FluPortal.org

The CDC has just released new numbers on H1N1 — estimates of cases, hospitalizations, and deaths from April 2009 to mid-January 2010.

This CDC chart summarizes the data:

[CDC]

Click here to find the data broken down into helpful bar graphs. Also to learn how CDC compiles its estimates.

We blogged recently about a Pittsburgh-area study that suggests roughly 63 million Americans were infected with H1N1 in 2009. This estimate — although based on a methodology completely different from the CDC’s — falls in the mid-range of the CDC estimates. (Note: the CDC numbers include data for two extra weeks in January 2010.)

[Voces de la Frontera / cc (usable on your site) / Flickr]

A study (PDF file) released in February by the Institute for Women’s Policy Research suggests that the lack of paid sick days in the private sector increased the spread of H1N1.

Some of the study’s interesting findings:

• “The vast majority of public sector employees receive paid sick days, but two of five private sector employees have no access to paid sick days.”
• “[E]mployees who attended work while infected with H1N1 are estimated to have caused the infection of as many as 7 million co-workers.”
• “The data suggest that more than 90 percent of public sector employees, but only 66 percent of private sector employees, took time away from work when infected with H1N1 [...] implying that many more private sector employees felt that it was necessary to attend work while ill.”
• “[T]he drop in absence rates between October and November was twice as steep in the public sector as it was in the private sector, suggesting that contagion was less common in the public sector.”

The study goes on to propose that “similar patterns of absence” might be “found among children and students” depending on whether their parents “have access to paid sick days to care for family members.”

(Our usual disclaimer: we can’t vouch for the study’s methodology or results; we offer it up as something you might be interested in reporting on.)

[Update 4 March 2010: This is an issue that public-health experts have worried about throughout the H1N1 pandemic. New York Times article from November 2009 here and WNYC report from September 2009 here.]

As the H1N1 pandemic emerged in the spring of 2009, many media organizations — both commercial and non-profit — were facing immense financial pressures. “Unpopular Science,” an article that appeared in The Nation last summer, argues that the economic crisis of journalism threatens the quantity and quality of science and health coverage.

It’s no secret the newspaper industry is hemorrhaging staff writers and slashing coverage as its business model collapses in the face of declining readership and advertising revenues. But less recognized is how this trend is killing off a breed of journalistic specialists that we need now more than ever–science writers…who are uniquely trained for the most difficult stories, those with a complex technical component that are nevertheless critical to politics and society… [E]ven in places where you’d expect it to hold out the longest, science journalism is declining.

Does this argument extend to public media? Public radio and television have long prided themselves on providing science and health reporting that contains substance – not the gee-whiz info-tainment reporting that pervades commercial media. But public media has not been immune to the economic downturn. National producers and local stations alike have been forced to cut staff and reduce spending. But is this hurting our science and health coverage?

Bill Hammack is a professor of engineering at the University of Illinois and a frequent public radio contributor – both at his local station WILL in Urbana, and to national programs like Marketplace. Hammack agrees that fewer dollars to go around has the potential to lessen science and health coverage. “I see the Nation article as pretty accurate. It’s a case of hard numbers. There’s often only one science reporter at any news organization. If that position gets cut – there goes your science coverage.”

But Hammack doesn’t see it happening yet, and thinks public media science and health reporting will weather the economic storm. He points to the continued commitment from NPR to an active and robust science desk as well as audience demand for — and interest in — scientific news and ideas. It’s much harder to cut programming the audience values. “Public radio and television audiences value reflection and analysis. They desire context. That’s exactly why science reporting by public broadcasters is so strong when compared to commercial media.”

Connie Walker, the General Manager at WUNC in Chapel Hill, is also cautiously optimistic for public media science and health reporting. Walker mentioned that loyal listener support during the recession is a public media positive that commercial media can’t share in. “Corporate underwriting is down here, but our listeners have really showed great support during our pledge drives.”

WUNC has a full time health reporter on staff and, until recently, the position was funded by a foundation grant. When the economy went south, the funding was pulled and the station had a decision to make. WUNC kept the health reporter position and folded the cost into their general operating budget.

Walker says, “We maintained the science coverage because we feel it is a valuable part of our service and something our listeners have come to expect.” WUNC’s listening area includes a number of universities in the Research Triangle region of North Carolina. “We not only have an audience that is interested in science, but also local stories to cover.”

Although the station has been able to maintain its science coverage, it hasn’t been easy. Due to general budgetary pressures, the station has deferred filling a number of open positions and had to trim overall spending. Walker says, “We’re more fortunate than most, but the staff is feeling it. We’re asking them to do more with less.”

