Posted by Sarah, a resident of the Midtown neighborhood, on Apr 27, 2009 at 3:14 pm
I notice that there are 2 kinds of people at work. One group doesn't wash their hands after using the bathroom. The other group grabs an extra paper towel after washing their hands and uses the towel to avoid directly touching anything that the first group might have touched. Pretty comical.
Posted by Rush, a resident of the Midtown neighborhood, on Apr 27, 2009 at 4:40 pm
The Democrats tried to include pandemic flu preparations as part of the Pres. Obama's economic recovery program, partially because a pandemic while people were out of work and without medical insurance could be catastrophic. Karl Rove and Senator Susan Collins actively fought this funding. Here is an article that Karl Rove wrote for the Wall Street Journal:
Posted by Walter_E_Wallis, a resident of the Midtown neighborhood, on Apr 27, 2009 at 4:52 pm Walter_E_Wallis is a member (registered user) of Palo Alto Online
I believe wash basins should be outside restrooms, so persons leaving the room would be seen to wash or not wash their hands. If your restaurant does not have a wash sink at the entrance to the preparation area, eat elsewhere.
Posted by martina, a resident of the Old Palo Alto neighborhood, on Apr 27, 2009 at 5:10 pm
i wonder if people are going to think twice about going to a mexican restaurant right now while this is happening for fear someone working there brought the virus back? also when going into any bathroom the places where germs are most at are the handles so no matter how much you wash your own hands then whoever didn't before you is now on your hands and when you unconsiously touch/rub/scratch, etc., your face you can catch the germ that way....not to mention in an elevator or shopping center (walmart and costco are always sooo crowded).
Posted by Gary, a resident of the Downtown North neighborhood, on Apr 27, 2009 at 5:38 pm
This is an interesting case where big pharma might come to the rescue. Tamiflu is produced and marketed by Roche. The leftiies hate big pharma, but it should be interesting to see if any of their children agree to take Tamiflu, if they get infected.
Posted by Pablo, a member of the Palo Alto High School community, on Apr 27, 2009 at 6:08 pm
Martina, most of the people bringing the disease back into the U.S. are the tourists who probably just traveled to Mexico for Spring Break. It doesn't matter what kind of restaurant you're in, if someone contagious is in there you will get the flu. You will probably be more likely to contract it from sitting next to a table seating someone with swine flu then getting it from a cook.
Posted by Mark, a resident of the Downtown North neighborhood, on Apr 27, 2009 at 11:44 pm
Perhaps Lytton Gardens should tell us what influenza strain is affecting their residents in their nursing facility (reported by the PA Onlinelast week). Rather unfortunate coincidence that the small outbreak happened there in addition to the Swine Flu outbreak in Mexico.
Posted by Wife of M.D., a member of the Palo Alto High School community, on Apr 28, 2009 at 12:06 am
You are wrong. A person could be sitting a table away from someone and not catch their virus. But cooks touch the food and if the food is not cooked (i.e. lettuce, tomatoes, unmelted cheese) then their germs can be transfered to the food and then the patron eats the food along with the germs. Voila! Successfully passed on!
Or if a waiter has germs on his hands and you drink that glass of water and then pick up your taco to eat, get sauce on your fingers, then lick your fingers, BINGO! Another successful transfer!
Question is how long the virus lives, and I'm guessing it doesn't die quickly. I'm eating at home if this virus hits Santa Clara County.
Posted by A Palo Alto parent, a resident of the Duveneck/St. Francis neighborhood, on Apr 28, 2009 at 7:42 am
There are two cases of suspected swine flu being tested in San Jose today (one a case of a man just back from Mexico who was so ill he delayed coming home to SJ), and some cases in Santa Cruz suspected. I'd like to hear a specific plan from Santa Clara County about how near verified cases will need to get before they start talking about closing the schools. Schools are the primary places something this contagious can be spread.
They have great plans for when it's obvious the flu is in stage 6 (which according to WHO's description is already here, but for some reason they haven't raised the level to reflect this), but no clear way to evaluate these days when the uncertainty is still high.
Posted by anonymous, a resident of the Duveneck/St. Francis neighborhood, on Apr 28, 2009 at 4:17 pm
I have to agree with you, a Palo Alto parent.
I am no longer a PAUSD parent but I have relevant input.
I received an email abaout swine flu from my older child's college. They only very occasionally send out emails to all the parents, and I did find this one reassuring (they are monitoring the situation in New York, the college will take steps to isolate any ill students, etc. -- all very responsible-sounding).
Posted by A Palo Alto parent, a resident of the Duveneck/St. Francis neighborhood, on Apr 28, 2009 at 5:17 pm
That's not an accurate number on the average number of seasonal flu deaths per year. For some bizarre reason, the CDC bundles ALL flu and pneumonia deaths from any kind of pneumonia, with or without flu symptoms. Most of those deaths are elderly people who are dying and simply die of pneumonia before they have multi organ failure.
So the three members of my family who died in recent years of underlying heart failure, pneumonia without any flu, and old age with immediate cause of death being pneumonia, were all counted as "flu deaths".
Posted by A Palo Alto parent, a resident of the Duveneck/St. Francis neighborhood, on Apr 28, 2009 at 5:40 pm
From the Merc:
As Santa Clara County recorded its first likely case of swine flu Tuesday, Gov. Arnold Schwarzenegger declared a state of emergency and public worry about the viral outbreak grew.
