Greg Dworkin, MD – Founding Editor of Flu Wiki

February 04, 2014

This week, Point of Inquiry welcomes Greg Dworkin, MD. Dr. Dworkin is a founding editor of Flu Wiki, an international, wiki-format clearinghouse of Influenza information designed to help local communities prepare for and perhaps cope with a possible influenza pandemic. He’s an expert on pandemic Flu preparedness and is joining us to discuss the Flu, the vaccine and staying healthy this H1N1 season.

Dr. Dworkin is Chief of Pediatric Pulmonology and Medical Director of the Pediatric In-patient Unit at Danbury Hospital in Danbury CT, where he has been in clinical practice for eighteen years, and serves on the Danbury city and school Pandemic Flu Task Forces. Dworkin holds academic appointments as Clinical Assistant Professor of Pediatrics at New York Medical College and Adjunct Assistant Clinical Professor of Allied Health Science at Quinnipiac College.

This is point of inquiry for Monday, February 3rd, 2014. 

This episode of Point of Inquiry is brought to you by Squarespace, the all in one platform that makes it quick and easy to create your Web site or online portfolio for a free trial and 10 percent off your first purchase. Go to Squarespace dot com and use the offer code inquiry. Try it today. Hello and welcome to Point of Inquiry. I’m your host, Lindsay Beyerstein, and my guest today is Dr. Greg Dworkin, co-founder of Flu Wicky and is a national clearinghouse of pandemic influenza information visited by millions, a pediatric lung specialist and an expert on pandemic flu preparedness. It’s flu season. And the only thing more contagious than the influenza virus are those bunko emails spreading misinformation about the flu and flu shots. Today, we’re going to learn the real science behind flu vaccines and dispel some popular myths. Greg, welcome to the program. 

Thank you so much for having me. 

What is influenza and why does it make us so sick? 

Well, it’s a great question. Influenza is a virus. It’s a specific virus. It’s RNA virus. And influenza comes in all sorts of different strains. One of my colleagues and mentors used this, say that, you know, the best way to think about influenza is think about dogs. You know, you can have adoption and you can have a bulldog and you can have a German shepherd and they’re all different, but they’re all dogs. So influenza comes in all sorts of different strains. 

And the ones that birds get are extraordinarily large and very the ones that human gets is a much smaller strain. So birds are probably the natural host for this virus. And in that sense, you could say all influenza, all flus are bird flu is the ones that we’re most concerned about is a strain called influenza A and there is a B, which can also cause a human element, but only a cause as pandemics. And that’s the one we tend to focus on. 

Is human influenza as old as humanity, or do we think it jumped from birds more recently? 

Well, it’s been around for for ages and exactly when it made the jump from birds to humans is absolutely not known. But influenza has been responsible for illnesses every year for for just that forever. The tendency to get a new strain that nobody has seen and therefore it goes around the world because everybody susceptible when that happens, that’s called a pandemic. And that happens two or three times, maybe four times a century. The last time we had one was in 2009, but before that we really hadn’t had one since about 1968. So they happen and it generally causes worse illness when that happens. But even the typical regular every winter flu season that we have now that we’re all used to hearing about can still be very, very concerning illness because people can get quite sick from it. 

How many people die of the flu in a typical non pandemic flu year? 

Well, in a regular flu season, the numbers are kind of debatable because everything is done with modeling. There are so many millions of people getting sick that it’s impossible to test everybody. CDC Center for Disease Control, which tracks this, can’t track every single case. So what we do is, is we do this. There’s something called an influenza like illness that means that you have a temperature more than one hundred and you have a cough resource throat, and there’s no other reason for having it. So if you have this influenza like illness that’s very, very common in the winter and doctors’ offices and CDC will track that. And as flu season hits and we have documented cases of influenza that we can test for, then we assume everybody who’s having an influenza like illness might have flu. 

So if I go to my doctor with these flu like symptoms, I’ll be entered into the statistics as a case of the flu. 

