Staying healthy this fall  is everyone’s business

Updated 8:52 PM Saturday, November 14, 2009

As the health commissioner, I often ponder, “What is the right thing to do for the community?” I also have to decide what is the right thing to do for my family. These two worlds converge when it comes to the H1N1 flu. As the health district advises the community on how to protect themselves and their loved ones this flu season, I am forced to ask myself if I am prepared to follow my own advice.

Over the past 11 months, I have watched my youngest daughter transition from a sleeping infant to an adventurous explorer who seems ready to investigate and conquer every corner of her world, in an effort to satisfy a never ending curiosity.

Reflecting on the process that allows her to learn new skills on a daily basis, I am amazed at the young age in which she started to comprehend that she is part of something much bigger than herself. An infant learns early that a cry can bring a response from a comforting mother, that a smile can cause much positive attention from her doting sisters, or that the accomplishment and repetition of a new skill can bring rounds of applause from almost any of her familiar crowds. The sense of interconnectedness and the recognition of the cause and effect principles are basic assumptions to navigating our world.

Circumstances such as H1N1 influenza provide us with the opportunity to recognize our remarkable interdependence on each other. Every individual has a role in the health of this community and the experience of H1N1 is no exception. Disease mitigation requires that we recognize that our actions are never without a reaction, and that we can make a difference in the health of our neighbors through self-isolation, vaccination and community engagement.

Self-isolation

Will my family and I stay home from work, school or day care if we are sick? Absolutely. It is our responsibility to protect our friends, neighbors, and co-workers. While the common H1N1 prevention messages of respiratory etiquette, staying home when ill, and hand washing may have already reached their peak of effectiveness, I am concerned that we have not acted to plan for the application of these messages.

The Centers for Disease Control and the World Health Organizations have been diligent in providing much guidance to prompt individuals, agencies and organizations to anticipate doing business by means of alternative solutions. The simple act of “staying home when ill” is more than an individual decision on the part of the person experiencing symptoms. Self-isolation due to illness is only possible with the support of the workplace or the faculty, the professor or the school teacher, who understands that the cost of a person with symptoms transmitting that disease is far greater than an interruption in the schedule that may be caused by an absent worker or student.

It is true that the world will not stop turning for H1N1 and that business must go on. Although there is an inclination to do business as usual, the use of technology enabling people to work from home, the preparation of policies or procedures, and planning for a reduction in workforce due to illness, are all discussions which should be occurring within agencies and organizations at this time. Decreasing disease transmission in our community is not up to the medical community or public health, it is up to you.

Vaccination

Will I make certain that all of my children are vaccinated against both seasonal and H1N1 flu? Absolutely. Will that include my 10-month-old daughter? Most certainly.

Immunization against H1N1 will offer some protection for our community. There has been much research and analysis completed to identify characteristics of the H1N1 disease. Based on this information, the vaccine will initially be targeted to certain groups within our population.

It is important to recognize that the priority groups for the first opportunities for vaccination are identified based on severity of disease within those groups or the potential for spread of disease due to occupation. It is the duty of H1N1 vaccine providers to follow the CDC recommendations regarding priority groups: pregnant women, parents and household contacts of infants under 6 months, health care providers and emergency medical services personnel, people age 6 months through 24 years, and older adults (25-64) with chronic medical conditions.

If vaccine supply is insufficient, a subset of these groups may need to be prioritized. Expansion of these groups will most likely occur, but it will depend on how the disease progresses and the characteristics of the disease. Unlike some other medications, vaccination for any disease not only has the unique characteristic of protecting an individual, but the effect that is equally impressive is the protection afforded to the people that are in contact with the vaccinated individual. That vaccinated person is now unlikely to become infected and transmit the disease to others.

For example, infants who are too young to receive the vaccination can be protected if their caregivers and household contacts receive the vaccine. You can affect the amount of protection others receive from the vaccine through your commitment to supporting appropriate vaccination strategies now that the vaccine is becoming available. We believe that we will have enough H1N1 vaccine for everyone. The individuals in the target groups, those who are most vulnerable, need to receive it first.

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