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December 31st, 2009
05:17 PM ET

Pandemic’s moderate numbers ‘best health news of the decade’

By Miriam Falco
CNN Medical Managing Editor

One of the biggest stories of 2009 – the outbreak of the pandemic H1N1 flu – coincided with the biggest story for my family – the birth of my son.

Many of my friends and colleagues asked me whether I missed being part of this huge medical story. At the time I easily said no. I'm a hard-core journalist, but having a baby and being there for him was much more important to me than any news story. That doesn't mean I didn't follow it.

Early on, the World Health Organization announced that the new virus was a new strain of the H1N1 virus, a type of flu virus that was not related to current or previous seasonal flu viruses. On April 23, the CDC said it had identified this new H1N1 strain to be a “swine influenza A, H1N1,” which usually infects only pigs, but in this case was also infecting humans. This is how H1N1 first began to be known as "swine" flu. However, not too long later, researchers determined it was brand new and included DNA from humans, birds and some European pigs, but that it did not originate in a pig.

Before the end of April, we first heard the word pandemic connected to this swine flu. On June 11, the WHO declared that H1N1 had reached the highest pandemic level – phase 6. Even though it had spread to several parts of the world, the virus was still deemed to be "moderate." But the fear was that the virus could change and things could get really bad.

By the time I returned from maternity leave at the end of July, nearly 8,000 people had been confirmed to have H1N1 and over 500 had died from this flu in the United States.

By the end of August, as more and more states reported "widespread" flu activity, a report from the President's Council of Advisors on Science and Technology described a worst-case scenario where the H1N1 flu virus could cause up to 90,000 U.S. deaths, mainly among children and young adults if it resurged in the fall. (Flu activity normally picks up in the fall, but it's estimated that 36,000 die each year from the seasonal flu – 90 percent of whom are 65 and older.)

Although the report was not meant to "predict" what would happen, it did suggest H1N1 could infect between 30 percent and 50 percent of the American population during the fall and winter and lead to as many as 1.8 million U.S. hospital admissions.

As of December 30, more than 120 million doses have been available for Americans. The CDC estimates that at least 60 million people have been vaccinated. Officials also estimate that as many as 67 million Americans had been infected with H1N1 by mid-November – not nearly 30 to 50 percent of the U.S. population as suggested by the president’s advisers. Hospitalizations are estimated at just over 200,000 – fortunately also nowhere near the worst case scenario of 1.8 million as the August report suggested.

Finally the death toll from the H1N1 flu was way below the 90,000 high estimated by the scientific advisers. The CDC estimates that as many as 13,930 people died from H1N1 between April and November 14, 2009. At least 243 of those were children who died since August 30. This number is very high compared with seasonal flu, which usually is a factor in only 80 deaths in children during a flu season.

H1N1 appears to have peaked in the U.S. for now. As of today, the last day of 2009, only four states are reporting widespread H1N1 flu activity. Around the world, many countries are seeing their case numbers decline while others are seeing a resurgence. And as the U.S. has had over 120 million doses of vaccine available already, many developing countries are still waiting for their first doses. Still as the WHO director-general Dr Margaret Chan told reporters this week, "the fact that the long -overdue influenza pandemic is so moderate in its impact, is probably the best health news of the decade."

So as 2009 comes to an end, the H1N1 story will extend into the new year. After listening and participating in countless CDC press briefings over the past several months, I asked CDC Director Dr. Thomas Frieden for his thoughts on this H1N1 pandemic. He says we need three things:

“First, perseverance. It's easy to say it's over, cases are going down, but influenza is unpredictable. We don't know what the future will hold. We have a unique window of opportunity to get vaccinated before the end of this flu season.

Second, we need preparation. Continuing to hone our preparations at every step of the supply chain, and every step of detection and response is important.

And third, we need to continue to invest in science - for better vaccines, and also better understanding of the pattern of influenza in communities and treatment. "


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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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