Yes, more links - including CDC e-cards (hilarious)

Some links (along with some commentary):

• CDC urges caution on estimates of H1N1 - A White House panel recently provided modeled estimates that up to 90,000 people could die of H1N1 this season. CDC cautioned against that number, saying that the scenario was unlikely and that it's still working on its own projections. This article also reports that some vaccine may be released early to some high-risk populations.
• HHS will collect hospital bed data electronically during the H1N1 flu season. This will be done through the HAvBED system that is currently in place due to emergency preparedness measures. It should be interesting to monitor this and see what data this system produces.
• Schools preparing for H1N1 - Colleges are already being hit by waves of H1N1 now that students are back to campuses. Lower-level schools are preparing to be vaccination clinic sites; according to a National School Boards Association survey, 75% of superintendents surveyed would be willing to host a clinic. And, don't forget, CDC is recommending that schools not close during an outbreak but rather remain open and mitigate the spread of the virus.
• Some H1N1 vaccine will be available as early as mid-September, says CDC's National Center for Immunizations and Respiratory Disease. (I can hear my colleague on a conference call discussing the implications of this as I write!) This was one of the recommendations put out by the White House Council of Advisors on Science and Technology earlier this summer. See all the recommendations here - they're quite interesting.
• H1N1 on social media - Public health, meet the 21st century! CDC is keen on keeping the public aware of public health goings on through various social media outlets.
  
  1. CDC has a Facebook page that includes periodic updates on recent findings & news.
  2. CDC also has several different Twitter accounts: CDC_eHealth (general social media), CDCemergency (emergency updates), and CDCflu (seasonal and H1N1 influenza updates).
  3. Other social media outlets include YouTube, Flickr, MySpace, and others.
  4. Check out these CDC e-cards - they're hilarious. Everything from creating a healthy home, thanking someone for their support as they become seizure-free (seriously), and Valentine's Day injury prevention tips (yeah, seriously).
     

Links

I know, you're saying "More links? Write a real article!" Well, there are just so many interesting links, I can't help myself.

• The Wall Street Journal reports that H1N1 (we are not calling it swine flu anymore, people!) may affect businesses and the workplace with people out sick. CSTE is heavily involved in putting together a Continuity of Operations plan so that we can carry on our work tasks while at home if needed. Talk to your employer about it!
  
• The 2009 Flu Vaccination Challenge - the beginning of flu season means the beginning of the flu challenge, a campaign to raise vaccination rates among health care workers. The podcast linked to on this page features Dr. William Schaffner, a great speaker!
• There is a new vaccine being developed for norovirus, very interesting. This vaccine stems from the tobacco plant; plant-based vaccines can be developed more quickly and therefore get to the public more quickly.
• A new study in Science (as reported here in the Atlanta Journal-Constitution) indicates that students and parents should get the H1N1 vaccine first, so that those most likely to get the virus are protected. The current guidance is for those who are most likely to be hit hard by the virus to be vaccinated first. An interesting debate.
• This article reports on a new finding that individuals enrolled in the food stamp program are more likely to gain weight. One of the recommendations of the study is that there be economic incentives for food stamp recipients to buy healthier foods.

Links for the day

A few interesting articles for your reading interest. (Is anyone reading this blog? If so, please comment below!)

• I don't usually post international news here, but this was too good to pass up. This article discusses chronic disease prevalence in Africa. You think it's a country filled to the brim with HIV and infectious disease problems, but chronic disease is creeping up too.
• This article discusses the rate of H1N1 among blacks and Hispanics, saying that the rate is much higher in Boston. I wonder if this is the case in other areas as well.
• Just found this blog about pandemic influenza. It links to a WHO report about transparency during public health emergencies.
• Surprise, surprise. The housing market woes affect people's mental health. The full article is available from the American Journal of Public Health, but here is an article summarizing it.
• The title of this article says it all: Swine Flu, The Next Wave: What you need to know as the virus threatens to spread with the start of the school year. (Note: the article is in Q&A form but is not as dramatic as the title suggests.)
• And last, but not least, a subject I'm sure you're all awake at night wondering about: How did Mozart die? New research suggests strep throat, says an epidemiologist.
  