Have you noticed any decrease in the quality or quantity of public media science and health coverage? Does it remain a part of your station’s local coverage?  Let us know in the comments.

SAFER (Station Action For Emergency Readiness) is an NPR-NFCB initiative to help pubmedia stations prepare for emergencies. It’s offering a session on emergency readiness plans at the Community Radio Conference in June. Here’s the full announcement from SAFER’s Ginny Berson. (Read more about the SAFER project here.)
__________________________________________________________________________________________________

SAFER — Your Station in an Emergency
9:00AM – 2:00PM, Saturday, June 12th, 2010
35th Annual Community Radio Conference in St. Paul, Minnesota
Richard Dillman, SAFER Manual Writer and KWMR Transmitter Engineer

Hurricanes, fires, blizzards, chemical spills, floods, earthquakes — is your station ready to provide critical public service in a time of critical public need? SAFER — Station Action for Emergency Readiness — is a joint project of NFCB and NPR, funded mostly by CPB. The SAFER project has created a detailed guide for stations to develop their own emergency readiness plans, plus digital tools for station websites.

This Intensive is for stations that have started work on their plan. It will be very interactive. We will work with plans from a variety of stations — different sizes, different kinds of markets. We will workshop the plans, help you solve problems that have you stumped and help you move forward.  

You will have opportunities to pick the brains of and share ideas with people from other community and public radio stations. Regardless of where you are in your planning — as long as you have begun — we encourage you to attend this Intensive and take advantage of the best thinking of the SAFER team and stations working through some of the same problems.  

Who should attend this Intensive? The staff person who is most involved with and responsible for developing your station’s emergency preparedness plan.

This Intensive is supported by a grant from the Corporation for Public Broadcasting.

Although the registration fee for the SAFER (Station Action for Emergency Readiness) Intensive is only $50, we know that for some of you the cost of getting to St. Paul, staying in the hotel, etc. will be prohibitive.  

We are able to offer 3 scholarships, each worth $1000, to 3 stations so that they may attend the Intensive (and the Community Radio Conference, if you wish). The scholarship application can be found here.

Ginny Z. Berson
Vice President and Director of Federation Services
National Federation of Community Broadcasters (NFCB)
510 451-8200 ext. 305
1970 Broadway, Suite 1000
Oakland, CA 94612
www.nfcb.org

When the World Economic Forum convened its annual meeting of high-powered business leaders this winter, it offered a panel examining the pandemic vulnerability of companies dependent on the global economy.

Here’s one statistic it cited to make people sit up and take notice. (It’s not clear whether the numbers refer specifically to H1N1 or to any pandemic.)

[A]lthough 60% of CEOs believe the threat of a pandemic is real, only 22% have an emergency plan and only 27% are working on developing one.

Among the key points it raised:

The interconnected nature of the global economy is likely to result in unexpected effects from a pandemic. A company may find that a disease halfway around the world stops it from receiving critical parts or materials needed for its own manufacturing.

To stress the importance of desigining a pandemic plan ahead of time, the panel cited examples of two Mexican companies navigating H1N1′s first wave. The first company weathered it well because it had a pandemic plan in place. The second one had “to suspend operations for nearly a month and ran a significant loss” because it apparently had no pre-existing plan. The panel emphasized that it’s virtually impossible to design an effective plan once a flu pandemic is already underway:

[O]nce a pandemic starts, the flood of conflicting and often misleading information is likely to dramatically increase the difficulty of making executive decisions and communicating them to employees. As a result, it is crucial to have a contingency plan already in place.

The full summary of the “Prepared for a Pandemic?” panel is here. To read our post highlighting what companies can do to prepare for pandemics — what steps they can take to ensure “business continuity” — click here.

[Disclaimer: We're featuring the following study and estimate as interesting food for thought. We can't vouch for their accuracy; you would need to do your own reporting to evaluate that.]

Two different assessments of U.S. immunity to H1N1 have emerged recently. The first suggests the number of Americans infected by swine flu in 2009 (roughly 63 million). The second estimates the number of Americans who currently have immunity to H1N1 (somewhere roughly between 150 and 165 million).

Ted Ross [U. of Pittsburgh]

Assessment #1: A new study published in PLoS Currents: Influenza estimates the number of Americans who were infected with H1N1 in 2009. (Read our post about PLoS — the Public Library of Science — here.) The lead author is Ted Ross, an associate professor of microbiology and molecular genetics at the University of Pittsburgh.

The study looks at levels of antibodies to 2009 H1N1 in Pittsburgh-area residents. (Infection with a virus stimulates antibody production, which then confers immunity.) It examines blood from “846 persons that ranged in age from 1 month to 90 years of age.” The samples were taken from “hospital and clinic patients in mid-November and early December 2009.”

