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H1N1 in India and California Nurses Protest Lack of Equipment


More than a thousand people thronged Pune’s government-run Naidu Hospital on Wednesday as panic deepened two days after the country’s first fatality from swine flu was reported from the city.  The city’s “walking worried well (or slightly ill) with the slightest hint of cough and cold, anxious to get tested for the flu virus, began gathering from early morning and doctors and hospital staff soon found themselves swamped by a jostling crowd.

Patients awaiting testing outside Naidu Hospital in Pune India
Patients awaiting testing outside Naidu Hospital in Pune India

What made things worse was private general physicians, who normally are the first point of consultation, turning back patients who came to them with cold and fever symptoms, telling them to get checked at Naidu Hospital.

As the crowd at the hospital grew larger, tempers rose. Around 11am, a scuffle broke out between members in the crowd and the hospital staff following confusion regarding entry into the medical officer’s cabin. However, policemen deputed at the hospital brought the situation under control.

Pune is located 150 km southeast of Mumbai and is the eighth largest city in the country.

US company’s who have facilities in India need to look at their pandemic plan carefully. India’s population of approximately 1.17 billion people (estimate for July, 2009) comprises approximately one-sixth of the world’s population and the median age is 25 years – a target age for the H1N1 virus.  The living conditions and hygiene challenges in the country will also make dealing with the disease a real test of the even the best pandemic plan.


The California Nurses Association held a protest on Wednesday (August 5) in San Francisco in the wake of a Sacramento nurse’s swine flu death last month. The union says some California hospitals aren’t adequately protecting nurses from swine flu.

California nurses protesting lack of adequate PPE in hospitals
California nurses protesting lack of adequate PPE in hospitals

The union wants hospitals to provide better masks, equipment and protocol to protect nurses from further sickness. The union says nurses across the state are reporting difficulties getting the masks recommended by the Centers for Disease Control and Prevention, and having them properly fitted to be airtight.

The protest follows the first death of a nurse due to swine flu last week, a 51-year-old marathon runner in excellent health, who worked in a Sacramento hospital, as well as a General Accounting Office report to Congress this week that warned the U.S. is still not adequately prepared for a worse outbreak of H1N1 this fall.

“Hospitals across California—and possibly the entire country—are putting registered nurses and other front-line caregivers at risk by inadequately preparing for this pandemic,” said CNA/NNOC co-president Deborah Burger, RN. “If hospitals do not take urgent precautions to reverse this lack of preparation, we may see our health care facilities become vectors for infections. That is especially worrisome for hospital patients who already have compromised immune systems, and our nurses who may be unable to respond because of their own sickness,” Burger said.

I attended a two-day Public Health conference this week and H1N1 was the dominant theme.  An overarching concern was how to adequately protect health care workers. Everyone remembers the SARS outbreak in Toronto and that health care workers bore the brunt of the illness and deaths.  There was deep concern that “this can’t happen again.”

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