Well, you might if you happen to have a doctor who is doing flu surveillance and there are 3000 doctors around the country doing this in all 50 states, you might be entered if you have an influenza like illness, but only a handful of patients coming to their doctor. But those symptoms will actually be tested. There’s a second group of surveillance for actual testing. Sometimes that comes from hospitals and that comes from a smaller group of volunteer docs who will do the testing and they’ll tell us whether or not you have influenza A and if you do have influenza A, is it the kind that spreading this year called the H1N1, very similar to what was spreading in 2009? So we have guesstimates based on that kind of modeling of what’s going on. And and that’s a long answer to your short question. But that guesstimates are that the, you know, thousands of people, maybe tens of thousands of people each year can can die from an influenza outbreak. And in a pandemic year, more than that, the flu shot. 

Changes every year. What kind of modeling do public health scientists use to figure out which strains to put in the shot each time around? 

Well, we kind of cheat because we have the advantage of having a northern hemisphere and a southern has a southern hemisphere. Don’t try to say that at home. We’re professionals. So what we do is you could look and see what’s going on in Brisbane, Australia, what’s going on in Argentina and the World Health Organization confirms. And they have an international conference. And based on the strains of this spreading in the southern hemisphere, we try to plan which vaccine strains should go in the northern hemisphere for the following winter. And so using the southern strains that are spreading a few months before we get it here in the United States, that’s how all of that is planned. And it’s remarkable in terms of how well that works. For example. There are some vaccines this year that have three strains of flu in it, two A’s and a B. There’s others that have four strains of flu. That’s a new thing offered this year, two A’s and two B’s. And those vaccines are matching tremendously well with what was guessed as to what’s going to happen some years. You have a mismatch. But this year, the match is actually quite good. Now, that doesn’t mean that the vaccine is perfect or that it’s going to work any better. That’s another story for another day. But in terms of guessing what’s coming and then getting the right strain of flu into the vaccine, rowing it up in chicken eggs, a lot of the eggs in New England and Connecticut, for example, don’t go to for people to be eaten their produce. The vaccine industry can grow there. The vaccine in the eggs, that’s, by the way, why when you have an egg allergy, you have to be a little careful about how you take a flu shot. Nonetheless, you make the vaccine. It takes about six months. And so months and months and months before the actual flu season hits. Scientists and epidemiologists are estimating what’s coming. Preparing the vaccine and then the vaccine becomes available, usually sometime in September. And then it turns out that like many years, you actually do a pretty good job guessing what’s happening. 

You said that a more accurate guess at what flu strains are coming doesn’t necessarily make for a more effective flu vaccine. Why is that? 

Well, it’s interesting and we don’t fully understand this. It seems that the better the match, the better protection you should have. And I think it’s important to talk about the flu vaccine in a realistic way. And what I mean by that is that for the most part, it’s safe and for the most part, it’s effective. But I don’t think doctors should oversell just how effective it is. If you’re looking to see the effectiveness, that is to say, if you give it to people, how much does it prevent you from getting flu? It’s somewhere in the range of 60 percent. And it depends upon how old you are, the older you are. That is to say, 65 and older doesn’t seem to work quite as well. If you’re a kid and I’m a pediatric pulmonologist and mostly treat kids, it actually works pretty well, better than the average. So depending upon who you are, whether you’re healthy or not healthy, whether you have underlying illnesses, whether you’re on other medications like prednisone that might interfere with the ability of the flu vaccine to work. It’s not a perfect vaccine, even in a perfectly matched year. If the match is not quite as good, the vaccine at effectiveness might even be a little bit less than that. But just because you have a 90 percent match doesn’t mean you’re going to have 100 percent effectiveness to give people a reference point. 

How would a flu vaccine compare to something like a polio vaccine or an HPV vaccine? In terms of efficacy? 

Well, polio vaccine works much, much better. And something like a pertussis vaccine works pretty well. That wears off in about six or seven years. Measles vaccine works much, much better. So some of the vaccines are higher in terms of their effectiveness than others. 

And does it, Barry? And by the way, that’s one of the reasons that’s one of the reasons why you might hear stories from people which are not just stories. 

