Two weeks ago, H1N1, the so-called swine flu, became a reality in my family’s household when our son woke up to a sore throat, fever, body aches and chills. Now, at the tail end of his recovery, I’m able to assess the cost of the illness, both financial and emotional

Financially, the cost of his bout with H1N1 was substantial if you take into account at least one physician visit, multiple trips to the pharmacy, and costly prescriptions. Add to that the loss of work hours and productivity and it becomes a major economic reckoning.

Emotionally, this particular flu, which appears to target children and teens, carries an additional toll, especially given the level of fear-mongering that has accompanied this outbreak. What parent doesn’t know the terror of watching a child struggle to breathe?

Finally, there’s a deep anger, the knowledge that preventive measures, had they been available, would have eliminated both the financial and emotional costs of this illness. High risk he may have been, but despite our combined best efforts, vaccine was unavailable.

Everyone in this house having now survived this experience, I see a number of failures associated with this epidemic.

• Failure 1: the lack of adequate quantities of vaccine, and the potential misappropriation of available supplies. Scheduled clinics are canceled and postponed; when clinics do have a vaccine, lines form hours before the start. Many, probably most, of those in high-risk groups (health care workers, the young, those with compromised immune systems and chronic illness, and pregnant women) have not yet been vaccinated. Meanwhile, there’s apparently plenty of vaccine for the grand poobahs at Goldman Sachs and Citigroup. For those fortunate enough to be immunized, it may be a case of too little, too late; H1N1 antibodies take two weeks to fully develop.
• Failure 2: despite the high profile of H1N1’s virulence, there has been a woeful lack of public health awareness. A business-as-normal attitude is often admirable, but keeping schools open and allowing public events to occur when school-age children are unprotected seems irresponsible; historically, influenza has spread most efficiently through crowded environments and gatherings. I am baffled that schools, which appear to be ground zero for the virus, remain open despite high levels of contagion within the school population—I’d much rather see the school year extend into July than deal with this illness, and I suspect I am not alone. Yet classes are still held, as are school dances, sports events, and concerts.
• Failure 3: the idea that slapping a band-aid called Purell on the problem will keep us safe. Yes, washing hands is very important, and alcohol washes can remove many of the germs that cause the contagion, but we seem to be walking around in a bubble that lets us believe that clean hands alone will keep us healthy.
• Failure 4: our inability to learn from history. Ninety years ago, a pandemic H1N1 flu killed between 50 and 100 million people worldwide. It spread quickly through crowds, and killed mostly the young and healthy. You need only look at the number of gravestones in Green Mount Cemetery with 1918-1920 dates of death to see the effect here, in Central Vermont. Only one person has died in Vermont so far from this current pandemic, but make no mistake, this flu is a killer; the CDC has recently updated its count of flu-related deaths to over 6,000 countrywide, and that number is sure to rise.

I don’t mean to be alarmist, but we’re not being smart about containing the spread of this outbreak. Schools should be closed once absentee rates reach a certain level, and community events should be canceled or postponed while contagion levels are high.  We cannot continually put ourselves in the way of this virus, and then express shock when it continues to spread.

The cost of this flu nationwide is already tremendous, and not only in dollars. The seams of our built-for-profit healthcare system are straining and ready to burst.  Shortages of vaccine here would perhaps be understandable if there were shortages worldwide, but there appear to be adequate supplies in Canada and the UK, for example, at least enough to inoculate the high-risk groups. Meanwhile, we have a shortage of primary care physicians and hospital beds, and emergency rooms are packed to overflowing with the afflicted. The only good news may be that flu survivors won’t need the vaccine when it finally becomes widely available as they’ll already have hard-won lifetime immunity against it.

The irony here is that the medical and scientific communities provided us with ample warnings and information about H1N1, but the for-profit healthcare industry has failed the public on a magnificent scale.

As a community, we’ll only know the total cost after the insurance companies tot up their balance sheets; next year’s premiums will almost certainly rise because of the increased number of claims associated with this epidemic. As the healthcare debate continues to rage in Congress, we would do well to remember that those increases will be due to the private industry’s mismanagement of a public health crisis.