington Post, MSNBC, Youtube