9 Jan 2018

Deadly influenza outbreak spreads throughout US, most severe in California

Dan Conway

The United States—and in particular the state of California—has experienced a drastic increase in influenza cases over the past few weeks, many of them life threatening.
According to the Centers for Disease Control and Prevention (CDC), influenza cases were widespread in 36 states at the end of 2017 and 21 of those 36 states were experiencing high levels of cases. Influenza is considered to be “widespread” if cases cover a wide geographic distribution while states experience “high” levels of cases if documented instances of influenza at a given time are much greater than seasonal averages.
According to the CDC, the 2018 flu season will likely be the worst since the 2014-2015 season which was the “most severe season in recent years” as the CDC reported at the time.
Like the 2014-2015 season, most patients are contracting a strain of influenza known as H3N2. This particular strain is unusually virulent even putting those with up-to-date flu vaccinations at risk. Flu vaccines often do not provide adequate resistance to the H3N2 strain with health officials estimating that this season’s vaccine may only be about 32 percent effective against it.
“Typically in years when the predominant strain is H3N2, there are more hospitalizations, more severe disease and people tend to get sicker,” Dr. Michael Ison, a professor of Infectious Disease at Northwestern University’s Feinberg School of Medicine, told NBC News.
Moreover, the flu season this year has only just begun. Most deaths occur among the elderly and infirm as the flu’s weakening effect on the immune system leads to heightened risk of disease and infection.
Pneumonia is a common influenza-related complication and can often prove fatal. This has led the CDC to monitor Pneumonia and Influenza (P&I) mortality rates together which it utilizes in its classification of possible flu epidemics. Using data obtained from the National Center for Health Statistics (NCHS) which reports mortality causes on a weekly basis, the CDC found a P&I rate of 6.7 percent during the last week of 2017.
The epidemic threshold for the flu is 6.9 percent, however there is a lag in mortality classifications due to the fact that many death certificates are still processed manually by the NCHS. This means that the flu may have already reached epidemic proportions using CDC criteria. At the time of the 2014-2015 epidemic, mortality rates due to P&I reached 8.5 percent.
Regardless, the latest outbreak has reached almost crisis level proportions in California, the nation’s most populous state. Twenty-seven people younger than 65 have died as result of the outbreak while only three died during the same period last year. Last year, 68 people died in California as a result of the flu by the end of February.
Hundreds of thousands have been forced to miss school and work due to the outbreak. Many others cannot call in sick due to the precarious nature of their employment, putting neighbors and family at risk of infection.
Pharmacies throughout the West Coast are reporting inadequate supplies of Tamiflu, an antiviral medication considered among the most effective in reducing severe flu symptoms.
Emergency rooms have been filled over capacity with long wait times for patients seeking treatment. UCLA Medical Center in Santa Monica, for example, typically sees around 140 patients per day. This week, it averaged more than 200 patients per day. “The Northridge earthquake [of 1994] was the last time we saw over 200 patients,” Dr. Wally Ghurabi reported to the Los Angeles Times.
Other area medical centers report emergency rooms so crowded that ambulances are not able to quickly unload their patients preventing them from responding to 911 emergency calls. Some hospitals in the San Francisco Bay area are refusing admittance to children under the age of 16 to reduce their exposure to the virus.
Dr. Randy Bergen, clinical lead of the flu vaccine program for Kaiser Permanente in Northern California, spoke to the Times of the perilous character of the recent outbreak. “Rates of influenza are even exceeding last year, and last year was one of the worst flu seasons in the last decade,” he said.
Several hospitals throughout the state have resorted to setting up makeshift emergency facilities in outdoor tents to take care of the patient flow.
This year’s flu outbreak as in prior years demonstrates nothing else so much as the contradiction between the basic health needs of the population and the obscene profit making of the capitalist health care industry. As hospitals and emergency services find themselves overcrowded and virtually unable to meet the demands of a predictable disease outbreak, health insurance company profits are increasing at levels in excess of the regular economy as a whole.
This is in large part due to the imposition of the Affordable Care Act, known as Obamacare, which from its outset has been used as a mechanism to provide expensive yet substandard care to the population in order to divert vast sums of wealth into the pockets of the managed care corporations.
Even as the stock market soared to record heights in 2017, managed care stocks performed far better than the average. The Standard and Poor’s stock index returned an average of 135.6 percent during the seven years preceding the end of 2017. During that same period, managed care stocks increased by 300 percent.

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