State health officials are braced for the impact of the H1N1 virus that could sicken 30 percent of the state's work force at its peak. The response has been years in the making.
"The main thing we want to emphasize to the community is that we are ready for it when it hits," said Dr. Melinda Rowe, commissioner of health for Fayette County.
"Outside the health care world, people are very nervous," said Dr. Kraig Humbaugh, the state epidemiologist. But "this is something that we have been thinking about for quite some time."
Logistical planning began in earnest in 2003, he said, when the avian flu looked as if it might become a pandemic. Because that planning had taken place, some practical measures — specific to H1N1— have already been put into place, Humbaugh said. For example, supplies of anti-viral medicines for H1N1 have already been laid in because, after the outbreak of H1N1 in the spring, Kentucky asked for and received its allotment of anti-viral medicine, along with supplies such as masks.
Anti-viral medicines will not help you avoid H1N1 but can, if administered early enough, lessen the severity of symptoms.
The state-controlled supplies can be used to augment the anti-viral medicines available to the public through pharmacies and hospitals. Those supplies are allotted to the state by the federal government.
The next step will be receiving the H1N1 vaccine. The federal government buys the vaccine from manufacturers and, as with the anti-viral medicines, doles it out to the states. The vaccine is expected to be available in late October.
It hasn't been determined exactly how the vaccine will be divided among states, Humbaugh said. There is still discussion of whether the vaccine will be effective in a single dose or require a second vaccination to provide full immunity.
Kentucky officials continue to monitor the severity of the H1N1 flu. Currently it is extremely contagious but has generally resulted in symptoms on par with normal, seasonal flu, he said.
Local health departments are preparing to give out seasonal flu vaccines and are planning for mass vaccinations when the federal government releases the H1N1 vaccine. Once the H1N1 vaccine is available, Fayette County plans to vaccinate thousands of people at a time on weekends in locations throughout the area, Rowe said.
The state and Fayette County health departments are putting together flu hotlines that will have staff available to answer questions. Also, Fayette County has created a flu outreach response team that is available to speak to groups about H1N1.
One of the biggest challenges for health care providers might be staffing, said Dr. Chris Nelson, medical director of infectious control for UKHealthcare. At the same time that clinics and hospitals will see an increased number of patients, 30 percent to 40 percent of the staff is expected to be out with the flu or home taking care of sick family members.
Dealing with staffing shortages requires some creative thinking, such as asking registration staff to use a brief questionnaire to determine whether someone has the flu so they can quickly be isolated from other patients.
"We will have a lot of sick patients," Nelson said. "We will also have what we call 'the worried well' — patients who think they have the flu."
Educating health care professionals is crucial so the proper antiviral drugs are used for the specific flu virus. Reminding everyone to wash their hands frequently and stay home when they are sick, and educating them about the difference between seasonal and H1N1 flu is important, officials said.
"It's the simple things that your mom told you to do, those things that prevent the spread of illness," Humbaugh said.
And there is a concerted effort to inform senior citizens, who are typically given priority for any type of flu vaccine, as to why they aren't first in line to receive the H1N1 vaccine. Analyzing the already diagnosed cases, it appears that people 65 and older have a built-in immunity to H1N1 that isn't present in the rest of the population, according to the CDC.
"We will have vaccine for them," Rowe said, "but it may not be until November or December."