The Santa Clara County case involves a 16-year-old San Jose girl who recently visited Southern California. She is staying at home under voluntary isolation. Local health officials' announcement of the "probable" case was the third likely Bay Area case announced Tuesday. Along with two other probable cases in Marin County, further testing must be done to confirm that the infections are the same strain of flu that has sickened hundreds of people in Mexico and around the world.
Posted by jardins, a resident of the Midtown neighborhood, on Apr 28, 2009 at 6:24 pm
One of the two deaths in L.A. County was NOT from swine flu. The cause of the other death is still being investigated. You need to wait for FACTS to emerge before you write publicly. Spreading panic is NOT helpful!
Posted by hyperbole, a resident of the Crescent Park neighborhood, on Apr 28, 2009 at 9:43 pm
"That's not an accurate number on the average number of seasonal flu deaths per year. For some bizarre reason, the CDC bundles ALL flu and pneumonia deaths from any kind of pneumonia, with or without flu symptoms. Most of those deaths are elderly people who are dying and simply die of pneumonia before they have multi organ failure."
You'll find that's the same for the 159 deaths in Mexico. Kind of surprising there have been no deaths in any other country.
Posted by Sharon, a resident of the Midtown neighborhood, on Apr 29, 2009 at 7:08 am
President Barack Obama said on Wednesday that the first U.S. death from a new strain of swine flu showed it was time to take "utmost precautions" against its possible spread.
He urged state and local health authorities to be vigilant in detecting and reporting possible new cases and asked schools to consider closing if they have confirmed or suspected cases of the virus.Web Link
WHO is poised to declare level 5 out of 6 for a pandemic, and California is in a state of emergency. I'm going to call the school district today to ask whether they have any plans for closing the schools if we reach level 5 and 6. There should be a clear statement from the school district about their criteria for closing the schools.
Posted by A Palo Alto parent, a resident of the Duveneck/St. Francis neighborhood, on Apr 29, 2009 at 1:28 pm
From WHO website:
PHASE 5: Human-to-human spread of the virus into at least two countries in one WHO region. Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.
PHASE 6: The pandemic phase, characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Indicates a global pandemic underway.
(My question is: at what level is the planning being implemented for our community? Is it the county, state, city? Where is the communication?)
Posted by A Palo Alto parent, a resident of the Duveneck/St. Francis neighborhood, on Apr 29, 2009 at 2:09 pm
AIDS isn't contagious on a community level, which means you can catch something easily from touching objects that are contaminated, or get it from airborne germs. WHO doesn't rate AIDS/HIV on their pandemic scale.
Posted by Me, a resident of Mountain View, on Apr 29, 2009 at 2:20 pm
Nobody can say people is prepare because not even the hospitals are prepared when you go there 2 days ago to ask about any protocol and they tell you "I dont know", or "No we do not have that kind of masks" or "There should be much more cases for anything to be done".
And when you have to make a trip you call to the airline and they tell you almost the same like, "No do dont have any protocol to follow" and you ask them, ok, do you have any recomendation for passengers to follow and answer you, "No we do not have"
These conversations happend in Kaisser center Mountain View
I am from Europe have to say and overthere they started taking steps from sunday night already, maybe because of the experience from birds flu and mad cow, and everybody know to tell you what to do and where to go.
Posted by Michele, a resident of the Greenmeadow neighborhood, on Apr 29, 2009 at 6:00 pm
Please let's not lose sight of the facts that this flu has not been fatal in the U.S., except the child who was from Mexico who died in Houston. Also, it is treatable with Tamiflu. The 1918 flu was not treatable.
Not to minimize the discomfort and problems flu brings but let's keep it in perspective.
Posted by Etiquette First, a member of the Palo Alto High School community, on Apr 29, 2009 at 7:13 pm
The danger is people who have poor etiquette. No matter what the warnings are, there will still be people who will cough and sneeze without covering his/her mouth and nose. Just like the regular cold and flu that speads in grocery stores, offices, schools, etc. this dangerous influenza is far worse then the normal seasonal cold's and flu we are use to and should be treated as such.
You don't see people going around with masks during our normal flu season. Masks at the airports, etc. press conference after press conference. I, for one, will not panic, but I also will not be eating out or being in large crowds unnecessarily. The last few restuarants I have eaten at had dirty silverware and unclean looking dishes. What's up with that. What happened to the high-powered dishwashers these places once used.
Posted by Close em, a resident of another community, on Apr 29, 2009 at 10:02 pm
Closing the schools for a week or two would be ideal. School buses, hot class rooms, and gyms are a breeding ground for this to spread. Not to mention school sports where contact with the opposing school is vital...let lone sitting in the stands watching the game.
Posted by Peter Carpenter, a resident of Atherton, on Apr 30, 2009 at 4:17 am
I am repeating and adding to an earlier comment - it is ESSENTIAL that individual citizens have access to good advice as to how to prepare for a pandemic - even if the pandemic either doesn't come or is very mild.
Hopefully, the current influenza outbreak will be both geographically limited and have a low mortality. However, we are incrementally closer to a pandemic than we were two weeks ago and no one can accurately predict what will happen to either the virulence or the spread of this new flu virus.
