H1N1

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needledox

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For those who were practicing at the time, what was it like? I was still in undergrad at the time.

We had 13k deaths over a year and a half span, so there had to be some of what we are experiencing today.

Where were the major epicenters? Were ICUs overrun like they are today?

In training, the ICUs seemed like they were always near capacity in the winter months for various reasons. Was just curious if H1N1 presented some of the same issues coronavirus is
 
H1N1 surges seemed to hit in the spring, at the tail end of the typical flu season. We had surges and overflow outside the ICU, but nowhere near the strain on capacity that this current pandemic represents. Our MICU rounds would last hours. Patients were sick and vented for weeks. At the time, high frequency oscillator vent strategies were en vogue and we were using it on a number of patients. APRV was also becoming a new vent toy. The scary thing about H1N1 was it affected the young and for some reason pregnant women seemed particularly vulnerable.

Hospitals were certainly strained at the time and were frequently “above capacity,” but I don’t remember ever contemplating vent shortages, splitting vents, or rationing PPE. We knew H1N1 was coming for what felt like months before we saw the first case. As a residency program we had plans in place to cover hospital surges and how coverage would work if someone got sick.
 
H1N1: No media frenzy, no multi-trillion dollar government spending program, no shutting down the USA, no lock-downs, no quarantining, no social distancing.
 
H1N1 deaths 18000
COVID-19 deaths 34,000 and still going exponential ... not the same thing
Screen Shot 2020-03-30 at 11.49.37 am.png
 
According to Washington post, We had 100million+ n95 reserve at that time(Bush junior administration set it up). 90million was used. Nothing was replaced.


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ICUs were a little busier. Most of us were unaffected. It was there, and there was concern about it, but its impact and the atmosphere were completely different. No one was really freaked out about it. I included this photo in a presentation I gave as a CA3 (on a completely unrelated subject). People laughed. No real worries.

h1n1.png
 
H1N1 deaths 18000
COVID-19 deaths 34,000 and still going exponential ... not the same thing

the CDC estimated between 280,000 and 570,000 deaths from H1N1 worldwide. 18,000 was only the cases they had lab confirmation for which was likely a very small percentage of overall.
 
We had a couple extra patients daily in the academic MICU I was on at the time. A few were sad cases where the lady was pregnant. A few died. A bunch got better.
The volume just wasn’t there, and neither was the rampant spread. I don’t remember doing anything excessive for PPE, gown/gloves, and I don’t even recall using N95s. I definitely had terrible technique for “doffing,” but nobody cared.
 
We had a couple extra patients daily in the academic MICU I was on at the time. A few were sad cases where the lady was pregnant. A few died. A bunch got better.
The volume just wasn’t there, and neither was the rampant spread. I don’t remember doing anything excessive for PPE, gown/gloves, and I don’t even recall using N95s. I definitely had terrible technique for “doffing,” but nobody cared.

we did not cancel elective ORs, we did not restrict hospital visitors (any more than normal flu season restrictions), did not use N95s, etc.
 
the CDC estimated between 280,000 and 570,000 deaths from H1N1 worldwide. 18,000 was only the cases they had lab confirmation for which was likely a very small percentage of overall.

34k is also confirmed cases. How many unaccounted for? Some Italy doc claimed 3/4 not counted.


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