The Centers for Disease Control and Prevention expects the highly contagious H1N1 virus, known as swine flu, to bear down on New England within weeks, and health officials are scrambling to prepare for the worst while hoping for the best.
However, the vaccine for the H1N1 virus won't be available for another two weeks, and only then for a certain segment of the population, Massachusetts health officials said.
"H1N1 is hitting now, but the vaccine isn't available yet," said Karen Nelson, senior vice president for clinical affairs at the Massachusetts Hospital Association.
Colleges, hospitals and health departments are leaving nothing to chance as the H1N1 virus, which can mutate from mild to severe in a short period of time, begins showing up as the weather cools and schoolchildren spend more time indoors with each other, increasing the chance of it spreading.
At Merrimack College, an unused section of a dormitory has been set aside as an isolation area for sick students who aren't from a local community and can't make it home on their own, while hand sanitizer stations have been set up on campus, according to Dean of Students Shawn DeVeau.
At Lawrence General Hospital, officials are prepared to erect tents in a section of the parking garage to be used as a staging area to assess sick patients if a large-scale outbreak occurs, said Barbara Keller, a spokeswoman for the hospital.
She added, however, that things won't likely get to that stage.
"We have a group meeting every Friday morning, internally," she said, made up of representatives from every department. "We have to be prepared for a possible upswing."
In New Hampshire, "plans are in place" in the event of a "medical surge," said Kathy Bizarro, executive vice president of the New Hampshire Hospital Association.
That would mean working with area hospitals to put some patients in locations outside the hospital setting "who are too sick for home but not sick enough for the hospital."
She added, "We are hoping the illness remains less severe."
The highly contagious virus, which mostly affects people under the age of 24, is believed to be responsible for the recent death of an Ohio college student originally from Hingham, Mass.
An outbreak at Phillips Exeter Academy in Exeter, N.H., sickened 10 students two weeks ago.
Hundreds of others have died from it since it began showing up earlier this year, first in Mexico in February and later in the United States.
Millions more have contracted the virus, but most only show signs of flu-like symptoms, which eventually abate.
When will the vaccine be here
Nelson, of the Massachusetts Hospital Association, said that based on what she's been told by the state Department of Public Health and the Centers for Disease Control and Prevention, 60,000 doses of H1N1 vaccine have been distributed in Massachusetts, although it's unclear who received them.
By Oct. 9, another 78,000 are expected to be available, followed by 330,000 Oct. 16, and another 340,000 doses by Oct. 23.
By the end of the month, she said, some 1 million doses will have been made available, mostly to pregnant women, health care and emergency workers, and youth at-risk of other illnesses.
"The priorities are based on higher-risk populations," she said. "Pregnant women, or women who plan to be pregnant during flu season, because the immunity goes to the mother and fetus and babies can't be vaccinated up to six months old.
"Children in general are next. Then young adults — teen and college-age — who are in close proximity and tight living quarters and highly mobile. Fourth are the folks with underlying chronic diseases at greater risk of complications, such as heart disease."
Once the H1N1 vaccine starts coming in, Nelson said Massachusetts is ready to start distributing it. Already, some 2,600 locations around the state have been identified as sites for dispensing the vaccine, from schools to CVS/pharmacies.
The hope, she said, is that people will keep an eye out for H1N1 vaccine availability in their towns.
Once the shots get to Andover, for example, Tom Carbone, the health director, said his department is ready to conduct large-scale flu clinics, during which the town could administer up to 800 vaccinations in just three hours.
"We do seasonal flu clinics very well," he said, adding that he recently attended a regional pandemic summit hosted by Holy Family Hospital in Methuen, during which the discussion centered around how health departments, schools and hospitals will respond to the virus.
"We know it's going to get worse before it gets better," he said.
At the state level, the Department of Public Health in Massachusetts, and the Department of Health and Human Services in New Hampshire are having weekly meetings with hospitals and other caregivers to provide them with updates on the constantly changing landscape of the virus and the availability of the vaccine.
The fight begins with prevention
While public health officials continue planning, much of the focus locally has been placed on prevention.
At Merrimack College, for instance, students entering the newly renovated lunch room at Sakowich Hall said they are aware of the highly contagious nature of the flu, which explains why the hand sanitizer stations at the entrance and exit are so heavily used by students coming and going for meals.
"They (college administrators) really stress it," said Andrew Wenstrom, 19, a sophomore in sports medicine from Norwood, as he rubbed sanitizer on his hands. "Plus, I don't want to get sick."
He said he has asthma, and that complications from the swine flu could compromise his health. "Whenever I pass the sanitizer, I use it," he said.
Others, however, may need prodding.
"I don't use it every time," said Kathryn Mariano, 19, a sophomore from Dedham, Mass. "But I do sneeze in my sleeve."
She also said she's not sure she'd take the vaccine, even if it's offered.
"They made it in two months," she said. "I'm not sure I trust it."
At UMass-Lowell, new students were handed thermometers during summer orientation so they can check their own temperatures if they think they might be getting sick, said Nancy Quattrocchi, executive director of Student Health Services.
Employees are getting their own thermometers this week, she said. If it's over 100 degrees, they have to go home.
In Andover, as in other schools, hand washing has been taught to elementary school students, said Rita Casper, director of nurses for Andover schools, where several cases of suspected swine flu have already been identified.
She strongly encourages everyone to get seasonal flu shots as well as the H1N1 vaccine, once it arrives.
But people who come down with the virus before the arrival of the vaccine might just have to wait it out.
Casper and others said the symptoms are usually no worse than the seasonal flu. She said that if someone has symptoms — a fever over 100.4, a cough and a sore throat — they need to stay home.
The CDC's Web site advises people to stay home at least 24 hours after the fever breaks.
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