No, boys and girls, the H1N1 flu has not gone away. Both a recent cover article in NATURE, with additional articles discussing the changes in its genetic makeup and how that affects treatment, and this page by Peter Sandman, "Would you like another wake-up call?" make it clear that the current scary flu is still a scary flu and could become a much worse scary flu. The current (as of June 25) CDC report on confirmed and suspected cases indicates cases in all 50 states, totalling over 27,000. Here in Texas, we've had almost 3000 cases.
What's scary about this flu is that it already combines genes from existing strains of bird flu, swine flu, and human flu, and it moved very quickly from its original source in Mexico to worldwide expansion. The human flu bits are part of what makes it possible for humans to pass it among them. The bird flu and swine flu bits are part of what makes it more serious to us. But the big deal here is that this flu was already re-designing itself to meet the conditions it found--switching genes in order to be more invasive--which is something most flu viruses are good at.
For instance, as originally characterized from Mexican samples early on, this strain was not resistant to the common anti-viral drugs. But resistance doesn't take long to develop in something that replicates as fast as flu does. U.S. samples show some resistance now--and those strains will select for increased resistance.
We still do not know what the mean severity of the disease is now, or what it could become. Because flu viruses play fast and loose with their assortment of genes, and humans themselves are not all alike genetically, it's impossible to predict until the disease actually breaks out. But the possibility of a 1918-type flu of unusual severity, with high mortality, certainly exists, and may be around the next corner of genetic recombination.
However, we do know, from the history of flu epidemics, that absolute "control" of a flu outbreak is impossible. People don't look or feel sick until they've already had a couple of days to infect those around them. Even if you quarantine new cases, they've already spread the disease to anyone who doesn't take precautions.
So far all the official sources will say is "Wash your hands" and "Avoid sick people." .Handwashing certainly does help, especially if you can keep your hands away from your face, where surface to surface transfer of the virus (hand to mouth, nose, eyes) is easy. (But try that with toddlers...fat chance!)
But there's a lot more each of us can do. For instance, masks. True, the only masks most of us can afford or stand to wear aren't perfect protection. But they are partial protection. Same with flu shots. Since flu vaccine requires months to ramp up production, it's never perfect--but its partial protection is still valuable.
Preventing illness in yourself is only one part of preparedness, though. Another part is anticipating what systems may grind to a halt if the epidemic turns out to be both widespread and severe, with a lot of people off work sick or dying, and more off work because they're scared. For both families and organizations (whether private business or public agency), preparedness means thinking ahead to what you need and stockpiling some essentials.
For families, this means having on hand extra food, medications, and (as winter comes on) plenty of heating (oil, coal, etc.) Nonperishable food, ideally things that don't need to be cooked and can be eaten right out of the container. Drinking water and water for sanitation. Supplies for staying clean (detergents, hand sanitizer, garbage bags, etc.) And it means planning how to care for sick family members at home (since clinics and hospitals are likely to be swamped.) This will be much easier if you don't have to go out to the grocery every day or so, don't need to go anywhere, in fact, to have what you need on hand. Even if no one in your family gets sick, delays in the supply chain of one or two weeks are easily predictable and delay in a particular chain might last longer. Some people, of course, cannot build up a stockpile (they're broke, they're homeless, etc.) and for this reason those who can should be prepared to support community efforts to keep people fed, clothed, housed, especially in severe weather.
For organizations, this means considering the weak spots in the flow of necessary activities. Is any essential task known to one critically important employee? What if he or she gets the flu? What will that do to your ability to carry on? Start now to cross-train employees so that more than one person knows each task--and ideally people who are not side by side all the time (and are thus likely to catch the flu at the same time.) Stockpile essentials rather than depending on "just in time" inventory replacement. (What if the trucking firm has half its driver down? Or some of the drivers refuse to come to your city because it's had an outbreak? And yes, drivers might do things like that--drivers refused to take buses into New Orleans after Katrina, despite knowing that the citizens were desperate for food and water.) Inform employees on their on preparedness--consider seeing if you can get bulk rates on durable food supplies or hold a flu-shot clinic on site.
Organizations providing critical needs and services--food, water, transportation of necessities, electricity, natural gas and other fuels--should be--if they aren't already--immediately ramping up preparedness and considering how they can continue operations no matter what. Organizations tasked with emergency management and care, from town councils on up, should be doing the same, and also getting the word out to those they serve on how to prepare for personal and family survival.
As Sandman points out, organizations (government, corporations, nonprofits) are often more concerned about "panic" than about preparing people to meet a problem...and yet, experience has shown that panic is driven more by loss of trust when people feel their organization is lying to them and covering up the problem. If you are in a position where you make decisions for others, especially about what they should know--read Sandman's website and realize that minimizing the problem does not prevent panic and can in fact cause it. What people need is something concrete to do that makes sense in terms of the perceived risk.
If you aren't in that position, check what your state and local governments are saying about this pandemic, and nudge them to do better (since most of them aren't doing well.) Point them at Sandman's website for expert information on risk communication, and find out what they're doing about their own preparedness (and see if that makes sense.)
Summer gives us a respite before the usual fall flu season--time to get serious about getting ready in case the H1N1 pandemic turns really nasty. Stockpiling one extra day's supplies each week for the rest of summer--and beyond until you're able to handle 1-2 weeks without resupply--would be a smart thing to do.
