In the regular weekly update, The California Department of Public Health, CDPH, recently reported swine flu deaths in California have now reached 297 since the pandemic began this spring. Hospitalizations now exceed 5,380 statewide. In Orange County, deaths are at 32, an increase of 8 in one week. According to Dr. Mark Horton, Director of CDPH, we should expect a significant increase in the number of deaths from H1N1 in the coming months.

CDPH’s Dr. Janice Louie recently conducted a study of the death rate in the first wave of cases which hit this past spring. This study found a 15% death rate in H1N1 hospitalizations in California during the first wave of the pandemic. But, the current death rate is much less, presumably due to a lag between hospitalizations and deaths.

The most recent statewide rate of deaths verses hospitalizations is only 6%. The study death rate suggests that deaths will eventually exceed 800 for the people who have already been hospitalized, more than double the existing deaths. As more people are hospitalized, total expected deaths will go even higher. Dr. Horton said “Recently we have reported that there have been increases in hospitalizations and deaths have seemed to be lagging behind. This is anticipated, that as a result of Increased hospitalizations, we fully expect to see some increase in the percentage of deaths that occur.”

This anticipated increase in the number of deaths is not related to the Centers for Disease Control’s recently reported increase in H1N1 deaths nationwide. The CDC expanded their definition of swine flu deaths to include not only cases where H1N1 was definitively confirmed as the cause of death, but also to include deaths caused by the virus indirectly through complications.

So far, California has counted only those cases where H1N1 has been confirmed as the definite cause of death. Dr. Horton said “We’re hoping to very soon get clarifications from CDC so that we begin to use the same criteria for determining deaths here in the state.”

Not only will deaths most likely increase as they catch up with hospitalizations, but the percentage of people going to the doctor’s office for flu like illnesses is growing. Dr. Horton reported that The percentage of influenza like illnesses seen in doctors’ offices has increased from 6% two weeks ago, up to 8% for the most recent period. “This is typically what we see during the height of regular seasonal flu, so another indication that we are seeing very, very, intense and widespread activity throughout the state.”

Dr. Horton said that children under the age of 10 should get the vaccine twice, which could represent a logistical problem. “to ensure that they get back for their second dose of vaccine, at least three weeks, and ideally, four weeks, after the first vaccine.”

Dr. Horton repeated his strong recommendation that people get vaccinated for both H1N1 and the regular seasonal flu. He said “Seasonal flu activity typically starts up significantly after the first of December and sometimes does not peak until late winter, or early spring. We’re still guarding against the possibility that, in addition to the H1N1, we may see an increased number of influenza cases due to seasonal influenza. We’re still fully committed to a seasonal flu vaccination campaign.”

The Orange County Healthcare Agency, HCA, reports that for the 32 OC deaths, “Most of these fatalities have underlying medical conditions that place them at higher risk for severe illness and complications.”

So far, OC has been supplied with only about 20% of the doses needed to cover all of the target groups, not to mention the rest of the population. According to Dr. Horton, the target groups represent about half of the state’s total population.

At the time of our last swine flu update, see related article below, HCA published a list of public clinics where people who were members of the target groups could get the vaccine. As of yesterday, the only clinical availability information on the HCA site was for pregnant women. That information has not changed since our last update. Pregnant women should get vaccinated. Click here to go to the web page.

Another way to find the H1N1 vaccine is through Google. They have a zip code based locator; click here to go to the page. However, when we tested it with the Rossmoor zip code 90720, we got the following message: “No flu shots found near 90720. All locations below are out of stock. Some clinics with flu shots are not listed yet, so check back often.”