It’s possible that some people with antibodies to 2009 H1N1 got them from the vaccine rather than infection with the virus — but “the timing of the sampling relative to vaccine availability in Pittsburgh suggests that these samples are likely from a largely unvaccinated population during the peak of the second pandemic wave.” In other words: the data probably approximate the number of people actually infected by H1N1 in 2009.

Here’s the study conclusion in a nutshell:

21% of persons in the Pittsburgh area had become infected and developed immunity. Extrapolating to the entire US population, we estimate that at least 63 million persons became infected in 2009. As was observed among clinical cases, this sero-epidemiological study revealed highest infection rates among school-age children.

Ian York [Michigan State University]

Assessment #2: Ian York, an assistant professor of microbiology and molecular genetics at Michigan State University, recently offered his best educated guess of the number of Americans now immune to H1N1 (on his blog Mystery Rays from Outer Space). As he puts it, there are three ways in which someone could have acquired immunity:

They could have been exposed to a related virus, some time in the past, and have developed a long-term immunity. They could have been infected with [H1N1], somewhere in the first or second wave. Or, of course, they could have been vaccinated.

He collects the available data for each of those categories — emphasizing that “[t]hey’re more or less approximate” — and concludes that:

• Over half the US population as a whole is now immune to the new [H1N1].
• As many as three-quarters of the elderly and two-thirds of the children — the most important populations as far as flu is concerned — may be immune.
• Between a third and about half of this immunity was due to vaccination.

To find York’s full table of high and low estimates — broken down by age group — click here.

Why is it useful to know what percentage of the population may have immunity to H1N1? As the PLoS study puts it, it “provides valuable information about the likelihood of a possible third wave and may be useful in decision-making about immunization strategies.” Or as York writes, the “level of immunity” that he calculated “is probably enough to impact virus transmission drastically.”

FluPortal will be winding up as an active project at the end of March. So we’ve recently been trying to evaluate what the site has done well and what its shortcomings are — with the idea that FluPortal might be a model for future “crisis portals.” (You could imagine a generic CrisisPortal or something more specific like EarthquakePortal.)

A few days ago, I spoke with Katie Donnelly, Associate Research Director at American University’s Center for Social Media. Donnelly focuses specifically on the intersection of social and public media. She featured FluPortal a couple of weeks ago in a blog post and told me she feels it’s a “really good solid model” for helping pubmedia to report on crises. So I pushed her on what she really thinks — on what constructive criticism she might have.

Donnelly had two main recommendations.

First: She suggested encouraging more direct interaction among stations. This could happen in a forum on the site, for example, or in something like a webinar or an online chat. The idea here, she said, would be to “improve ways for stations to connect with each other” to share ideas about crisis coverage.

FluPortal did experiment early on with a Google Group for just this reason, but very few people signed up. Perhaps it was the wrong technology for convening pubmedia people — or perhaps it indicated that station staff are simply too busy for this sort of thing.

I also mentioned to Donnelly that the FluPortal blog was a possible place for stations to interact (in the comments section). She observed that for some reason pubmedia people very rarely seem to comment on blogs — that blogs probably aren’t the right place to persuade stations to talk to each other.

Second: Donnelly felt that FluPortal is “lacking first-person accounts” about H1N1. She suggested soliciting crowdsourced information and encouraging the general public to tell their swine-flu stories on the site. Donnelly understood that FluPortal is aimed at public media — and not at a general audience — but felt it could be a good place for reporters to make contacts with regular people who are part of the H1N1 story. She acknowledged, however, that any public forum on swine flu would require active moderation to avoid “propagating inaccurate information.”

During the FluPortal project, we’ve searched the blogosphere for good H1N1 stories but haven’t found much that stood out. (Most posts and tweets were of the “I’m on my couch and I feel terrible” variety.) For other types of crises, however — earthquakes or storms, for example — personal narratives offered up online might indeed be more provocative.

What would you add to Donnelly’s critique of FluPortal? And what improvements could you recommend for future crisis-reporting sites modelled on FluPortal? (If you prefer not to comment directly on this post, you can email us!)

The Harvard School of Public Health (HSPH) recently hosted a talk evaluating how well journalists and health officials communicated H1N1 information to the public.

Dr. K “Vish” Viswanath
[Viswanath Lab]

One of the speakers, Dr. K “Vish” Viswanath, runs a lab at HSPH dedicated to researching health communication. Viswanath highlighted some particularly difficult aspects of transmitting the H1N1 story:

• Health journalists have to straddle two cultures: the world of medical complexities and uncertainties; and the world of deadlines and commercial pressures.
• “More information does not necessarily mean more communication”: even if scientists and journalists do an exemplary job during a health crisis, the internet makes it impossible to control the spread of misunderstandings and misinformation.

