FARMINGTON — As the first full-fledged flu season of the novel H1N1 influenza approaches, health officials are preparing for a worst-case scenario while hoping for a best-case scenario.
"This is, potentially, one of the biggest challenges that this department has ever faced," said Lewis Garrett, Davis County Health Department director.
The challenges are threefold, Garrett told the Davis Board of Health on Tuesday morning: communication, vaccination and care sites.
Of the three pandemics in the past century, two are hardly a footnote, but the other — the 1918 influenza outbreak — was a disaster, he said.
And as information is available about how the H1N1 virus is transmitted, who is most at risk and how to fend off an infection, local health departments will help in spreading those messages, Garrett said.
There's some comfort right now that unlike the avian flu, which is quite deadly, H1N1, also known as swine flu, seems to have a low mortality rate, he said. But also unlike the avian flu, H1N1 is transmitted easily.
In Utah, H1N1 has led to 298 hospitalizations and 17 deaths, five of which have been in Davis County.
Unlike the seasonal flu, which usually hits the elderly population and very young children, this particular strain seems to be hitting young adults and pregnant women, Garrett said.
That's why pregnant women will be the highest priority for vaccinations, which are currently in clinical trials. Pregnant women will be followed by household contacts of children under 6 months, health-care professionals, people 6 months to 24 years old and then the non-elderly population with underlying medical conditions, Garrett said.
The vaccination regimen for H1N1 is two doses taken three weeks apart, meaning those who are vaccinated this year will receive three flu shots — one for the seasonal flu and two for H1N1.
Garrett said health officials expect to see an increase in the number of people who catch the H1N1 strain, which was identified in March and declared to be a worldwide pandemic in July.
"We're very, very likely to see a second wave of cases in the fall," he said.
But if the worst happens — high hospitalization rates and deaths — officials will need to figure out how and where to care for people.
Even if Davis County's two hospitals cleared their beds for those seeking elective procedures, that would only open about 100 beds. That means other sites would be needed in the county. The downside is that even if bed space could be found, respirators and other hospital equipment probably couldn't be located, Garrett said.
Despite so many unknowns — the attack rate, secondary attack rate, mortality rate — there is room for optimism because of where the flu season is in full swing.
"We're not seeing catastrophic cases in the southern hemisphere," Garrett said.