I got the flu shot, but I got sick anyway. Part of that might be because what you got really wasn’t flu again. Remember, most people aren’t tested. But if you did get the vaccine and you did get sick and you were tested and it was the flu, definitely that happens. The thought is that even if you get the flu, you weren’t as sick as you would have been if you didn’t get the vaccine. But it doesn’t make you flu proof. And so I think it’s fair and important for docs not to oversell the vaccine. 

Tell us about herd immunity and how healthy people who get the vaccine are protecting those who can’t get vaccinated or who aren’t getting the full benefit of the vaccine because they’re older? 

Yeah, that’s a really important point. And thanks for bringing it up. The thought is that if 90 percent of the population gets their vaccine, that you can protect people who can’t get it. Where the circumstances were that might have. We don’t suggest doing the vaccine in babies under six month, for example. So it’s very good to get everybody in the family who has an infant too young to get the flu vaccine. Everybody around him should get the flu vaccine. We call that a cocoon. And that way you helped to protect everybody. If you have somebody who has an egg allergy, who can’t get the vaccine, everybody around them should get the vaccine. And it’s an issue for health care workers as well. If you’re working in a hospital, you owe it to your patient to get the vaccine. And I think that although it’s not always been the case in the past, in fact, far from it. And we can talk about that more, I think health care workers are the ones who should be on the forefront of not only being proponents for the vaccine, but actually getting the vaccine themselves. And that includes nurses and includes people who who work in the cafeteria, people who clean the floors, everybody who’s in a hospital or health care, setting the patients at risk want to protect those patients by getting the vaccine themselves. These days, more and more, it’s becoming either mandatory or strong, strongly voluntary, like where I work to get the vaccine. And the goal is to keep that herd immunity above 90 percent. And it’s not just true in health care settings. It would be true for the population in general. 

What percentage of the general population gets vaccinated for the flu? 

Well, it varies, again, depending upon region and depending upon age. But we’re talking about maybe, you know, 55, 57 percent, and we’d like to see it much, much higher. 

So we’re nowhere near where we need to be to protect the most vulnerable. 

No. Now we’re looking at vaccinations in general. If you’re looking at, for example, the easiest ones to track are that child regular vaccinations, theory of pertussis and tetanus shots, things like that. Deputy shots that kids get various parts of the country, like New England, like Connecticut, you might well be in the 90 percent range. But when it comes to flu shots, people are still very skittish about getting flu shots. 

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Well, there are many and many of the reasons that people give as to why they don’t want to get a flu shot turned out not to be true. For example, the traditional shot, which is a needle injection into your shoulder, contains that virus. And that means you cannot. And let me repeat, you cannot get the flu from a flu shot. You can’t. It’s impossible. Unpossible cannot happen. Can you get sick from a flu shot? You can get a fever for 24 hours, a low grade fever. 

That is the same 100 range. You could get a sore arm. That’s typically the the symptoms that you get. In rare cases, you can get something a lot more serious than that. But we’re talking about one in a million. What is one in a million mean? Well, you know, on a scale of of what it means, let’s just say the chances of you getting struck by lightning are one in 100000. 

What’s going on with that one in a million? Bad reaction. Is it an allergy? 

Some people have, as I say, egg allergy and they can be allergic to it. In the worst rare cases you can get Gambi Ray. There’s an association with neurologic disorder. Very rare blood has been recorded. So when you’re looking at the worst possible reactions, they exist, but they’re extremely rare. More common reactions are fever or flu like illness, which again, one of the funny things is we always get flu shots in the season, which you get sick. As a pediatrician, I’m always telling parents, you know, the major reason kids go to school is to make sure everybody in town is sick with the same thing at the same time. So you can’t send your kids to school and expect them not to get sick. This is the season. If you give somebody a flu shot in the season at which you’re going to get sick, because that’s the natural history of what happens. And I guarantee you, whether it’s true or not, if you get a flu shot and then two days later you get a cold and you don’t feel good, you’re going to blame it on the shot. It may not be the shot at all. If we gave flu shots over the summer, maybe people wouldn’t get us in my anti vax chain. 

