Conversation with Dr. Sarah Hendrickson about the H1N1 response in Lane County
Sarah Hendrickson, MD, has been Lane County’s (part-time) Public Health Officer since 1999, combining her love of medicine with a love of teaching she inherited from her parents. She has been a family medicine physician in Lane County since the mid-1970s. She received her undergraduate degree from UC Berkeley, and was granted her MD by the University of Pennsylvania, where she did her family medicine training. She had a practice in Eugene for nearly 20 years until changes in medicine and her family altered her career.
RH: First off, thanks to you Dr. Hendrickson, and all of the hard working professionals at Lane County Public Health who have been preparing since last spring for the anticipated emergence of the H1N1 virus at the onset of this winter’s flu season. It has been a coordinated and prodigious effort with a lot of energy and planning focused on how to prevent the spread of the virus. I appreciate getting the word about our county’s voluntary vaccination program.
Given that the highest-risk groups total more than 40% of Lane County’s population and are not the same high-risk groups that have been historically associated with the seasonal flu, how are the efforts going to inform and educate our community about our plans?
SH: As you know from the information meetings you’ve held and interviews you’ve given to the press, Commissioner Handy, the public’s awareness of H1N1 and our preparedness plans is continuing to grow each week, and that is good. What has been a challenge for everyone at the local level, is that the Federal plans for rolling out the vaccines into our communities have changed frequently. We have a system of over 90 contracted providers set up in Lane County to make this vaccine available to the high-risk groups, but we have only received enough vaccine to date to a small portion of the 168,000 individuals we believe should have access to it.
RH: There is so much increased awareness I am seeing as to the preventative steps people can be taking to stem the spread of the virus. Vigilant hand washing has always been one tried and true approach, and many of us have taken steps to have hand sanitizer in our pockets to use frequently. For all of the times I shake hands with people, or touch surfaces that others also touch, washing hands just is not enough to get me through the points in the day when this virus can be spread.
It’s also been tough with the work ethic and discipline of our culture -- hard workers need to NOT push coming to work when they are feeling fluish, and risk infecting their co-workers who then can expose their families when they go home; and hard working families who when in doubt in the past have sent their coming-down-sick kids to school or to day care, now must be much more conservative with keeping them home.
SH: For the last years and months, our preparedness planning has developed baseline strategies informed by the many schools, businesses, governments and non-profits who have been our key partners. For instance, the U of O did a great job preparing for the influx of students at the onset of flu season; they tailored their information to the newer communication avenues that young people use such as Twitter and Facebook, and they have geared their prevention messages to the lives of young people. Non-profits have focused their communication to reach the economically, culturally and developmentally vulnerable in the community who may lack communication resources that others have access to.
RH: With information overload a factor in these modern times, it is a challenge to get the most up-to-date info to people with the H1N1 news. Fortunately, the Lane County website, lanecounty.org has been a good source for the latest, breaking news.
SH: There is good info from the state, too, at the website flu.oregon.gov This site also includes school lessons for various ages, and even a coloring book!
RH: Our Board of Commissioners added back two Public Health nurse positions during our budget last spring. Still, our Lane County staff has been working long and hard for months in prep for flu season, and now they are working even harder. Dr. Sarah, I’ve stated many times that our amazing public health professionals have been working tirelessly on our behalf, but I have to imagine that rather than being tireless, they must be flat tired by now. As part of the preparedness plan, we also put out a call to retired nurses and other health care professionals to help us through flu season. What’s been the response?
SH: We have had more than 65 volunteer nurses and doctors step up to help Lane County Public Health with administering our voluntary vaccination and education program. Individuals in this community have always been very giving of their time and expertise during times of need. As you know, Rob, health care providers are just one of the high-risk groups, the others are pregnant woman, kids from 6 months to 24 years old, and people who have chronic health conditions such as asthma, lung and heart disease, diabetes, or other serious medical conditions.
People over 65 years old are not a high-risk group, which is very different than the risks associated with the common seasonal flu. To date, most all of the flu we are seeing is the H1N1, so people should not worry about getting tested. Most people will do just fine being cared for at home; the best plan is to stay home, treat the fever and drink plenty of fluids, keep from spreading the infection to others. Don’t go back into school or work until you have been fever-free for at least 24 hours. If you have a high-risk medical condition, or if your child is younger than 2 years old, call your doctor at the first sign of flu symptoms .Early diagnosis and treatment with anti-viral medicine may keep members of these groups healthier and out of the hospital.
Watch out for symptoms that indicate an urgent need to be seen. These symptoms include:
In children
· Fast breathing or trouble breathing
· Bluish skin color
· Not drinking enough fluids
· Not waking up or not interacting
· Being so irritable that the child does not want to be held
· Flu-like symptoms improve but then return with fever and worse cough
· Fever with a rash
In adults
· Difficulty breathing or shortness of breath
· Pain or pressure in the chest or abdomen
· Sudden dizziness
· Confusion
· Severe or persistent vomiting
If you have the emergency warning signs of flu sickness, you should go to the emergency room.
The emergency room should be used only for people who are very sick. You should not go to the emergency room if you are only mildly ill. You may give the disease to others, or you may be exposed to other illnesses.
Most people with 2009 H1N1 influenza have had mild illness and have not needed medical care or antiviral drugs. Home care should include lots of fluids, acetaminophen or other anti-inflammatory medication. Take care not to spread the infection to others in your household.
There are still lots of flu like illness in the community. Estimates are that your chances of being hospitalized with influenza are considerably less than one in a thousand if you are a healthy adult or older child.
RH: The emergency preparedness planning has also been helpful for the thoughtful continuity of business, government and schools. H1N1 is here. We’ve done our planning. This flu is mostly behaving like other flus, but more people are susceptible to it, thus more people are getting sick. We are in a serious situation, and working together as a community, we can get through this.
SH: For those wanting them, we are getting vaccines out as soon as we receive them. We will continue to share evolving information as we learn it, but information changes weekly. Stay in touch with the informational websites. The flu season will probably continue late into spring.
It’s important we take of ourselves and minimize our risks to others.
RH: Thanks, Dr. Hendrickson, for leading our County’s efforts in addressing the H1N1 and in sharing more information here.
SH: Thank you, Rob, for your support of Lane County Public Health in a difficult economic climate. We appreciate the hard job you are doing also.