Occasionally, we get an health update from the practice our birth doctor in Hong Kong is a part of.

Due to Swine Flu, Hong Kong basically shut down for 2 weeks. China is considering taking similar measures: no school, no activities of any kind where groups of people gather, encouragement to stay indoors, etc.

Hubs just hosted a group of American students in Beijing because our city did not want them to enter until they had shown no Swine Flu symptioms for 7 days.

And the entire neighborhood is thankful and relieved when they learn that we will be spending the summer here instead of America – where surely almost everyone has Swine Flu.

All of this to say, that throughout this entire Swine Flu Pandemic we’ve been living in a country that has taken measures to make sure the spreading is minimal.

Are these measures extreme?

When 1.3 billion lives are at risk, I don’t think it’s my place to judge.

I was thankful to receive this update because it clarified one thing: If we do catch Swine Flu, we should take a Tylenol.

OT&P Influenza Update
June 24, 2009.

We have now accumulated a significant amount of information on the current flu epidemic. We have explained in our previous newsletters the rationale for the public health interventions. Remember the key questions in infectious disease relate to:

The Epidemic: How likely am I to catch this illness?

The Disease: What will happen to me if I catch this illness?

There is now very good evidence that the current influenza is very infectious and it is therefore likely that a high percentage of the population will eventually be infected. The current statistics almost certainly underestimate the true incidence. It is our opinion that the virus is freely circulating within our population.

Fortunately the current flu strain produces a mild illness. It is tending to infect younger members of the population. The vast majority are experiencing mild symptoms and making a full and complete recovery. As an example there have been more than 2700 cases in the UK with 1 death occurring in a patient with significant medical problems. (Note: That’s a .03% mortality rate.) Hong Kong has had 408 cases with no deaths. The case numbers in both countries are certain to significantly underestimate the true incidence of the illness. Most countries and many doctors in Hong Kong (including ourselves) are not testing for the virus. By comparison seasonal flu has a mortality of between 1 and 3 per cent.

This obviously produces a contradiction between the public health measures, such as isolation and school closures and the mild illness. We have explained previously the rationale for this in public health terms. Hong Kong has an excellent public health system and decisions on social distancing (such as school closures) are made in an attempt to reduce the intensity and severity of the illness in population terms.

Currently patients testing positive for influenza are being isolated in hospital and treated with tamiflu. Whilst there is very clear evidence for isolating infected individuals we do not believe that an influenza epidemic is best managed in hospital. There is no evidence base for the widespread use of tamiflu in this situation. The initial use of tamiflu was a population intervention aimed at slowing the spread of an epidemic. Now we know more about the natural history of the infection it is our opinion that the majority of patients will require no medication for this illness.

What Should I do if I have symptoms?

If you develop a fever you should manage the illness as with any normal viral illness. Wear a mask if you have upper respiratory symptoms and stay at home. Wash hands regularly and encourage household hygeine. Cover the mouth and nose when sneezing or coughing and dispose of tissues. “Catch it, Kill it, Bin it”. Treat the fever with paracetomol. Children under 2 and pregnant women who become ill should see their doctor. If you are concerned contact your GP. Please wear a mask when you visit the surgery.