Letters are always pointing to some additive in the flu shot that supposedly dangerous. Are there any additives that we should be concerned about? 

Any. Part me. Can you repeat the question? 

Additives, stabilizers, preservatives, anything in addition to the dead virus, is there any validity to any of these concerns? 

Well, there is. The short answer is no. But the longer answer is these days what we’ve done is taken a Mirasol, which is the form of mercury that is felt to be fairly harmless, but then most people don’t like. We’ve removed that from most other vaccines. It’s a preservative with influenza vaccine. There’s two ways of getting shots. One is individual syringes, which do not contain any mercury, don’t contain any same aerosol, the preservative. And then a flu vaccine is still sold as 10 vial shots where you suck up some into a syringe and then you go back into it after cleaning it off and soak up some more. And you do that 10 times until you enter empty the vial. The reason that’s done is you’re trying to vaccinate millions and millions and millions of people. And so it’s very difficult to make each one of the flu vaccinations an individual syringe. It’s very expensive. And people don’t like to pay for stuff that they don’t have to. And it’s also difficult in terms of storage and it’s difficult in terms of doing this on a mass scale. It just doesn’t scale up very well. And that’s why there’s still say, Marisol, in the 10 person, 10 shot vials of influenza vaccine that are commercially available. You can ask for an individual vial if you don’t like the idea of getting five Mirasol or Mercury in it. But for most people, it’s kind of a non-issue. It’s not only been shown to be you can’t ever show something to be safe, but it’s shown not to be associated with harm. And it’s certainly absolutely, positively not associated with the main concern, which is autism. There is no relation whatsoever. In fact, there are some pretty solid studies showing that in Europe, when you remove some aerosol from flu vaccines and continue to give flu vaccines, the cases of autism go up, not down. It’s not because non mercury flu shots cause autism. It’s because diagnosis has become much better and much keener. And so we’re better at picking up cases and that’s why the cases go up. But there is no association with the mercury and it’s pretty safe to do. Most people do it and don’t think about it. But if you wish as an option, you can get a flu vaccine that doesn’t have any mercury in it at all. 

How would the mercury exposure from a thigh, Marisol, containing vaccine compared to the. Fury in, say, a spicy tuna roll or tuna fish sandwich? 

Well, it’s a different kind of mercury in a different form of mercury. No, comparing methylmercury to ethylmercury is like comparing methanol to alcohol. No one makes you blind in. One doesn’t. And so it’s not the same substance. It’s not the same chemical. The safe form is the one that’s in the vaccine. Not safe form is the one that’s in the environment in terms of tuna exposure. For example, when you’re pregnant, you have to be limited in terms of how many times you can eat tuna a week and so on and so forth. So it’s it’s basically a completely different topic. 

Speaking of pregnant women, what’s the thinking on whether pregnant women should get flu shots? Do it. 

Thanks for asking. No, it’s it’s a little bit more complicated than that, of course, because you have to and everybody should be extraordinarily careful about what you do. 

But the thing is that pregnancy is actually one of the huge risk factors for getting the flu. That is to say, pregnant women who get the flu are are five times more likely to be extremely ill from it. And also getting the flu can make you miscarry. So there’s a variety of reasons why the pregnant population is actually the population that you want to protect the most. And so the advice is at any time, any trimester. It’s good to get a flu shot during flu season because you want to protect the baby further by getting a flu shot, because antibodies are moved from mom to baby and stay there for around six months or so. As I said before, if you’re younger than six months as a newborn and infant, you don’t get a flu shot. You can’t get a flu shot till you’re six months old. But if mom got the flu shot before you were born, you’re protected for that six months by having some of mom’s antibodies. So the longer answer to the short answer is, is it is strongly advised that all pregnant women in any trimester get a flu shot. Now they need to get a couple of different kinds of vaccine. There’s a alive vaccine which has a flu virus that’s been altered so that it doesn’t cause illness. Pregnant women should not get that. And people who have underlying illnesses should not get that. But they can’t get the shot, which is an inactivated vaccine, is a dead virus that doesn’t make you sick. So if you deliver, even if you’re breastfeeding, you can get either one of those two flu vaccines alive virus or the inactivated virus. But if you are pregnant and haven’t delivered yet, then you should get a flu shot. It should be an actual shot and it can be given at any time. 

