It was worse, we were running out of kits that do the rapid test to check for influenza. We have to run test that take a long time to come up with a result
We had 10 patients who almost certainly had the swine influenza virus, which makes me think we have hundreds of cases only in town. In the US, it's almost certain there are thousands of patient with the infection who are yet to be diagnosed, and probably will never get diagnosed.
The CDC (Center for Disease Control) encouraged anyone with symptoms resembling influenza to go to the ER. Meanwhile, they told physicians to not check those with mild or moderate symptoms for the virus. So we have more people coming to the ER with large numbers, but we won't be testing them.
Our ER is full, so we are emptying one of our wards and transferring all patients coming in with such symptoms to that ward. Most will not be tested, and only the very sick will be admitted to the hospital and treated. I'm still not sure were will the drugs come from , but they will come from somewhere. Even in America, you'll need someone influential to push some buttons and get some drugs sent to those who need them.
Homeland security (headed by the former Arizona governer) will be shipping doses of Tamiflu (influenza drug) that will be enough to treat 30 patients in our hospital. It's harsh to say that, but I'm glad the first case of swine influenza was reported in Arizona yesterday, which allowed them to send us some Tamiflu. It didn't occur to them that Arizona borders Mexico, and that we have hundreds of people coming to Arizona from Mexico everyday.
And here comes the challenge: we had to make a policy of treating only a certain group of patients who we believe will be the sickest and who may actually die from this influenza. It's not an easy decision to tell someone with the infection that they will not be treated because there isn't enough drug on board.
What makes things less dramatic is the fact that those drugs work only within 2 days of the onset of symptoms, so even without the extreme shortage that we're experiencing we wouldn't have treated a lot of those infected to start with.
Last year I took part of an enormous workshop lead by former Surgeon General Richard Carmona to teach students from the colleges of medicine, pharmacy and law about the dangers and implications of an influenza epidemic. It was a little overwhelming for most participants, but the point we all agreed upon: We can never be 100% ready to face an epidemic. The ethical and economic challenges of any epdiemic can be more dangerous than the epidemic itself.
Take this for example: In 1972 in Yugoslavia, one citizen came back from Saudi Arabia carrying a small pox, and infection that had been eradicated long before that. This one person infected many relatives, and those relatives spread the infection all over the country. The military had to act and lock those infected or even anyone with symptoms in buildings. They forced everyone in the country to be vaccinated, and held checkpoints to make sure everyone was vaccinated, and would force everyone to get the vaccine. They succeeded in eradicating the infection, and thanks to science smallpox has been eradicated from the face of the earth since 1979.
If you think the military would only violate the privacy and freedom of citizens in communist Yugoslavia, think again. If the US was faced with a similar epidemic , it won't be surprising to see soldiers down the streets forcing sick people to stay home, forcing laws that decide on the patients who need to be treated, and shutting down schools and arresting whoever aims at spreading mass hysteria and panic among people.
Fortunately, this current swine influenza epidemic is similar to "the regular human influenza" that have affected everyone of us several times in our lives. Even though the number of those infected will continue to rise, and very few people may succumb to the diseases, it's nothing out of the ordinary and most infected people will recover beautifully. This outbreak showed that we are much better prepared for epidemics than we were a century ago, a lot of work still needs to be done, and influenza will keep mutating and hitting and the next hit may not be as soft as this one.
And Egypt slaughtered all pigs- for this moment I am ashamed of being an Arab, seriously.