In Seattle recently, I met a pulmonologist who said that the H1N1 virus has him busier than he’s ever been, his hospital beds full of flu patients. The uptick hit particularly hard about 10 days ago, he said.
How has the flu been playing out across the country?
Craig Feied, the physician and technologist we write about in SuperFreakonomics (yes, we’ll run a virtual book club session with him soon; he’s in Chapter 2), sent along the following data picture. “Some doctor,” he writes, “made in a few seconds using Amalga.” That’s the hospital software system that Feied and Mark Smith developed at Washington (D.C.) Hospital Center, and which was later acquired by Microsoft.
Here’s Feied’s commentary on the picture:
For anybody who wonders how much “hype” there is in the H1N1 story, here is an Amalga-created graph of flu seasons in Washington, D.C. from 2002 to 2009.
ILI stands for “Influenza-Like-Illness,” meaning that this includes everybody who shows up at the hospital primarily for symptoms of flu (there’s no attempt to confirm the diagnosis of influenza with specific tests, so this likely includes some people with the “common cold” and people with pneumonia or other respiratory infections).
For each year, January 1 is at the left side of the screen and December 31 is at the right. Historically, the “flu season” has a small bump in the fall, with the serious spike usually beginning early in January and extending into the beginning of March.
It’s instantly apparent that this year is unprecedented in recent history. Long before the typical spike season we are already seeing more cases than we’ve ever seen — and presumably the worst is yet to come.
It’s possible, of course, that some of the surge was caused by patients who wouldn’t have gone to an E.R. but for the media “hype,” as Feied puts it, about H1N1.
To that end, Feied offers another data tool: the the Emory screening algorithm — a self-assessed flu survey “to help people decide when it’s time to go to the E.D.,” he says, “versus when they can safely stay home. As this problem reaches disaster proportions, emergency departments and physician offices will need all the help they can get.”
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But the one big thing that it does not tell us is how much of it is the regular seasonal (non-swine) flu and how much of it is the swine flu.
The problem, as I see it, with H1N1 is the symptoms range and vary in the population, just like regular flu. So someone could catch a cold or have a minor fever for a few days and never know they’ve caught the dreaded swine flu.
I had something flu-ish a couple weeks back. Stayed home for a few days and was good as new. Could have had it.
As far as regionally, I haven’t noticed anyone especially concerned about h1N1, except for pregnant mothers.
Like Geoff, I wonder about severity. My two roommates and our three upstairs neighbors all had what seemed like the flu last week, though none of them went to a hospital (a friend who stayed with us right before they got sick apparently did end up with swine flu). I got the sniffles for a few days, not enough so to change my life. Did I have a mild case of H1N1 and not notice? Who knows…
H1N1 does seem to be a big deal in New York, though. Lots of people talk about it, and I’m increasingly seeing respiratory masks, especially in Manhattan.
If you look at the CDD FluView page (http://www.cdc.gov/flu/weekly/index.htm), it appears that the number of cases and deaths is certainly higher than normal for this time of year, but the hospitalization and death tracking numbers are declining, which may mean that the epidemic may have peaked already in October.
If I had to bet, I would predict that the number of deaths continues to decline. The total number of deaths over this year’s flu season will end up similar to or lower than a typical seasonal flu season.
gonna go hide in my closet now
@Dave
It has been estimated by various doctors/organizations that somewhere around 95% of all flu cases right now are H1N1. Basically if you have the flu it’s just assumed to be H1N1 at this point.
In my mind, any statistics beyond deaths and hospitalizations for this season are essentially invalid due to media hype.
It is very common for there to be complication and deaths during the regular flu season.
Something different about the H1N1 is that it seems to be hitting different demographics than the regular flu does because of the lack of immunity (for instance: college-aged and high school students have been hit harder). Also, it has hit much earlier than the regular flu season and there is a concern among health officials that when it is seasonal-flu combined with H1N1 flu season, it could overload health providers. However, no one knows yet.
But CK is right, as of now, they are assuming everyone who tests positive (and sometimes negative because the Flu A test only tests positive 70% of the time that H1N1 is actually positive) or has flu-like symptoms is considered to have the H1N1 flu and not seasonal. Health providers and officials have not found a seasonal flu influx at this time – to my knowledge.