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H1N1 Flu and Law Enforcement

Written by Ed Nowicki

How dangerous is the H1N1 (swine flu) virus to law enforcement officers? No simple answer exists because there is a considerable amount of information and misinformation out there.

H1N1 has a deadly history. Between March 1918 and June 1920, an H1N1 virus called Spanish flu reached most parts of the world. This pandemic killed between 50 million and 100 million people, most of whom were healthy young adults. The current H1N1 virus bears a close resemblance to the 1918 H1N1 virus, but medical experts seem to agree that today’s H1N1 is not nearly as lethal as the 1918 virus. In fact, people born before 1920 had a strong antibody response to the new H1N1 virus, meaning their immune systems remembered it from an H1N1 exposure early in their lives.

“We think the [current H1N1 virus] is virtually everywhere in the country,” stated Rear Admiral Anne Schuchat of the Centers for Disease Control and Prevention (CDC). “It’s only October 2009 and we’re seeing really uncharted territory. Typically, in the month of October we would not have seen so much influenza. We would not see the whole country with widespread disease. That’s something that we often will see in February.”

In the second week of October 2008, seven cases were reported. In the second week of October 2009, nearly 5,000 cases were reported. By mid-October 2008, there were seven deaths. In mid-November this year, the CDC had just revised its data through mid-October. They had underestimated the deaths. By mid-October 2009, the death total was 4,000.

According to the CDC, H1N1 is a pandemic, meaning it is a global epidemic. H1N1 is spreading in an unprecedented way. It’s the first flu pandemic in 41 years.

Schuchat stated, “People who are in the prime of their life, totally healthy, can suddenly become so sick. The virus is serious. It can cause overwhelming bacterial pneumonia in some people. Influenza can damage the respiratory tree’s lining and make it easier for bacteria to invade, and then the bacteria can cause a pretty overwhelming pneumonia in those circumstances.”

James Williams, MD of Tactical Anatomy Systems in Wisconsin, said, “H1N1 is without question a major concern for law enforcement officers in the coming months. Although most people who contract this virus do not get seriously ill, a significant number of people do get very sick. These include people with pre-existing pulmonary illness, immune deficiencies, the very young, the very old, and women who are pregnant,” Willaims said. “These people may get very sick, very quickly and face a much higher than average likelihood of dying from the disease. Officers, as first responders, are likely to be the first on the scene when concerned relatives call 9-1-1, and they need to know what to do.”

Not all members of the medical field see H1N1 as a major concern. Fabrice Czarnecki, MD of St. Joseph Medical Center in Townson, MD, sees the concern of H1N1 for law enforcement officers somewhat differently. Czarnecki is also the chairman of the Police Physicians Section of the IACP. According to Czarnecki, “H1N1 is not a serious concern. It is probably milder than the seasonal flu, though most people are not immune to the novel H1N1 virus.

“Most H1N1 deaths and serious illnesses happened in people with other serious medical problems, typically children with asthma or adults with immune disorders. Unexpected groups at risk are pregnant women and morbidly obese young adults. I think that the H1N1 risk was overstated by media and emergency preparedness and public health personnel hungry for more funding.”

It is impossible to avoid all possible exposures to H1N1. Dr. Peter Palese of the Mount Sinai Medical Center in Manhattan said, “The virus can travel at least 10 feet from person to person.” So, if the virus transmits readily across 10 feet, people in a police agency, in an elevator and in just about any place where people are together, are at risk to H1N1 exposure.

According to the CDC, there are actions that can be taken to reduce exposure to the virus. Cover your nose and mouth with a tissue when you cough or sneeze and throw the tissue in the trash after you use it. Wash your hands often with soap and water—antibiotic soaps, not antibacterial soaps, can kill both bacteria and viruses, so they are preferred. Also, if soap and water are not available, use an alcohol-based hand rub or sanitized “germ killer” wipes.

Avoid touching your eyes, nose and mouth because germs spread in that manner. If you get sick, stay home. Limit contact with others to keep from infecting them. This includes family members, if possible. Avoid crowds, although the nature of law enforcement makes that virtually impossible. Stay informed via the CDC Web site.

The federal government allotted $3 billion for its H1N1 immunization vaccine project. About 120 million vaccines were supposed to be ready by fall of 2009. That figure was revised to 40 million, although only about 17 million doses were shipped by the end of October 2009.

The government decoded the virus to prepare an H1N1 vaccine in record time, which was a real achievement. Then the project hit snags. The vaccine took longer than expected to produce, and there were, and are, shortages of supplies. Seasonal flu is different than H1N1, and they are two separate vaccines. One vaccine does not protect for both H1N1 and the seasonal flu.

There is some concern over the safety of the H1N1 vaccine. Dr. Andrew Dennis of the Trauma and Burn Surgery section of Chicago’s Cook County Trauma Unit is also a sworn law enforcement officer. He said, “The H1N1 vaccine is a flu vaccine similar to those that have been used for years. Safety is supported by years of prior use and by the current CDC recommendations. Nothing in medicine is risk free, but looking at benefit versus risk, balance is weighted toward the vaccine.”

Individuals who receive the H1N1 vaccine receive the dead, not live, virus, so there is no exposure to the live virus. The full anti-virus protection afforded to the H1N1 virus is not immediate. It takes two full weeks for the vaccine to be fully effective through the development of H1N1 antibodies.

First responders, who include law enforcement officers, should have a high priority of receiving the H1N1 vaccine. However, receiving the H1N1 vaccine should not be mandated for any officer. Chief Jeff Chudwin of the Olympia Fields, IL Police agrees. He stated, “Getting vaccinated must be a personal choice. However, if an officer comes to work and is obviously ill, he must go home.”

Chudwin brings up another issue concerning the death an officer as a result of contracting the H1N1 virus. He stated, “There is no way of proving whether or not the officer was exposed to the H1N1 virus while on duty. This has already become a workers comp issue.” It would be very difficult to classify an officer’s death, as a result of the H1N1 virus, as a “Line of Duty” death.

Chudwin says there are additional considerations. He said, “We should be prepared for an infectious disease issue before any widespread outbreak. What is the agency doing for continuity of operations? Have you entered into mutual aid agreements with neighboring jurisdictions to provide manpower if you lose 40% to 60% of your staff over a 7- to 10-day period? Do you have maps and radios to issue to such assisting officers who may be teamed up with your remaining officer in two-officer units?”

Another doctor says all officers should receive training on the H1N1 virus. “Only with education and knowledge of the type of threat will officers be able to use good equipment and tactics to defeat or neutralize these threats, same as any other threat,” said John Wipfler, MD, Associate Clinical Professor of Surgery at the University of IL College of Medicine and a physician for the Peoria County, IL Sheriff’s Office.

“The curriculum should include basic education about the virus, how it works, the symptoms, when to stay home, when to go back to work, how contagious it is to family members and how to prevent it from spreading, how to kill it (germ-killer wipes) and medication that may help.”

Chudwin offers additional advice if exposed to the H1N1 virus: “How are you going to protect your family when you return home? What are you going to do with clothes and boots on return? How are you going to decontaminate before going home? Officers should meet with their family doctors or those they know at the ER to get a prescription for Tamiflu. As a first responder, this fast access to the anti-viral may make a life-saving difference.”

Ed Nowicki, a nationally recognized use-of-force expert, is a part-time officer for the Twin Lakes, WI Police Department. He presents Use of Force Instructor Certification Courses across the nation and is the executive director of ILEETA. He can be reached at ed@ileeta.org.

Published in Law and Order, Dec 2009

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