Wednesday, August 12, 2009

The Latest from the Government on H1N1

My sister-in-law wrote this morning to ask for my thoughts about the latest post in the White House Blog about H1N1 preparedness.  This post is an abbreviated form of a longer op-ed piece by Secretaries Kathleen Sebelius (Health and Human Services), Janet Napolitano (Homeland Security) and Arne Duncan (Education) that ran in a number of newspapers in the last couple of days.

The basic message of the communication is fairly simple:  We're preparing for the flu, you should take it seriously, and we need you to prepare too.  In my sister-in-law's e-mail, she points out that the blog post does not address the rumors or panic about H1N1.  That is true, but there is some good stuff in the full article:

This new H1N1 is not the flu we’re used to. It was just getting started when our flu season should have been ending. While anyone can get sick, the pattern of infection is unusual. It hasn’t yet affected many seniors, but it spreads rapidly among otherwise healthy kids up to college age. Scientists at the Centers for Disease Control and Prevention continue to observe higher levels of flu-like illness than normal for this time of year.  
But there’s one way in which the 2009 H1N1 flu isn’t different: it can still send you to the hospital with fever, cough, sore throat, headache, chills and fatigue, and sometimes, diarrhea and vomiting. For the worst cases, it’s still deadly. And it’s especially dangerous for people with chronic illnesses such as asthma, heart disease, or diabetes, and women who are pregnant.  

I will admit to being somewhat surprised at the tone of this, and I'm wondering about the choices they made.  This is written as though they do not believe we (and by "we" I mean the general public) are taking this disease seriously enough.  In my experience, that hasn't been the problem at all.  On the other hand, maybe folks have become complacent since the fall, I don't know.  In my opinion, what is missing from this section is a third paragraph, pointing out that in many ways H1N1 is the same as seasonal flu in the number of people it doesn't kill or send to the hospital.  At the very least, some clear statement about the relative danger from H1N1 as compared to seasonal flu would be helpful.  And talking about the flu sending people to the hospital without putting it into some context can only add to the overwhelming of our ERs of which I've written before.

I think the government is getting better at communicating with us about H1N1 and sharing information.  I think what they still need to work on is nuance.  They seem really unwilling to convey that the situation is in shades of gray, not black and white.  They can't seem to manage the message that we should take this seriously and prepare, as well as recognize that for most of us this isn't a very serious danger.  There is something to be said for, when you want people to behave a certain way (e.g. wash their hands) being very directive and giving them reasons to do it.  But don't forget, people don't only do what you say, they interpret and extend it.  And if getting us all to plan and being very directive in one direction also makes us all panic, freak out and go to the Emergency Room, that's not actually a good thing.


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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