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Has the latest H1N1 outbreak reached its peak?

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CTV.ca News Staff

Date: Mon. Nov. 9 2009 9:59 PM ET

An Ontario infectious diseases expert believes the worst of the H1N1 outbreak is over, and says the federal government should not waste resources pushing forward its plan to vaccinate the general public.

Dr. Richard Schabas, Medical Officer of Health for Ontario's Hastings and Prince Edward Counties Health Unit, said most Canadians will not need the vaccine by the time they can get it.

"I'm increasingly convinced this outbreak is past its peak," he told CTV News on Monday. "By the time we're going to be able to offer the vaccine to otherwise healthy people, the outbreak, for all intents and purposes, will be over."

But Schabas represents a minority opinion, and federal health officials completely disagree, including Chief Medical Officer of Health Dr. David Butler-Jones. They say Canada has yet to endure the peak of the latest swine flu outbreak, and that the vaccine is crucial to stopping its spread.

"If you look at the pattern across the country, it's still continuing to rise," said Butler-Jones. "So we're not there yet."

Last week, infectious diseases expert Neil Rau noted that when death numbers rise, many assume the infection rate is rising too, but that may not be the case. He points out that flu viruses take a few days to incubate and a person can often be hospitalized or die many days after being infected. So deaths can be a sort of "lagging indicator" of a virus' spread.

"What can end up happening is that even as an outbreak is getting better, the death counts can still rise. So people can look at those deaths and think it's getting worse, when in fact, it's getting better," he told Canada AM last week.

Some officials believe the outbreak will peak in late November or early December. However, that's when Canadians who are not at high risk may finally be able to get inoculated. 

And since it takes about 10 days for the vaccine to generate the necessary antibodies to protect against H1N1, a December vaccination may not come soon enough to protect against the latest "second wave."

The first wave of swine flu happened from April 12 to Aug. 29, according to the Public Health Agency of Canada. During that time, 1,492 people were hospitalized and 76 died.

In the second wave so far, fewer than 1,000 people had been hospitalized by the start of November, with about 76 deaths.

Dr. Donald Low, chief microbiologist at Toronto's Mount Sinai Hospital, said it's worth getting vaccinated, even if the current outbreak is milder than the first.

"We're going to see it come back again. Whether it's next spring or whether it's next fall, it's not over," he told the Globe and Mail.

"Why not get protected when you have the vaccine available? If we get enough people vaccinated, the third wave may either never happen, or it may be very minor."

The Public Health Agency of Canada reports that, as of Nov. 5, swine flu had killed 115 people, and more than 2,000 people have been hospitalized.

Seasonal flu, by contrast, sends about 20,000 Canadians to hospital each year and between 4,000 and 8,000 Canadians die of flu complications each year, depending on the severity of the season.

With a report by CTV's Graham Richardson in Ottawa

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