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Flu (flu de fafa), in Canada

September 18, 2009

The flu. I’ve had it, you’ve had it, and now we are all in a fuss about it. As well we should be. It can make your muscles ache, your fever rage, and it could kill you: but it probably won’t. Our regular seasonal flu, along with the more virulent H1N1 strain, is due to wallop us in a big way. Those who are immunocompromised, like the frail elderly and the very young, are more vulnerable to the serious consequences of this infection. The Center for Disease Control (CDC) has everything you need to know about the flu. Government officials are advising something in the likes of: hang on to your Hitchhiker’s Guide, and

DON’T PANIC!

Isn’t that just the worst thing to say to people who are scared and vulnerable? What I mean to say is that the flu is a regular occurrence and though its burden may be a bit heavier this year, it is not unexpected and it is not insurmountable. The World Health Organization (WHO) classifies H1N1 as a moderate pandemic, meaning the majority of people recover without hospitalization or medical care. Influenza is not a nice thing, but it is happening, and lots of smart people have been working for years to lessen its impact. Being vigilant with measures to protect ourselves (and those around us) is our best bet.

As a healthcare worker, I need to know what to do for patients who are affected or who think they are affected. I need to keep myself safe, and learn the ways to keep others safe too. We know that there are strains of H1N1 already resistant to Tamiflu, so prevention will be key. Everyone should adopt conservative measures, such as thorough and frequent handwashing, staying home if sick, and coughing into our sleeves instead of into our hands. Only certain people will need to invoke the more invasive measures, such as vaccination, isolation, donning masks, being admitted to hospital, and receiving anti-viral treatment.

Vaccinations are good, but when it comes to this virus, they aren’t perfect. There is limited protection and limited availability. Canada has controversially chosen to take the slower route in making the vaccine available (CMAJ, Globe and Mail editorials). Finally, the distribution scheme for the H1N1 vaccination has been announced for Canadians. With this in place, I will of course still advise all health care workers and the immunocompromised to get the annual seasonal flu vaccination (EDIT: if or as directed by my provincial guidelines).

I had been wanting to write something about the H1N1 “hamdemic” for a while now. American news services seem to have quieted on the issue, but the rumblings in Canada are growing into loud roars. We have some different issues than do the United States. With a larger area and much much smaller population, there are isolated, outlying communities that don’t have immediate access to high-acuity care, let alone a regular doctor. But Canadians do travel a lot, within our country and to others, and the openness of the system makes everyone vulnerable to encountering a flu virus.

My current ICU preceptor, and internist and intensivist who also works regularly in the Arctic, wrote an in-depth piece for the Globe and Mail. He illuminated the disproportionate degree to which First Nations communities have been and will be affected, and explored some of the the reasons for this. Unfortunately some of his warnings were spot on. Communities like Wrigley, NWT are now in an uphill battle.

Our government made a bad move when it comes to servicing these communities. In their flu-preparedness packages, First Nations in Manitoba received body bags from Health Canada. Naturally, they are outraged. Of course the flu will cause deaths, all over Canada, including in aboriginal communities; however, this gesture only served to perpetuate the message that our federal government is sitting back and watching it happen, allowing First Nations to be ravaged more extremely than the affluent 49th to 50th parallel cities (& Co.)

Things are not great. But we are working on it, and sometimes public outrage is what’s needed to give the government a kick in the pants.

To make light of a serious topic… but every time I hear “flu flu flu!” I think of the Flight of the Conchords “Foux de fa fa.” It has nothing to do with influenza but frankly, we could all use some lighter fare:

9 Comments leave one →
  1. Jabulani permalink
    September 19, 2009 10:26 am

    Another good post, but forgive me please, for losing it during the video! As you say: “we could all use some lighter fare”. It’s better if you understand French, but amusing even to just watch.
    I have a friend who contracted swine flu (we still call it that here) and was extremely ill; she could certainly have done with some Foux Da Fa Fa during that week in bed!

    • September 19, 2009 11:12 am

      I’m not sure what you mean by ‘losing it’ during the video. Hopefully you meant you enjoyed it and I’ve not offended anyone! Yes, French is helpful, and Canadians who remember only fragments from their youth will certainly recall ‘ananas’ and ‘bibliotheque.’

      Being ill with the flu is no joke, certainly, and some of the swine flu witticisms out there are really not appropriate.

      The Conchords are great fare for when we are ill in bed at home, bored out of our minds, but too sick to go to work.

  2. ahrcanum permalink
    September 19, 2009 6:38 pm

    Why if a patient is already immunocompromised would you recommend the annual seasonal flu vaccination or the H1N1 vaccine that is laden with toxins like mercury, antifreeze, spermicides, adjuvants? Knowing full well there is no efficacy rate or long term clinical studies on fertility or any thing else WHY DO YOU RECOMMEND THIS for anyone let alone patients with underlying problems?
    First Nations in Manitoba might consider themselves lucky, as there may be an uptick in deaths and containment of cadavers as nasty as it sounds, may prevent the spread of disease.

    • October 7, 2009 8:50 am

      Thanks for your comment. While my first instinct is to not reply, I don’t want to censor your views. I expect that you have had a negative encounter in the healthcare system that has encouraged you to approach medical intervention – namely vaccination – with belligerent scepticism. I don’t expect to derail that, but perhaps I can address your concerns.

      I think it would be more productive to address them one by one. So, I am doing so in a separate blog post. Bear with me as it will take some time to compose.

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