However, if this new strain spreads widely and has a high mortality rate then we need to realize that the resources of both government and the private sector will very quickly be exhausted and will not be easily replenished. True resilience in the event of a highly virulent and high mortality pandemic depends upon individuals and families being prepared to be self sufficient.
In prudent preparation for such a worst case scenario we need to start now educating our employees and other citizens about how they can be better prepared and what they can do if and when government and other resources are no longer available. Unfortunately, once we reach the stage of a widespread pandemic we will also have lost the lead time necessary to educate individuals. Most government and business pandemic plans focus solely on the role which those institutions can play in performing their functions and fail to address, expect very superficially (wash your hands, etc.) on what individuals should do both to be prepared and to be self sufficient when external resources are no longer available.
You and your family and friends may therefore find this Citizens' Guide to be useful:
Posted by A Palo Alto parent, a resident of the Duveneck/St. Francis neighborhood, on Apr 30, 2009 at 6:36 am
A note on masks: there's no evidence that they do any good to prevent the spread of the flu, and they may even lull people into a false sense of security. Hand washing, social isolation and shielding sneezes are better bets.
About Tamiflu: if used within 48 hours of first symptoms it may help alleviate some of the syptoms, but it's in no way a cure for the flu. Also, some people have very adverse effects from Tamiflu, so for some it will be a matter of the benefits outweigh the detriments. If you get the flu and take Tamiflu within 48 hours of first symptoms, you may have lessened symptoms and a quicker recovery, but there are no guarantees.
As Tamiflu gets widely used, the virus will very likely adapt to it and become resistant, so no one knows how long this particular virus will be sensitive to it.
Posted by Resident, a resident of Another Palo Alto neighborhood, on Apr 30, 2009 at 9:07 am
I don't like the advice to cough and sneeze into your sleeves (particularly for kids). We need to use fresh kleenex and then throw them in the trash. I don't want snot covered sleeves on my kids' clothes. The message they are getting is that it is ok to wipe runny noses on clothes. All my years of telling them to use kleenex is being wasted as I have seen the state of my kids sleeves.
We need to get kleenex boxes, put saranwrap on the outside, instruct the kids to pull a fresh kleenex each time without touching the box, and don't use their clothes.
We also need to use the wipes provided by Safeway and other stores on our grocery cart handles and also on our own hands before entering the aisles. Don't touch an item on the shelves unless you are going to put it in your cart. I am concerned about buying any produce that has probably been touched by hand. All produce that has skins should be removed by parents and untouched until the child eats it (not bananas) and go for bagged lettuce, etc. As the produce probably arrives on our shelves with plenty of precautions, we have no idea how many hands may have touched the apple or bunch of brocolli.
I am washing everything well and cooking vegetables more than usual rather than eating raw salad.
Posted by Floyd, a resident of the Green Acres neighborhood, on Apr 30, 2009 at 9:18 am
It's been more than three years that our first action when we sit at a table in any restaurant is to use our packets of hand sanitizer. We wash our hands at home as the first action when we come in, for many years now. Maybe it could be considered obsessive but I wipe the steering wheel of my car also. I've carried my own pen for many years to sign credit card purchases ( not the store's pen) for years but the new style electronic signing requires the use of the store's wand (used by everyone) which bothers me. I hope it all helps.
Posted by jayjan, a resident of the Meadow Park neighborhood, on Apr 30, 2009 at 9:23 am
THIS BELOW IS FROM THE NEW YORK TIMES
This is unprecedented and Santa Clara county now has 7 supsected cases.
WHAT ARE THEY WAITING FOR!!!!!!!!!!!!!!
SHUT DOWN THE SCHOOLS NOW!!!!
The teachers dont want to come if the kids are sick but have to if the district forces them.
This is a level 6 unprecedented global pandemic and PAUSD is out to lunch.
It is not unreasonable to do this. CDC has actually said it a good idea. Here we are in the thick of it.
I personally dont think it wise to wait until a kid gets sick before shutting down the schools.
If it is done district wide for two weeks only, then we working moms have a reason to not go to work and can negotiate with our employers,
If the district sits on their hands in the usual bad decision making way then slowly this will grind us down.
ALL WE NEED IS TIME they will develop a vacine we just need to survive the next few weeks.
The fallback position, experts said, is mitigation, the use of “nonpharmaceutical measures.” They include personal ones like washing hands and wearing a mask, occupational ones like working from home or arranging care for children who are sick or whose schools close, neighborhood-level ones like closing theaters, museums or restaurants, and metropolitan-wide ones like shutting a school system or canceling a major league ballgame
Posted by chaffy, a resident of the Leland Manor/Garland Drive neighborhood, on Apr 30, 2009 at 9:31 am
This is what Joe Biden said.
When the going gets tough the tough get going. I expect the president is keeping his girls home although we wont hear about it.
I think they should officially close the schools too. It is in our county and that is enough. Schools are the major vector. The virus lives for 10 days in children 5 only in adults, plus children are not
good at "social distancing"
Asked on NBC's "Today" show whether the U.S. government should close the border with Mexico, Biden said health authorities advise that would be impractical and noted the new flu is already in the U.S. and several other nations.
Instead, Biden said, the focus should be on slowing the spread of the virus through groups of people in close quarters, such as airplanes, malls, stadiums and classrooms.
