Inside the Fight Against a Flu Pandemic

Super spreaders Kids are more likely to pass the virus on to others

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Fortitude and Pandemonium
However the pandemic plays out, the chief mantra for everyone — wash your hands, cough into the crook of your elbow rather than your palms, stay home if you're sick — will be repeated endlessly over the coming months in ad campaigns, public-service announcements and the global media. A certain fortitude is required of the global population as well. At the height of the spring flu outbreak, hospitals in the U.S. were overwhelmed by crowds, including large numbers of the so-called worried well, who, when they showed up en masse, had the ability to delay services for the seriously ill.

In America, the sheer size of the pandemic response has begun to hit home for people like Kevin Sherin, the public-health director in Orlando, Fla. He oversees a school system with about 175,000 students, a county with more than 1 million residents and a tourist industry that cycles through 49 million visitors in a typical year. He says he has eight nurses in the schools and 20 other nurses ready to do immunizations. But if they each spend five minutes per injection, it would take them a month and a half — working 24 hours a day — to deliver the vaccine to all the local students. "For most of the local health departments, they are not going to have the resources to do the job," Sherin says. "We are really going to be relying on volunteers to help us." In addition to turning to private-sector doctors and nurses to aid the effort, Sherin is looking into renting empty storefronts, reopening vacant schools and even using the downtown Amway Arena, home to the Orlando Magic professional basketball team, for mass-vaccination campaigns. "It could be a little bit of pandemic pandemonium in the beginning," he says. (See the 5 things you need to know about swine flu.)

Back to Normal
Meanwhile, things have calmed down at Camp Modin. No child was hospitalized, even though about 1 in 5 of the campers and staff came down with the illness. Quarantined campers were carefully screened for any rise in body temperature, and Tamiflu was broadly administered, despite federal recommendations. The pandemic was integrated into normal camp life — just another reality like bug bites and sunburn. "The kids made light of it. It was just the flu," says Howie Salzberg, the camp's director. To help pass the time, quarantined kids were given access to television, DVDs and video games, causing some healthier campers to feel jealous. "They were saying, 'How do I get sick?'" Salzberg says.

If the global experience this fall mirrors what happened at Camp Modin, the virus may go down in history as a case study in preparedness. But with a once-in-a-generation bug on the loose and schools opening in the coming weeks, the drama known as H1N1 may just be starting.
With reporting by Elizabeth Dias and Sophia Yan / Washington, and Austin Ramzy / Beijing

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