Friday, October 2, 2009
BOH takes proactive path
“You can make predictions about flu, but you’re likely to be wrong,” Dr. Thomas Frieden, the head of the Centers for Disease Control (CDC) told reporters last Friday, summing up the current confusion about the H1N1 (swine flu) virus at all levels of government. But last week there was some good news: the newly minted vaccine will be highly effective; eventually enough will be available for everyone; and only children nine and younger will need two doses. But delays in delivery of the H1N1 vaccine and a distribution system very different from the usual will challenge public health officials.
Week by week the information available changes, with the timing of vaccines – delivery, interval between doses – mostly unknown. So last week, Massachusetts Department of Public Health (DPH) managers, unsure how much vaccine the state will be allocated or at what rate it will arrive, told local health leaders not to plan for mass clinics before November.
More good news – the virus is not in Carlisle yet. But as national incidence has risen for six weeks and the disease has spread rapidly (26 states so far), its arrival seems inevitable. The fluid situation has made it difficult for town leaders to plan for any local response, including whether to offer H1N1 vaccinations, in particular for children at school. Frieden summarized the arguments for school-located vaccination last week. “When kids get sick from flu . . . they end up spreading flu widely in the community. So if you protect kids, you probably protect not only the kids, but the community as well. And school-located vaccine programs can reach a lot of kids quickly.” Moreover, keeping their companions from getting sick also helps to protect the school children most vulnerable to complications, and by slowing the spread of infection through the community can help keep adults with underlying conditions like asthma or heart disease out of the hospital. School-located vaccination programs, even though voluntary, also seem more likely to prevent infection in more students if they do not depend on the initiative of busy parents or the vagaries of routine appointment schedules.
Nonetheless, both CDC and DPH stop short of recommending that children be vaccinated in school. Instead, DPH suggests, schools should focus on prevention, especially “keeping all students and staff with symptoms of influenza out of school and [other activities],” and “work closely with local boards of health [and others] to ensure that students are vaccinated.” Given such hesitation, along with the hazy information available, it is not hard to understand why the Carlisle Public School has decided against offering H1N1 vaccinations in school.
However, rather than waiting for better information, or for medical offices to be overwhelmed, the Board of Health has chosen a proactive approach. Tuesday evening the board and the executive committee of Carlisle’s Medical Reserve Corps (MRC) began planning for voluntary vaccinations at the school, initially for children from five to 18. Without much concrete data, their plan must be tentative, with several sessions to be scheduled a week or more apart sometime in mid-November. In one sense, the delay in vaccine deliveries may be an advantage. We will have a bit more time to get our ducks in a row, and MRC has not had the chance for a drill. Practice for them in working together as a team, with advance planning rather than on short notice, is bound to be helpful for the town in the long run.
Meanwhile, the BOH and MRC will need our patience, and may have to act on short notice. So, keep washing your hands, and stay tuned . . .
[The Mosquito welcomes Nancy Pierce to the team of editorial writers.]
A few years ago, my wife and I were enjoying a weekend getaway in New York. As we were walking down Fifth Avenue on our way to dinner, we reminisced about an old friend whom we had not seen in a long time. “Wouldn’t it be funny if we ran into Dennis this weekend?” she said. At that precise moment, Dennis rounded the corner and literally bumped into us. In a city of nearly ten million souls, what are the odds? Then there was the time on Nantucket when we were headed into town for dinner with friends. It was a perfect summer’s night in August, warm with a light breeze, and the village was jammed to the gills. We were running late and knew that parking would be a nightmare. Now Nancy’s mother is a bit of a parking savant; she always seems to find a space no matter how crowded the streets. “If only Mama were here, we’d find a space for sure,” she said. Presto! As soon as those words passed her lips, a parked car pulled out in front of us, leaving an empty space for the taking (and a parking meter with time still left on it).
We’ve all experienced moments like this. We unexpectedly run into friends at a concert, a restaurant, or a museum. It happens frequently enough that sometimes we are not really that surprised . . . we half expect to see someone familiar (even though we don’t know exactly who it will be). This week, I really hit the jackpot. On Saturday night, we attended a performance of modern Chinese music at Jordan Hall with old friends. While catching up in the “whatever happened to old so-and-so” department, sure enough, Mr. So-and-So materialized, right on cue. He literally appeared right at my elbow the instant his name was mentioned.
I’ll admit to being somewhat distracted during the performance. Our IT guru at the office, who is really superb, has just begun paternity leave. We had to import another IT specialist from Philadelphia, whose name is Wayne, to cover. Naturally, my computer chose Friday night to go haywire, denying access to email, crucial files, and word processing. With several important deadlines looming Monday morning I was in a bit of a panic. What to do? Well, it turns out that Wayne is of Chinese descent, and being new in town and with no plans for the weekend, he had scanned the local papers and decided that this particular concert would be the perfect diversion. He was sitting directly in front of me (of course!), something that we didn’t discover until intermission. Now alerted, he diagnosed the problem and had things up and running by Sunday morning.
Weird stuff, to be sure, but maybe not all that surprising. While the odds of any given “close encounter” may be remote, daily life is chock full of chance. Over the years, I’ve probably walked by all kinds of people I know at Logan Airport, or even been on the same plane, oblivious to their presence (and they to mine). It all depends on whether or not we’re paying attention.
© 2009 The