Is it true that children born to mothers in years of pandemic flu are at higher risk of developing schizophrenia and other chronic health problems? 

I am not familiar with that particular study, so I can’t tell you it doesn’t exist. I just haven’t seen that one. That’s that’s a new concern to me. One of the concerns, and this comes from some Canadian studies, is trying to track what happens after you get the flu shot to make sure that you don’t get sicker rather than less sick. 

But the problem with small studies is that if you’re not looking at a large enough scale, you really don’t have enough information to make definitive statements about it, which is why there’s still so much discussion about how much do flu shots protecting anyway. After all, the same technology for flu shots in the same process has been used for decades and only now in 211, 2011, 2012, 2013, 2014, are some of these questions about how well the flu vaccines actually work are being asked? You know, it’s great to study these things. And I think whenever somebody does have a legitimate question and this is a legitimate question that comes up, it ought to be looked at. But you’re going to need enough patients and enough power to the study to really make some definitive statements about it. 

What are you and the volunteers at flu? What are you doing to track emerging trends in the flu around the world? 

Well, it’s kind of a cool story. So back in 2005, George W. Bush was president and in 2003, there had been an outbreak of what people now called bird flu. Remember all flus, a bird flu. But there was a particularly nasty strain, H5N1, which broke out in Hong Kong. 

And H5N1 is especially nasty because although it’s difficult to catch if you do catch it and had something like a sixty six sixty seven percent mortality rate. You got really, really sick. And the concern was maybe that’s going to be the next flu pandemic, not just one of our seasonal flus. So the U.S. didn’t really have any plans for what to do if it pandemic broke out. And some of the activists, online doctors and ordinary folks. Started pushing the feds to do a little bit more, a little bit better. And in July of 2005, I, along with a couple of other colleagues, started a Web site called Flukey, which was to collect information about what to do about a pandemic if the feds were helping us. What do you need to do locally? What do you do for yourself? Activists are like that. Why do we have to wait for somebody to tell us? What are you going to do if it happens in your own community? What’s your plan in your local neighborhood? Can you identify the elderly in your community who will need watching? Maybe you need to have some sort of alternate plans for if you’re sick for 10 days and can’t go to work. The thing to do when you have flu is not go to work and not give it to everybody else. What does that mean? Does that mean you have to have 10 days worth of food in your home? You have to have a plan so that, you know, you can stay at home for 10 days. Not too easy if you haven’t planned for it. And that’s the kind of thing that we started to get together and try to brainstorm about. We push the federal government to do something. And by November of 2005, George Bush came out with the very first ever national pandemic preparation, national pandemic plans. And it was good, although it had some holes in it. And we pushed back on that and we got, you know, some involvement from people who were online talking about this to the point where by 2007, we were getting invited down to the Center for Disease Control to participate in drills to see how well the system worked. We were getting invited to tabletops at HHS to talk about how to communicate this better. Here’s the thought. If the Centers for Disease Control is the most respected name in public health, which it is according to Harvard School of Public Health Polling, that comes in at 65 percent. But what about the other 35 percent who don’t trust the government? Who are they going to get the information from? Maybe they don’t want it from CDC. Maybe they want it from some other source. And so putting all of this together, we continue to to look at the news reports and other indications that there were other outbreaks of H5N1 soon. And this year we have H seven and nine, yet another different kind of bird flu. And volunteers got together and decided to to crowdsource this. So they started looking for individual newspapers. They decide himself, regions of the world they would take any case that was in the newspaper, corroborated twice and start listing them. And so now there are online lists of all the different cases. Usually the crowd sourcing cases are about a two or three weeks ahead of the official list of cases that you can get from the World Health Organization. And it helps track to see is there family cluster having illness, suggesting that maybe you have easier transmission or are there docs in the E.R. who are now getting sick suggesting now you have human to human transmission more and then just bird to human transmission, kind of an early warning sign that something is amiss and that more attention needs to be paid. So it’s it’s a great system. The CDC looks in on it now and again to see what’s going on through that. We’ve been invited to conferences. I’ve been to two discussions with health officials from literally all over the world about how social media can interact with public health to make things better. I’ve actually lectured on that at CDC. It’s been a farce. And anything that to the point where in 2009 I was invited to the White House to testify to the president’s casual Council of Advisers on science and Technology in terms of where we were at in the midst of an actual pandemic. And how did the preparations that the White House thought they were doing match what people see on the ground with Google and with the ability to track things by smart phones, that biology continues to evolve and there’s different ways of tracking flu besides the traditional ways. It’s all been a fascinating look at how citizen involvement and activist involvement can lead to something that actually turns out to be beneficial for everybody. 

