H1N1 threat mishandled

Consider last fall’s response to the arrival of H1N1 as a trial run for an inevitable global health crisis.

Consider last fall’s response to the arrival of H1N1 as a trial run for an inevitable global health crisis.

And Alberta has more to learn than most of Canada about how to respond to a health crisis.

Although H1N1 was officially labelled a pandemic by the World Health Organization, there is little doubt that the influenza of 2009-2010 was modest in both its impact and its duration when measured against worst-case forecasts. (Alberta officially shut down its free immunization clinics on Wednesday as flu season comes to a halt, although the vaccine is still available to those travelling abroad.)

Certainly H1N1 had all the earmarks of a disaster in the making — it spread rapidly and widely, it brought devastating illness and it could be deadly. It certainly emptied out school classrooms and handcuffed employers as it jumped from one victim to another.

Yet, in the face of a menacing health threat, significantly fewer Albertans received the vaccine than other Canadians. Close to 50 per cent of all Canadians were immunized, but only about 40 per cent of Albertans got the vaccine; in some parts of the country, immunization rates were above 70 per cent.

Perhaps many Albertans believed that the threat was overblown, or the vaccine ineffective.

Perhaps our hardy, independent mindset got in the way of practical, informed health choices.

But consider this: the death rate from H1N1 in Alberta was 19.1 per million people; the death rate nationally was about 12.6 deaths per million.

Health officials say hospitalization rates in Alberta as a result of the influenza strain were also above the national average.

In all, 71 people in Alberta died from H1N1, and 429 died nationwide.

Why, with 11.1 per cent of the national population, did Alberta suffer 16.6 per cent of all H1N1-related deaths?

It’s fair to assume that the relatively modest immunization numbers played a critical role.

In part, we can blame ourselves. Ultimately, many Albertans simply couldn’t be bothered. (One local seminar on business pandemic planning, funded by the Public Health Agency of Canada, was cancelled because of lack of interest.)

But we can also blame a confused health bureaucracy. Initially, the lines were long and supply limited at immunization clinics around the province. Alberta Health Services did a dismal job of organizing those early clinics; failing to prioritize recipients in the early days was a huge mistake. Not going into the schools compounded the problem.

Those first few weeks were critical. Answering the need promptly and smoothly is critical in the face of a health crisis, and Alberta officials stumbled badly.

Even as spring arrives and flu season seems a distant memory, the examination of our response to H1N1 shouldn’t be ignored. This particularly virulent strain of influenza is not yet gone. Wendy Schettler, director of public health programs with the International Centre for Infectious Diseases, says that H1N1 is likely to be around for a couple years and the future is uncertain.

Certainly, global health officials are convinced that a devastating pandemic, whether H1N1 or something else, is overdue.

And the next time the threat is imminent, Alberta — and its citizens — need to be better prepared, and easier to convince of the danger.

John Stewart is the Advocate’s managing editor.

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