"Closing the classroom and closing the border are two fundamentally different things
Posted by A Palo Alto parent, a resident of the Duveneck/St. Francis neighborhood, on Apr 30, 2009 at 9:32 am
I suggest that anyone who thinks it would be a good idea to close the schools for 7-10 days call their principals and/or the district office to leave messages to that effect. At least the administrators would know where parents stand on this. The worst thing that could happen is that for a week or two the kids do their lessons from home via email and computers, and even get their lectures on youtube and the community TV station. Where's our Palo Alto know-how?
Posted by rufous, a resident of the Barron Park neighborhood, on Apr 30, 2009 at 9:34 am
Whether you like the advice or not, health professionals agree it is far more sanitary to sneeze into your sleeve where the germs will desiccate and die. If you use a tissue, you still contaminate your hands. I just haven't met many kids (or adults) who are so well trained that they wash their hands for 20 seconds with soap *each time* they cough or sneeze. I also haven't met many kids (or adults) who actually have tissue handy when they're running on the playground or riding an elevator or walking down the grocery aisle and suddenly need to sneeze or cough.
Now, if you're talking about someone who is already home sick, that's completely different. Sure, they can sit on the couch or in bed with a whole box of tissue. If your kids are generating so much snot that it's visibly covering their sleeve every time they sneeze, then they are too sick to be out and about and you can keep them home with their box of tissue. But for the vast majority of coughs and sneezes, a sleeve is the best place.
Consider your grocery store scenario. You're walking down the aisle when you are overcome by a need to sneeze. (Maybe it's just allergies -- it doesn't have to be something so serious as the flu). What do most people do? "Politely" sneeze into their hand so as not to spray germs everywhere. But two seconds later they have their hands on the cart handle and a minute later (fresh germs still on hand) they open the freezer door to grab a bag of frozen peas and another minute later they're handling produce to find the unbruised apples. Or maybe they're a really prepared person and they pull out a tissue, sneeze into it, crumple it up and shove it in their pocket. How many of those people do you know who actually abandon their cart, figure out where the restroom in the store is, and go wash their hands for the CDC-recommended 20 seconds with soap before touching a single other thing in the store? I have never seen anyone do this, but I sure have seen the sneeze/touch cart/touch freezer door/touch produce scenario hundreds of times.
On the other hand, if you sneeze into the fabric in the crook of your elbow or your shoulder, you not only stop the spray of germs, but also haven't contaminated your hands, so you won't spread germs to the produce, your cart, or the bathroom door handle when you touch them. And if you happen to get a little snot on your sleeve in the process -- well that's why man invented washing machines.
Posted by Full spectrum of opinions, a resident of the Barron Park neighborhood, on Apr 30, 2009 at 10:18 am
Interesting point of view from the LA Times: Web Link
Money quote: "In fact, the current outbreak of the H1N1 virus, which emerged in San Diego and southern Mexico late last month, may not even do as much damage as the run-of-the-mill flu outbreaks that occur each winter without much fanfare."
Posted by Sharon, a resident of the Midtown neighborhood, on Apr 30, 2009 at 11:15 am
In 2006 Warwick McKibbin and Alexandra Sidorenko found in a study for the Lowy Institute for International Policy in Sydney that even a mild pandemic could shave 0.8% off world GDP.
For the worst possibility they considered, the drop would be a staggering 12.6%.
They reckon a pandemic similar to the one that began in 1918 would reduce growth in the American economy by 3 percentage points and in Japan by 8.3 points.
Roughly comparable numbers emerge from a study by economists at America’s Congressional Budget Office (CBO), which found that a Spanish-flu-like pandemic would lower real GDP growth in America by about 5 points.
Even a milder episode would lead to a 1.5-point drop.Web Link
Posted by you know im right, a resident of the Midtown neighborhood, on Apr 30, 2009 at 12:52 pm
Get a handle on the immigration problem, slam the door on the mexican emigrants. Why does the united states have to take on the rest of the worlds disease ridden country cause they were to poor or to stupid to inoculate their kids.
Posted by Resident, a resident of Another Palo Alto neighborhood, on Apr 30, 2009 at 1:10 pm
Closing our elementary and even middle schools may or may not be a good idea, but I think our high schools should stay open as long as we can. STAR testing is irrelevant, but for many high schoolers, this is AP test and SATs time and these kids need to be in school and getting ready for these important exams. These age kids should be at a better developmental stage to take the hygiene precautions that the younger ones don't.
Posted by rufous, a resident of the Barron Park neighborhood, on Apr 30, 2009 at 1:14 pm
I particularly liked this quote from Full Spectrum's link:
"A pandemic relates more to geography ... not severity," noted Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta Hospital.
Which is not to say that I think we should *ignore* the pandemic, just that we shouldn't overreact, panic unnecessarily, or assume that if it hits our community we'll all die.
"Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world," said the Canadian-educated official.
I'm sure this one will hit Level 6 soon (outbreaks in at least one other country in a different WHO region in addition to the 2+ countries in the current WHO region that are affected). But the level just indicates how wide-spread is in the world, not how dangerous of a virus it is.
Yes, this is more contagious than the average flu, and we should do everything we can, within reason, to slow the transmission, but it is not shaping up to be any worse of an illness than the average flu. I certainly have no desire to catch it, or any other virus, but I don't think closing schools or businesses where there are no active cases is the right answer.