  
  

Links of the day

Some links to peruse:

• CNN's thoughts on H1N1 as school begins across the country
• Recommendations to not close schools but sequester students at home in case of H1N1 this fall
• New food safety legislation was passed by the House
• An unexpected beneficiary of the new food safety bill - technology companies
• The new OSHA head (officially named the assistant secretary of labor for the U.S. Occupational Safety and Health Administration) is an epidemiologist!
• Another outbreak - this time of ground beef primarily in California

And, finally, an article combating Dr. Sears and his "alternative vaccine schedule." The article states:

"Dr. Sears claims to listen to parental concerns and to be impartial when it comes to whether or not, or how, to vaccinate. He says that, rather than tell them what to do, he prefers to give parents all the information they need to make their own, informed decisions. But instead of accurately discussing the science for concerned parents, correcting the pervasive vaccine myths and misinformation so prevalent in the media, on-line, and in our communities, he distorts, misinterprets, and misleads."

Immunizations: Not just for kids!

Today's subject is adult immunizations. That's right, they're not just for kids! Adultvaccination.org says that "each year, about 50,000 adults die from diseases that can be prevented by vaccines."

Here is the adult immunization schedule from CDC. It includes Tdap, HPV, varicella, influenza, shingles, and more.

A recent National Foundation for Infectious Diseases survey found that people are most likely to listen to their doctor about getting immunized. The Foundation reports that "The vast majority of respondents (87 percent) said they are very or somewhat likely to get a vaccine if
their doctor recommends it." And as adult vaccination rates are low, physicians are being urged to talk to their patients about immunizations.

There is also a racial disparity in adult vaccination rates. For example, 67% of older adults received a flu vaccine, but only 50% of blacks and Hispanics. The disparity is even wider for pneumococcal vaccination.

Some of the issue is the lack of knowledge about the important role vaccines play. According to the AMA News, "only 30% of young adults know that flu kills more Americans than any other vaccine-preventable disease."

So get on it. Get vaccinated. It's pretty likely you've been meaning to get that tetanus shot that's out of date. Go ahead and update your other vaccines as long as you're at the doctor's office. It may just save your life.

Preventive care

Preventive care. Good, right? Prevent diseases from occurring in the first place instead of treating those conditions once they occur. Sure, sounds great! And it probably saves money too, right? Wrong.

While prevention makes good sense, and should happen (in most cases, anyway), prevention does not save money. (See this Kaiser article.) There are some exceptions. Childhood immunizations by and large save money, as do smoking cessation programs. But Pap smears, screening for prostate cancer, and other preventive care programs do not save money.

Many involved with health care reform mistakenly tout that these new prevention measures will save us money in the long run. That simply isn't true. Adding prostate cancer screening, for example, will cost Medicare $2.8 billion over 10 years.

Please don't misunderstand me. I am a big proponent of cost-effective preventive care. Stressing the cost-effective part. Cost-effective doesn't necessarily mean cost saving. If the intervention costs less than, say, $50,000 per life year saved, it may be deemed cost-effective. (This is an arbitrary figure that just illustrates how cost effectiveness is measured. An intervention may cost $1 per life year saved - pretty good! - or $1 million per life year saved - pretty bad! - and the cutoff point is VERY subjective.

Let's take the example of cervical cancer screening. Screening women (who have had a normal Pap smear) for cervical cancer every 3 years costs $262,800 per life year saved vesus the $1.1 million screening every year. (Russell's "Educated Guesses") Indeed, the Agency for Healthcare Research and Quality (AHRQ) does not recommend annual screening, because there is no evidence "that annual screening achieves better outcomes than screening every 3 years."

So, in sum, preventive care is not always cost-effective. Sometimes it is. Sometime it's not. But the determination of when something is cost-effective is extraordinarily subjective. Screening your mother for breast cancer may be worth $1 million to you but only $1 to someone else. It's a very tricky business.

More articles about prevention:
Health prevention often costs more than it saves
Do prevention or treatment services save money? The wrong debate
Preventive care and cost savings
Preventive care not always cost effective
Does preventive care save money?

News links

Several interesting articles from the weekend that may be of interest:

• Keeping healthy while flying - Spreading germs on a plane can be mitigated by keeping your hands clean (duh) and using common-sense public health practices.
• Possible vaccine controversy with the coming H1N1 vaccine - The author discusses the importance of a public education campaign around vaccine safety.
• Our very own Lisa had an article published in a recent MMWR! This article discusses the paper about the National Electronic Disease Surveillance System (NEDSS).
• The House passed a food safety bill - This bill will require more frequent FDA inspections.
• Mental health is an important issue in the military - This article discusses suicide rates among soldiers.
  
• And, just for fun, Michael Pollan had a recent article discussing the changes in American cooking habits in light of the new Julia Child movie, "Julie & Julia." I thought it was an interesting article.