Article by Erik Smith/ Washington State Wire. Published on Friday, November 13, 2009 EST.

Washington Responding With Precision, Says Secretary Selecky

The H1N1 virus

By Erik Smith

Staff writer/ Washington State Wire

OLYMPIA, Nov. 12.—The latest wave of swine flu seems to be tapering off, but you can count on one thing, said Secretary of Health Mary Selecky – it’ll be back.

            Selecky told a state House panel Thursday that she expects a third wave of the flu beginning in January, peaking in February and March. That’s going to coincide with the rush of travel to the winter Olympics in Vancouver, B.C., not to mention the next session of the Washington State Legislature. And also the regular outbreak of the seasonal flu.

            “Yes,” she said. “You can get both.”

            Selecky appeared before the House Health and Human Services Appropriations Committee Thursday to describe the public health response to the swine flu pandemic, which has crested twice in Washington state since it began to spread worldwide in April.

            So far there have been 28 confirmed deaths in Washington, with three others in the process of confirmation. Some 918 people have been hospitalized requiring treatment in intensive care units.

            It’s a far cry from the 800 people who normally die every year from the ordinary seasonal flu, but Selecky said public concern is no overreaction. Usually those who die from the flu are older, or have weakened immune systems. But the swine flu’s victims are a much younger population. “I think we’re going to hear about a two-month-old dying. We’ve already had a six-month-old die. We’ve had a pregnant woman die. We don’t hear that from seasonal flu. So I think we’re reacting in a way that protects the public. This is a young person’s disease.”

            And she said the outbreak has been a difficult challenge for the county public health agencies that are on the front lines – because they have been decimated by the last year’s budget cuts.

            The Rush to Vaccinate

            Right now five private companies are rushing swine flu vaccine to the states as fast as it can be produced – not as easy as it sounds, because it depends on the cooperation of viruses cultured in the laboratory. One company’s production line is moving much slower than the others, Selecky noted. About 846,000 doses have been allocated to Washington, of which 629,000 have already been distributed.

            Washington’s share of the national production is based on its population – about two percent of the total U.S. population – and the state also has been distributing the vaccine to counties based on population. “So you bet there’s more going out to King [County] or to Pierce than to Stevens County,” Selecky said.

            But deliveries to the state are still spotty. “The production is continuing to grow but we aren’t doing an all-press communications campaign until there is some consistency in the flow. We don’t need to have more pent-up emotion than there already is.”

            The short supply means that the highest-risk populations get shots first – those under age 50, health care workers, those who care for infants and small children. “When there’s enough vaccine, we’ll be able to take care of everyone,” she said. And Selecky noted that because she is age 62, she hasn’t obtained a swine flu immunization herself.

            Federal money has made it possible for local public health agencies to respond – and to retain staff that otherwise might have been laid off because of state cutbacks this year, she said. Washington received $29.8 million from the federal government, of which $22 million has been distributed to county agencies. The remainder has been set aside for  epidemiology and laboratory functions and for a statewide media campaign.

            “On the one hand, you might say, ‘Wow, that’s a lot of money, but I hear from my colleagues that it’s not nearly enough to help a public health system that’s in distress,” she said.

            And she added, “When this money is gone and everyone is exhausted, and we’re done dealing with H1N1 [the swine flu virus], it’s gone, and we’ve got a lot more issues in this state.”

            County Agencies Under Stress

            County health officials told lawmakers that the federal money hasn’t solved their budget problems. Most agencies have been forced to lay off significant percentages of their staff, and the focus on swine flu inoculations has meant that they have had to shunt remaining staff from programs that normally generate revenue. John Wiesman, director of the Clark County Public Health Department, said his agency has been forced to lay off 74 people out of a staff that numbered 161 in 2008. With the additional complication of the swine flu mobilization, programs dealing with birth defects, tobacco prevention and food-safety inspections have had to take a back seat.

            “Despite massive layoffs, public health is responding to the H1N1 challenge, but I must tell you this is coming at a high cost,” he said. “Important public health services are being delayed and people are going without services when demand is higher than it has been because of the economic downturn.”

            Wiesman’s agency has been coordinating inoculation efforts with three other counties, working with hospitals, other health care providers and a legion of volunteers. “Our staff is stressed out to the max,” he said. “They are worn out. The daily work is piling up because there’s nobody there to fill in behind them.”

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