I like to watch the national flu map. But if you are of a paranoid nature, you'd never leave the house. Look at how rampant the flu was in the beginning of March:
Outbreaks of either laboratory-confirmed influenza or ILI (influenza-like-illness) were occurring in geographic areas representing more than 50% of the country's population. And people were DYING from this!
Wash you hands, get outside, and get some fresh air!
Posted by Resident, a resident of Another Palo Alto neighborhood, on Apr 30, 2009 at 3:38 pm
I concur you are probably right about sick kids not going to school and also the occasional sneeze and cough particularly in grocery stores. But I am not sick and yet I know that in this cool weather we have at present, while I am outside exercising, my nose runs and nothing in my fiber would make me feel comfortable wiping my runny nose on my sleeve while I have a clean kleenex in my pocket. Just call me old fashioned.
Posted by jb, a resident of the Leland Manor/Garland Drive neighborhood, on Apr 30, 2009 at 5:47 pm
Sharon, You asked what you might be missing in the flu info and calculations. It might be this: The disease is fatal most often to the elderly and the very young. AS far as I know, there has been no consistent breakdown for the ages of the ill so far. The death in Texas was a 22-month-old who had come from Mexico.
Mark, the illness at Lytton Gardens was norovirus, not influenza. It is the bug that steers cruise ships into port when it breaks out amongst the vacationers. It has been found in several continuing care facilities in the last few years.
Posted by jb, a resident of the Leland Manor/Garland Drive neighborhood, on Apr 30, 2009 at 6:17 pm
Sheesh! AS I read these posts again, they sound like genuine panic. Have some faith in the herd. We are 300,000,000 strong in the US. One million of us could get sick and die and hardly be noticed. And those of you worrying about the GDP, get a hobby. All this worrying is probably worse for you than any sickness you could contract in the next month.
Good health to everyone. Hug your kids and read to the whole family. Buy stock in Kleenex if it makes you feel better.
Posted by Me, a resident of the Downtown North neighborhood, on Apr 30, 2009 at 9:21 pm
I lived through a really nasty flu in Sydney Australia about 15 years ago. Then young and healhy, my friends and I were absolutely flattened. One 30 year old guy got diabetes after that, and strangely another, clinical depression. Before neither had a trace of these things.
Both think that it was some massive overeaction to this terrible virus.
So yes. DOnt think its just babies and old people. Babies and old people are absolutely tragic enough but this case is likely to be the fit and well (palo altonians!) whos immune systems go mad, and may as far as my unmedical knowledge goes, stay mad!
Posted by Peter Carpenter, a resident of Atherton, on Apr 30, 2009 at 11:12 pm
I am in Israel and they have instituted the following policies:
1 - no official travel to Mexico
2 - at Ben-Gurion Airport a special clinic, manned by doctors with expertise in infectious disease, has been set up to examine all those who say they have just been to Mexico, where the outbreak began last week. The ministry will continue to monitor people who were in Mexico in the past week and ask them to remain at home in case they develop symptoms of fever, respiratory problems and coughing in the next few days.
3 - tourist and business travel to Mexico is advised against
4 - The Defense Ministry has asked all government ministries to prepare lists of "essential staff" who would be required to continue working if swine flu evolved into a nationwide epidemic.
Posted by A Palo Alto parent, a resident of the Duveneck/St. Francis neighborhood, on May 1, 2009 at 9:49 am
Kids now call the move when you sneeze or cough into your inner elbow "the Dracula cough". Nice, easy way to remember.
A note on alcohol gel cleansers: it's true they won't directly kill viruses, but they work in a similar way to regular soap, they scrub the very top layer of skin cells off your skin, taking germs with it. That's why your skin feels so dry when you wash a lot. You can use moisturizers for that.
Posted by rufous, a resident of the Barron Park neighborhood, on May 1, 2009 at 9:58 am
I don't mean to imply (nor do health professionals recommend) that you wipe your runny nose on your sleeve! That would be gross. By all means, use a tissue. (But toss the tissue in the trash and wash your hands after, of course). The sleeve is just for coughing and sneezing. With a runny nose you have time to think and time to grab a tissue. With a sneeze or cough, there usually isn't time. We want the instinct to be to "do it in your sleeve" rather than to cover it with your hands (or not to cover it at all).
Posted by Think, a resident of Another Palo Alto neighborhood, on May 1, 2009 at 11:53 am
Re: people with stronger immune systems having higher mortality.
It's important to make observations but dangerous to take action based on speculation as to the cause. People with stronger immune systems supposedly are getting sicker than people with weaker systems. That's an important observation to make.
It is dangerous to assume that this is because of something about the immune system. If one assumes this and gives immune suppression because of it, then it will be the wrong step and and a dangerous experiment on people.
What if people with stronger immune systems face higher mortality because they take longer to slow down and take care of themselves, or take longer to realize they have contracted something -- and thus are sicker by the time they realize they are sick, have a more aggressive stage of disease by the time they take the important measures they need to combat the virus, etc.?
In that case, the best step is to do the harder work of getting people who are very healthy to be as protective of their health as people who are not. The best response is a public health measure -- which frankly has less risk and fewer down sides than treating with immunosuppressants to see what happens.
Posted by Think, a resident of Another Palo Alto neighborhood, on May 1, 2009 at 11:58 am
P.S. I did not mean to imply that immunosuppressants won't play a role, by the way, but if the supposition on which their use is based is wrong, people could be killed who might otherwise have survived. I only meant to say that we should be aware of the difference between our observations and our suppositions, and looking at all of our options when we act. We should act first on those things that are most likely to be helpful without being dangerous. (First, do no harm.)