What did you tell the president’s council that we need to be doing in order to better track the flu? 

Well, it isn’t just tracking the flu. Let me give you an example. One of the methods that we use in order to try to help with flu is using a medication called Tamiflu or Rossel, Tamiflu. And if you give it to people who have the flu, you can perhaps cut their days of being sick down by a day or so. And that’s for an ordinary person with an ordinary case, if a little bit in the hospital, it can be lifesaving. And so if you have one of those high risk groups that we were talking about before, particularly patients with neurologic disorders as matics, people like that, Tamiflu can be lifesaving. And if a flu season hits and it’s particularly hard hit, your local pharmacies may start running out of Tamiflu. So what happens then as it happens? There is a national stockpile of Tamiflu. Which the federal government and individual state governments have put together so that if this a huge giant need for a real disaster, kind of a flu outbreak and they have some sort of stockpile reserve. OK, well, that’s all well and good. But here’s the next stage. Here’s the government planning on what to do just in case. And here are the activists saying, all right, so that’s all well and good. How are you going to get the Tamiflu that the state has stockpiled to people? You can’t resell it to pharmacies because you’ve already paid for it. You can’t get free drugs to the pharmacies. And the pharmacies are how people normally get their medications. So what’s your distribution system going to be? And of course, they hadn’t planned on that because I hadn’t thought of that. But that’s something that the Actavis handful of. And that’s an example of how you can discuss things from every different level and kind of close gaps that you didn’t realize were there until you talked to everybody. 

Ideally, where would people go to get Tamiflu? 

Well, in an ideal scenario, you go to the pharmacy because that’s the system that we use in a much less ideal scenario. You have perhaps Department of Public Health run places where you can go to get Tamiflu with no one else has one. That would be what happens in a terrible, horrible pandemic. But it’s not ideal because departments of public health don’t have extra manpower to do this. And don’t forget that in all our discussion about health care and the Affordable Care Act and Obamacare, public health usually gets the short end of the stick and often isn’t funded at proper levels to really help people do stuff like this. And how could you? Because it’s like planning for snow in Atlanta that they got yesterday. It only happens once every once in a while. So you can’t keep a pharmacy staff on board just in case in 15 years we get a pandemic in your local town. So therefore, you have to have some sort of a plan to do that. One of the worst ways, which is one of the ways federal government first came up with is why don’t you give it to the hospitals and then the hospitals can give it? Well, the problem with that is that you want to keep the hospitals open for motor vehicle accidents and heart attacks. You don’t want everybody with flu going in the hospital. Far from it. You want everybody with flu to stay away from the hospital. But if that’s where the medicine is, that’s where they’re going to go. So the ideal way to do it would be to figure out some way of getting it to the distribution systems that people already use, because doing what you already do is much better than trying to reinvent something on the fly that you’ve never done before. 

Has Obamacare changed the way we deal with pandemic flu or flu vaccines? 

Well, certainly for preventative purposes, it becomes much easier to get people to get vaccines covered. 