One interesting positive lesson: Viswanath noted that whether or not the subtleties of the H1N1 story were getting through to the public, people seemed to be following recommended behaviour — if it was easy to follow. He tracked sales of hand sanitizer during the pandemic, for example, and saw that they went up significantly:

[Dr. Viswanath, screenshot from lecture on H1N1 communication]

Finally, Viswanath made one more very important point: different social groups — whether based on “class, race, ethnicity, or language” — differ widely in their access to information and where they go to look for it. This “communication inequality” is hugely significant during a public-health crisis.

Not everyone, for example, has equal access to online information — or the skills to learn from it or act on it. As he put it, while “it’s exciting to see social media being exploited [...] not everybody uses the internet.” If media and public-health departments rely too much on the web, he says, this can actually widen disparities in access to reliable information. In a survey done in April 2009, only 19% of people reported getting “the most information” about H1N1 online. The lesson here: local and ethnic news sources in traditional media — whether broadcast or paper — remain critical; it’s not just all about Twitter and Facebook.

I asked Viswanath whether he feels there’s a dearth of experienced health reporters (see this post). He said yes, that because of cuts in journalism, reporters are covering multiple beats and not necessarily able to stay on the health beat over the course of their careers. He hasn’t had a chance, however, to study this in relation to the H1N1 story specifically.

You can learn lots more from Dr. Viswanath in this video of the talk.

Food aid distribution in Haiti (David Schaper/NPR)

As a reporter for NPR, David Schaper has done his fair share of crisis coverage. He was in Mississippi during Katrina, covered Midwest floods, and reported from towns leveled by tornados. But nothing prepared him for the scenes he witnessed during two weeks in Haiti. I spoke to Schaper earlier this week about his experiences reporting on the earthquake recovery efforts and what lessons can be gleaned for public media crisis planning.

Based out of NPR’s Chicago bureau, Schaper was part of a second wave of reporters, arriving in Haiti two weeks after the earthquake struck to relieve staff that had been in place since the first days. He had been following the news from Haiti, but had not expected to cover the story. With just a few days to get ready for the assignment, Schaper did his best to prepare himself — emotionally and professionally — for the conditions in and around the Haitian capital. “I knew I would be faced with immense human suffering, but you have to be able to separate what’s sad and what’s really a story for the news.”

Schaper hit the ground running and was filing news spots from Haiti the day of his arrival. The challenge of getting his work done in a disaster zone was made easier by the NPR production and operations staff.  “The reporters and producers who were there before me and ops staff back in Washington did a fantastic job in dealing with the complex logistics that made the NPR coverage possible.” A makeshift production office had been set up in hotel that had suffered minor quake damage. Schaper described it as “the best you could expect under the difficult circumstances.” The NPR team had shelter, power (with intermittent interruptions), and fairly reliable internet connectivity via satellite phones.

Haiti is a poor nation to begin with and Schaper pointed to the difficulty of discerning which of the conditions he witnessed were a direct result of the earthquake and which ones were merely the local standard. Schaper informed me that Port-au-Prince is one of the largest cities in the world without a sewer system, and sanitation issues that arose after the quake have to be traced further back than January 12^th.

Schaper says his time in Haiti reinforced his belief that public broadcasters can be a lifeline for local communities during crisis situations and he urges local stations to review their emergency response plans. “What public radio does best — provide depth and context to a story — becomes even more important during a crisis.” Schaper urges reporters to remember that emergencies often mean dealing with the unexpected and less-than-ideal conditions. “Who are your emergency contacts in local and state governments? What are your contingency plans if the power goes out or the transmitter goes down? That kind of preparation creates opportunities to make a difference during a crisis.”

You can listen to David Schaper’s reports from Haiti on the NPR website.

Today WHO recommended that next winter’s seasonal-flu vaccine include H1N1. Keiji Fukuda, WHO’s resident pandemic-flu expert, apparently cautioned in a press conference, however, that “[t]he inclusion of the H1N1 pandemic virus in the influenza vaccine does not signal that the pandemic is over.” WHO will meet next week to determine whether the pandemic is waning.

Here are the three viruses WHO recommended for the 2010/11 vaccine:

– an A/California/7/2009 (H1N1)-like virus;
– an A/Perth/16/2009 (H3N2)-like virus;*
– a B/Brisbane/60/2008-like virus.

* A/Wisconsin/15/2009 is an A/Perth/16/2009 (H3N2)-like virus and is a 2010 southern hemisphere vaccine virus.

Click here for a link to a PDF of the full report.