Posted by jb, a resident of the Leland Manor/Garland Drive neighborhood, on May 1, 2009 at 5:12 pm
Just a thought. Could the young and hale be dying of A(H1N1) in Mexico because Mexico City is at least a mile in altitude and has some of the dirtiest air in the world. Being the ones out working could overtax lungs that are already weakened in the young and healthy. Plus being out and about makes more chances for exposure.
Posted by Martin, a resident of the College Terrace neighborhood, on May 3, 2009 at 4:40 pm
I have a good friend who works at Stanford and says 5-7 colleagues are out of work with the flu. None has gone to get him/herself tested. Meanwhile, my daughter has several friends in high school who are sick. And yet ... Palo Alto has no reported cases of swine flu? I suspect a cover-up. Jump on me everyone, if you like. I'm just sayin'. It takes several steps to get a report. First, the suffered must go in. Second, the health care provider must test. There is a level of superiority and arrogance in this town that I think will serve to suppress reporting both by sufferers and by the health establishment. Go to PAMF's web site and all you see if self-congratulatory boilerplate assurances about the measures they are taking. No statistics, no data, no reports on recent respiratory cases. Meanwhile, tiny towns in Wisconsin, and Minnesota, are reporting cases. Yet with all the travel between Palo Alto and Mexico, not a single case? Give me a break!
The head of the World Health Organisation hit back at critics who have accused it of over-reaction to the swine flu crisis, warning it may return “with a vengeance” in the months ahead.
In her first extensive media interview since alerting the world to a potential flu pandemic nine days ago, Margaret Chan, the agency’s director-general, told the Financial Times that the end of the flu season in the northern hemisphere meant an initial outbreak could be milder but then a second wave more lethal, as happened in 1918.
Posted by Martin, a resident of the College Terrace neighborhood, on May 3, 2009 at 6:00 pm
You missed my comment about cases popping up in remote areas of Wisconsin, Michigan. Go to this site and see how many locales are reporting confirmed cases (meaning someone cared enough to get him/herself to a doctor, and the doctor cared enough to send the test to the CDC), and ask yourself how Palo Alto could have zero at this point.
Posted by Erin, a resident of the Leland Manor/Garland Drive neighborhood, on May 3, 2009 at 6:10 pm
Martin - there's definitely something going around PA and PAMF won't test for it unless you answer yes to the question of whether you've been to Mexico or have been in contact with someone from Mexico. My daughter (age 5) was out sick with all of the symtoms for a week. Another classmate was out at the same time with the same thing. Two others had low-grade fevers and slight cold symptoms, the brother of another classmate was sick with the same thing.
I ran into an elementary school teacher who said he had a handful of students out sick last week.
I'm frustrated by the clinic's failure to be proactive and test these kids when their symptoms showed up and instead just blew me off saying that my daughter would be fine in a couple of days. Whatever my daughter had, whether it really was the swine flu or not, ran it's course and was more tolerable than the normal seasonal flu, but I don't think the clinic acted responsibly from a public health standpoint.
Posted by Martin, a resident of the College Terrace neighborhood, on May 3, 2009 at 9:33 pm
Yes Erin, I agree with you that this is irresponsible from a public health point of view. Walking through "Town & Country Village" the other day during Paly's lunchtime break, it was apparent to me that the average social distance of high school kids is about 6". And how many of those kids went to Mexico for Spring Break? It's beyond comprehension to me that a place like, say, "Cold Spring, MN" or "Muscatine, IA" would have several confirmed cases, while Palo Alto CA has zero.
Posted by rufous, a resident of the Barron Park neighborhood, on May 3, 2009 at 9:43 pm
Why is it important, from a public health standpoint, to test everyone to see exactly what kind of virus they have?
Two years ago 14 of the 20 kids in one classroom at our school, 10 of 20 in another class, and a handful or so of kids in other classrooms were all out sick with a nasty, highly contagious virus that rapidly went through the school, but hit 4th and 2nd grade hardest. So many students were out in 4th and 2nd grades that academic instruction was postponed two weeks so that not too many kids would miss lessons. As far as I know, the virus was never named. (And the school was never shut down, despite the highly contagious nature of the virus). Was it irresponsible not to name that virus and test for it? Is it irresponsible to not identify exactly which virus has hit you or your child each time you or they are sick? It seems to me PAMF is trying to not contribute to public hysteria by not testing (or at least, not telling you they're testing.)
When was the last time you actually went to the doctor for a fever? And if you went, when was the last time you had them test for Influenza A, B, or C? And if you had A, when was the last time you had them check whether it was H1N1, H1N2, H3N2, or some other variety? I can't recall ever going to the doctor for a fever or virus, and most people I know don't either. Should we suddenly go now, just because there's a named virus elsewhere in the state and country, even though the vast majority of people who get that named virus typically recover on their own?