So that’s always an important aspect of it. But I think that it’s way too early to to really guess how it has affected things. Up until now, the vaccination for flu season this year, for example, started in August and September, late August, last few days of August and September. That’s the time that the vaccine this year came. And so Obamacare didn’t really kick in until January 1st. So next year is probably a much better time to sit back and say, OK, what were the results? And even if it’s available, even if it’s something that you can get your hands up. As we talked earlier in the show, it’s still something people are skittish about. So it isn’t just the availability of the vaccine. It’s the discussion that people can have with their primary care doctors so that they could advise patients to get the vaccine. People are five times more likely to get a vaccine if their doctor suggests it, rather than just, let’s say, look at an ad campaign on TV or something along those lines. 

So how does Obamacare help if he can get a doctor? That’s a good thing. Then the doctor could tell you that maybe you need a flu shot. 

Do insurers now have to cover the flu shot? Do insurers have to pay for the flu shot as part of Obamacare as preventive care component? 

Well, it’s a little bit unclear. 

There is in many cases and here in Connecticut, for example, I can’t really give you a straight answer to that because we have a separate program that has nothing to do with Obamacare, where flu shots up until age 18 are paid for by the state anyway. So in some states, that’s how it works. In other states, it doesn’t work as is typical in the U.S.. This is a 50 state strategy. Each state has a different answer to your question. It’s an excellent question, but it’s just not too easily answered. 

Are you guys seeing any interesting trends for the 2014 flu season if Luigi. 

Well, right now, I probably the best place to look at that, not just on flu week, but is the CDC. They have something called flu view that they publish every Friday afternoon and give you up to date data from the week prior in terms of how things are going. And it really does look like we’ve peaked and that we’re actually getting a little bit better. So I’m hopeful in the next week or two, the number of cases of flu drops significantly, according to CDC, that’s already started to happen. You hate to say anything too early because you could get a little peak and then it goes down and then you get a much bigger peak that you weren’t expecting. But we may already have been at the top of the flu season. If that’s the case, that would be a good thing. It’s also a funny thing about this, particularly here, the 2014 year, because it’s H1N1 and not the H3 N2 that we had last year. This particular strain of flu seems to be hitting younger people. And that’s a strain that’s that’s a pattern that’s been established by looking at hospitalizations and the surveillance of things we were talking about before. If you’re in your 30s and your 40s, if you’re an adolescent, you’re much more likely to get the flu this year than last year. And so it’s less seniors and more younger people. 

Is it true that the flu is more dangerous in younger people because their bodies mount a stronger immune response? 

Well, there’s something called the cytokines storm, which has been theorized to be the reason why the terrible, horrible, no good worst case, 1918 flu is so bad. And that tended to hit younger people, including folks that were in the army and trying to fight World War One. And also in very close conditions and packed into the trenches and packed into camps and packed into the troop ships and transport ships and so on and so forth. The truth is, though, that the people who were at highest risk for flu year after year after year are kids under the age of two seniors over the age of 65, pregnant women and then those with underlying conditions, not so much young, healthy people. 

If people want to get active with flu wicky, how can they get involved? 

Well, they can talk to their local Department of Public Health and see if there’s anything that’s there in terms of official ways of doing it. 

There are actual iPhone or smartphone applications, apps that they can download flu near you and other ways where you tell people whether you’re having symptoms and then that data is is collated so that you can see what’s going on in your area these days. You know, people are a little skittish maybe about giving that kind of data out to everybody. But if you want to participate, it’s voluntary and you can do so. 

Can people join your flu with you watchers monitoring the media for local flu cases? 

Absolutely. Just go over to flukey and and and look and see if there’s anything of interest to you and register on the site and leave a comment and people will find stuff for you to do. My hands are always welcome. 

That’s great news, Greg. Thanks so much for coming on the program. 

Lindsay Beyerstein

Lindsay Beyerstein

Lindsay Beyerstein is an award-winning investigative journalist and In These Times staff writer who writes the blog Duly Noted. Her stories have appeared in Newsweek, Salon, Slate, The NationMs. Magazine, and other publications. Her photographs have been published in the Wall Street Journal and the New York Times’ City Room. She also blogs at The Hillman Blog (, a publication of the Sidney Hillman Foundation, a non-profit that honors journalism in the public interest.