“Preparedness is really about personal safety: People cannot relate to the term “preparedness” but can relate to the concept of personal safety.Here's the deal: I live in an urban area of California. I'm not realistic danger of wildland fires (unlike some other urban California areas) earthquakes are quite probable
The overall probability of a magnitude 6.7 or greater earthquake in the Greater Bay Area is 63%, about 2 out of 3.
So I have made prudent preparations, in terms of having a kit in my car with water, food, shoes, weather gear and so on. At home, I'm ready for no city-supplied water, no electricity, no gas, and enough foodstuffs on hand for six or seven days.
That's not "panic" -- just prudence.
Which brings us to the current situation, which is the novel H1N1 pandemic. The virus is here in my area. . Family Medicine physician Enoch Choi reported H1N1 "highest they've ever been" on October 12th. Illness means a prolonged absence from work or school:
The new CDC recommendation for most persons states a person can end self-isolation at home when they are free of fever for more than 24 hours (when not taking anti-pyretics such as acetaminophen or ibuprofen). For health care providers and day care workers the old rule still applies: seven days after onset of illness or 24 hours after symptoms are gone, whichever is longer (resolution of symptoms means fever is gone and coughing much less). This gives a good idea of when to return to work, school, and lab testing is not necessary.
Science-based physicians like Dr. Choi are urging those most at-risk (persons 6 months - 24 years, household contacts of infants less than 6 months, pregnant women, persons 25-64 years with chronic medical conditions, health care workers, and first responders) to get vaccinated.
I have gotten the seasonal flu vaccination and I will get the H1N1 vaccine when it is available to people like me (low risk group). I hope to get it before my 3rd grandchild is born in February. I've urged my children to be vaccinated, especially the pregnant daughter-in-law.
I think it is just prudent, as the vaccine is likely to be as safe and effective as the seasonal flu vaccine.Jay Gordon, a Santa Monica pediatrician, has another view. He is generally unenthusiastic about vaccination in his practice:
I do not vaccinate all of my patients and I don't feel that these partially vaccinated or unvaccinated children are at high risk.He does not recommend either the seasonal flu vaccine or the H1N1 vaccine for children:
I also won't be giving the flu shot to the kids and parents in my practice unless there are extraordinary risk factors. I anticipate giving none at all this year. I doubt that there will be any really large problems with the vaccine, but I also doubt any really large benefits. As I said, I think that this year's version of this particular H1N1 is as "mild" as it will ever be and that getting sick with it this year will be good rather than bad. The chances that a new "flu shot" will be overwhelmingly effective are small.and
I don't think that this year's pair of flu vaccines will create disasters but I also don't think that they're a good use of our health care dollars. They are definitely not worth the amount of media and medical attention they've received and continue to receive.
Dr. Gordon feels that the "media" and physicians recommending the H1N1 vaccines are indulging in "scare tactics" and are not acting with integrity.
Over the weekend, I tweeted the story of Attila the Mom's son, who has been hospitalized since October 23 with complications from H1N1 infection.
It is exactly this kind of absurd, exaggerated rhetoric (not from our Peachheader, but from the doctor she's quoting) that is creating anxiety and fear and making it harder to make an informed intelligent decision.
Dr. Gordon replied this morning with the following tweet
What is worth pointing out is the Attila the Mom's story is a first-person story -- a mother detailing for family and friends the day-to-day struggles of her son to survive. What is immoral about that? Who is "panicking" -- Attila the Mom certainly is.
Well, Jay Gordon and I disagree on the value of vaccination. We also evidently disagree on citizen journalism.
Steven Novella, M.D. analyses Dr. Gordon's vaccine views in Dr. Jay Gordon -- Anti-vaccination David Gorski, M.D., wrote a lengthy description of Dr. Gordon's views in Dr. Jay Gordon and me: Random encounters with an apologist for the antivaccine movement