Now, as a statistician, I think it would be way cool if there were a simple costless test one could give everyone with any sort of sniffles to identify exactly which mutation of which cold or flu virus was afflicting you. I'd love that data on myself. If it didn't involve going to the doctor and exposing myself to more sick people, and didn't cost society extra $, I'd certainly take that test each time I was sick. But from a public health standpoint, I hardly see the necessity. There has been (at least one) virus circulating Palo Alto schools for weeks before swine flu became part of our vocabulary. Anyone sick right now is much more likely to have that unnamed virus than "swine flu." (fwiw, I know a local teacher who had a fever & other symptoms last week and got the test -- it was negative -- so I know they are taking some proactive measures)
This isn't to say that I don't believe we *could* have an epidemic like 1918, I just think there's no point in panicking needlessly. The only thing that will stop an epidemic is taking the proactive measures to keep ourselves healthy. Knowing whether or not you have X, Y, or Z virus isn't going to keep it at bay any better than staying home and away from other people when you are sick. You can always self-quarantine your own household if you're that concerned.
Posted by rufous, a resident of the Barron Park neighborhood, on May 3, 2009 at 10:02 pm
My uncle lives in Muscatine, IA, and he and his wife are frequent world-travelers. So why not there?
Spring Break in Palo Alto was over a month ago. Anyone who caught anything during Spring Break would be well over it by now. Plus, Mexico City is rarely the destination of choice when going to Mexico for Spring Break. Think Cabo, and I from what I've been able to find, there were no cases of swine flu in Cabo 4 weeks ago (or even now, though there are some now in Baja). Ditto Puerto Vallarta, another popular tourist destination, that so far has no confirmed cases.
Yes, social distancing among high schoolers (and anyone younger, and as far as I'm concerned, far too many adults) is close to 0. So maybe everyone was out sick with some other virus when swine flu appeared here, so no one got it. Or maybe they had swine flu, thought it was some other virus, and slept it off without bothering to get tested. Would that be the end of the world?
You could also turn your argument around. Isn't it inconceivable that Mountain View doesn't have a confirmed case? What about Gilroy? Hell, even the San Jose cases are still just probable. Why would Palo Alto be particularly susceptible as opposed to the rest of Santa Clara County?
Posted by Cover Up...Farfetched?, a resident of the Midtown neighborhood, on May 3, 2009 at 10:26 pm
With all the immigrants and their families going to and from Mexico regularly, why does HLS think the virus won't spread?
Dr. Gupta was interviewing a man in Mexico who said he believes his own government is giving false data. A member of his band died from swine flu and isn't even in the count reported. The man spoke on TV saying Mexico had been keeping their own people in the dark and he believes there are way more cases than reported.
Nip this thing in the bud before the regular flu season gets started; and the only we can do this is quarantine / and shut off Mexico so no more people can cross the border carrying this virus.
Posted by Martin, a resident of the College Terrace neighborhood, on May 4, 2009 at 8:20 am
Rufous wrote: "PAMF is trying to not contribute to public hysteria by not testing (or at least, not telling you they're testing)."
Rufous, why do you assume that anyone is panicking or hysterical? There would seem to be a fine line, in your thinking, between hysteria and taking proper measures against a real threat. Is it hysterical to pay for home insurance year after year, when the fact is your own house probably never will burn down? Is it panicking to buckle your seatbelt every time you get in a car, even though you've never once come anywhere close to being in an accident?
Seatbelts wouldn't be as effective as they are if SOMEONE wasn't interested enough to do tests and collect data. Think of public health the same way. Knowledge is power and there are three things we know about the current outbreak: 1) The numbers are abnormally high for this late in the flu season. Go to the CDC web site and look at their archives. By May 1, flu cases for the U.S. should be in the single digits or low double-digits, not the triple digits. 2) This strain is a new recombination of several other strains and human resistance to it is weak; 3) This strain has killed young adults with pneumonia, which was a hallmark of the 1918 strain.
I'm not counseling panic, I'm counseling knowledge. I suspect that folks like you, who accuse others of fear-mongering, may in fact be the most deeply fearful of us all. You may be on the edge of panic, having trouble sorting out all the information and coming to conclusions in the absence of complete information. Situations like this are by their nature ambiguous. The thing may grow or it may shrink, and no one knows.
Which was, really, my original point: PAMF could help us, here, by collecting data.
Posted by Martin, a resident of the College Terrace neighborhood, on May 4, 2009 at 9:43 am
Another reason to expect more of PAMF (and also Stanford Hospital): The CDC has been very explicit that they are leaving all the key decisions to local authorities. The CDC also uses phrases like "[do such and so] ... when the flu arrives in your community."
If you feel that your local health officials are asleep at the wheel, and if you know sick people at a prestigious institution of higher learning who aren't bothering to get themselves tested, and other people who've tried to have their kids tested but have been turned away ... These things tend to reduce one's confidence that you'll even KNOW when the flu arrives in one's neighborhood.
BTW, cases *have* been reported in surrounding communities (San Martin, Morgan Hill, Sunnyvale, San Jose)
Posted by rufous, a resident of the Barron Park neighborhood, on May 4, 2009 at 9:43 am
I agree -- data is great. I think it *should* be collected. I think PAMF should test anyone they think warrants testing. The difference of opinions, I think, is that I believe they *are* testing, and Erin was stating, and you agreed, that they were irresponsible. I read into some of the posts a tone of allegations of conspiracy to cover up known cases.
