90,000 Swine Flu Deaths? Possible, Not Likely

'Plausible Scenario' From President's Panel Is 'Not a Prediction'

By Daniel J. DeNoon
WebMD Health News

Reviewed By Louise Chang, MD

Aug. 25, 2009 -- Could H1N1 swine flu kill 90,000 Americans this winter and hospitalize 1.8 million? Yes -- but not likely, CDC officials say.

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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.

SOURCES: Anne Schuchat, MD, director, National Center for Immunization and Respiratory Diseases, CDC, Atlanta. Kathleen Sebelius, secretary, Department of Health and Human Services, Washington, D.C. Influenza Workshop for Journalists, CDC, Atlanta, Aug. 24-25. Report to the President on U.S. Preparations for 2009 H1N1 Influenza, President's Council of Advisors on Science and Technology, Aug. 7, 2009.

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