The reason that I believe there is public hysteria right now is quite clear if you read this entire thread, with people hysterical that PAUSD hasn't already shut down our schools because kids are natural transmitters of viruses. I guess where we differ is that I don't think every single case of the sniffles requires a visit to the doc and insistence on a swine flu test. Like I said, I know someone in Palo Alto who *has* had the swine flu test (and it was negative). My guess is there are some panicked parents who go in with their kids and say "hey! the symptoms match! give my kid a swine flu test!" and the doc disagrees and thinks the kid is just fine. I think if you do go to the doc and s/he doesn't suggest a swine flu test, that just means s/he doesn't think it's advisable, not that s/he is part of some great conspiracy to hide the fact that there are swine flu cases in Palo Alto.
I think it's public panic when parents storm the principal's office 4 weeks after spring break and insist on the school being closed because they know some families went to Mexico over Spring Break. (Yes, this really happened.) The incubation period for the virus is way less than 4 weeks, and the families weren't anywhere near Mexico City.
I think you and I are probably mostly on the same page. I *do* like data. I buckle my seat belt, not because I'm hysterical, but because statistics say it's the right thing to do. I also take pro-active measures to avoid viruses, not because I'm hysterical, but just because I like to be healthy (or maybe I just have OCD). I see absolutely nothing wrong with staying home when you're sick, washing your hands frequently, coughing & sneezing into your elbow, and not shaking hands with people or otherwise exchanging germs. If it were trivial to get the swine flu test, I'd agree we should all go get it just to help build a good database of information, but it's just not that easy yet. Read this story of one person's attempt to get tested: Web Link
Posted by Erin, a resident of the Leland Manor/Garland Drive neighborhood, on May 4, 2009 at 10:26 am
I'm the LAST person to take my kids to the doctor for a cold or any other kind of illness unless it's a fever that's hung around for more than 3 days and then I like to get their ears checked out for infection.
Here's my issue: My child is extremely healthy. She's had perfect attendance this year until this last week. She was in full-time daycare as an infant with kids who had pink-eye, hand,foot, and mouth disease, flus, colds, you-name-it, and she never got any of it. This had to have been a very serious bug to have gotten her so badly. PAMF KNOWS this. She's been a patient there since she was born. They know how healthy she is.
When I called about her symptoms and was asked the quesion "Has she been around anyone from Mexico recently?" I told them I couldn't convincingly answer that question. Unless you quarantine your entire family for two weeks there's no way to know that answer. She's in school with all kinds of kids, she was at the clinic with her little sister for a well-child visit the week before, she was at the local pool the week before, etc. How can they expect anyone to answer that question in this area and get a true answer?
I guess I just expected more than a brush-off that she'd "be okay in another two days." She had a fever for a total of 7 days (4 days after we went to urgent care for the first check).
I don't want to shut the schools down. Trust me. But I do want to keep our kids healthy. I was responsible and kept my child home for the entire week that she was sick but I'm not sure all parents would do that.
Posted by rufous, a resident of the Barron Park neighborhood, on May 4, 2009 at 11:06 am
Sounds like you did all the right things (and that your kids are like mine -- unusually healthy most of the time). I'm guessing you got the brush-off from a receptionist/advice nurse who has probably been overwhelmed with too many calls from the types of parents who *are* trying to shut down the schools. I'm sorry you had to face that. It certainly would have been better to have been able to see your regular doc, who probably would have taken the time to examine your child and make you feel confident about his/her conclusion. (Which may or may not have included ordering a flu test -- though if this was over a week ago, that would have been really hard, since the test wasn't available locally.)
Glad to hear your child got better. Sounds like it wasn't a fun week.
Posted by Resident, a resident of Another Palo Alto neighborhood, on May 4, 2009 at 11:57 am
Realistically speaking, I think we have to look at this differently from what we are doing.
In a given week in late April/early May, how many kids are typically sick with flu and off school in the Bay Area? I have no idea but I feel sure that it would be more than 30. In a given week how many of those with flu symtoms would report their illness to their health care provider? Once again, I don't know the numbers but I suspect it is a very small percentage. So in reality, we have no idea how many people would typically be ill at this time of year with regular flu.
Of those who would normally have regular flu, it must be a very small percentage who would have symptoms bad enough to cause death although we do know that each year flu patients die.
Why are we therefore so overly concerned about this flu. Yes it is a new strain and we have no immunity to it. Yes the WHO may call it a pandemic, but the definition of pandemic only means that it is occurring in all parts of the globe, but so are many other illnesses which don't cause us to panic unduly. Yes, people are getting sick with this flu and yes it may be a little more unpleasant than regular flu and a little more contagious also. But, they are all getting better. Those that are getting bad doses and/or dying are probably little more in number than would normally happen with regular few.
Does this mean that we should really have cause for panic. Be alarmed yes, be more cautious yes, be well educated on the subject and be prepared in case the slight chance of your family getting it or the situation suddenly escalating yes, but we are in no way seeing a crisis situation yet.
Posted by Erin, a resident of the Leland Manor/Garland Drive neighborhood, on May 4, 2009 at 12:09 pm
I actually think this is a little late in the year for the kids to be getting sick. Most of them, at least in my daughter's class, had these colds and flu symptoms earlier in January until late February/early March. Most kids were well and all back in class again until this hit.
As for PAUSD, they do a stellar job of teaching good hygeine in Young 5s and I'm guessing in Kindergarten as well. Not sure how far it goes up into elementary school but if you start them off right and practice it at home too the kids will think it's second nature, just like putting on a seatbelt.