News Conference with Minister of Health and Chief Public Health Officer

The Honourable Leona Aglukkaq, Minister of Health
December 2, 2009 – 11:30 EST

Thank you, and welcome to this week’s update on the H1N1 flu virus in Canada.

As we begin the month of December, we are seeing that a possible epidemic peak has been reached by all provinces and territories. We will be able to confirm this in the coming week. Regardless of whether this milestone has been reached, it is important to keep in mind that several million Canadians could still be infected on the other side of the peak, resulting in lots of sick people and several deaths. Let’s also remember that this is the time of year when people are coming together with family, friends and work colleagues to celebrate the holiday season. So while we may be seeing less flu activity in many communities, the risk of H1N1 transmission is high. In other words it is as important as ever for Canadians to get vaccinated. It is also an ideal time with all provinces and territories having made the vaccine available to the general public, with shorter lineups at clinics and enough vaccine to immunize everyone who needs and wants it. In fact, as of the end of this week, we will have distributed over 21 million doses.

Recognizing the need to sustain the vaccination message, the Public Health Agency of Canada issued ads this past weekend in daily, weekly and ethnic newspapers across the country to encourage Canadians who have yet to do so to get their vaccine. This will be echoed in radio ads being aired from now until mid-December. Vaccine coverage rates reported in provinces and territories currently vary – from 23 per cent to as high as 65 per cent of the population, in some jurisdictions.

There is no question that Canada is at the forefront in its response to the H1N1 pandemic. The H1N1 flu vaccine is safe and effective. It is a simple way to prevent illness, even death. The more people who are immunized, the harder it is for the virus to spread. By simply getting the H1N1 flu vaccine, you can help ensure a healthier holiday season for yourself and for the people you love.

Thank you. Dr. Butler-Jones will now deliver a few remarks.

Dr. David Butler-Jones, Chief Public Health Officer

Thank you Minister.

I would like to elaborate on a few points the Minister made. Firstly, on reaching a possible epidemic peak. We’re trying to be careful when we use terms like “peaks”, for two reasons. One, because we won’t know we’ve reached a peak in flu activity until we’re clearly on the other side of it. Two, because a peak in activity doesn’t mean we decrease our concern. Coming down the mountain can be just as treacherous as scaling it. During the first wave, as many cases occurred after the peak as before it. Several signs will confirm this with certainty. For example, in most of the provinces and territories, the number of hospital admissions is decreasing, there are fewer outbreaks in schools and there has been a drop in the volume of antiviral drug purchases. The surveillance systems are suggesting that things are plateauing or reducing. But that’s not happening everywhere, yet. For example, while Alberta is seeing only sporadic activity, there is still widespread activity in Saskatchewan and B.C. Sometimes with seasonal influenza, we can see a bit of an upswing, then a dropoff, then it can pick right up again. All this is to say, you can’t say it has peaked for sure until you are well beyond it.

We can say that, as of November 21, overall flu activity decreased again across the country, compared with the previous week. For example, there were 330 reported influenza outbreaks across the country for the week ending November 21, compared with 374 influenza outbreaks for the week ending November 14. Again, for the week ending November 14, a comparison of patient visits shows us that for every 1000 patients seeing their health care providers, 91 were seeking medical treatment for flu. For the week ending November 21, that number was down to 57. However, current activity levels are still well above the expected range for this time of year, when compared with normal seasonal flu activity. The risk of community transmission remains high. We can expect to continue seeing hospitalizations and deaths. Between November 19 and 26, 59 deaths were reported.

The H1N1 virus is unpredictable. The current pandemic is unrelated to the seasonal flu. For example, in the last few weeks, the number of people with influenza-like illness seeking medical treatment was more than three times higher than what is usually seen at this time of the year for seasonal flu. Additionally, what we have seen so far is that 16 per cent of those hospitalized with H1N1 have been admitted to ICU; up to 80 per cent of those admitted to ICU have required breathing assistance. This is over three times the frequency for respirator support for flu and pneumonia seen during the 2007-08 flu season.

Our surveillance is also confirming that, while H1N1 can strike anyone, this is a younger person’s disease. We are seeing that the highest proportion of H1N1 infections is in people under 15 years of age. Forty per cent of the deaths are occurring in people 40 to 65 years of age – in some cases, people who were otherwise healthy. Forty per cent of those who have been admitted to the intensive care unit – and one third of people who have died – have not had an underlying medical condition. We are also seeing too many young people and young adults in Intensive Care Units on ventilators. Children under 5 years of age have had the highest rate of admission to the ICU, followed by adults 45-64 years of age. The median age of people with H1N1 in hospital, admitted to ICU or who have died has been substantially younger than what was seen during the 2007-08 flu season.

During 2007-2008, the median age for hospitalization from flu and pneumonia was 71, for ICU admission the median age was 68, and for death, 82 years of age. As of November 21, the median age for H1N1 hospitalization was 26 years old; ICU admissions, 45 years of age and for deaths, 54 years of age. As we reach this peak, and come down the other side, we have a real opportunity to avoid these situations by continuing to take a very aggressive approach with this pandemic. By providing early treatment, and most importantly, by immunizing in a broader way than we ever have before for seasonal flu. The pandemic H1N1 flu is a preventable illness. Canada is fortunate to have a safe and very effective vaccine that is available to everyone. Thanks to foresight and planning, we have a vaccine that is cost-effective and can prevent illness, prevent hospitalizations, and prevent deaths.

About a third of Canadians are now immune to H1N1, because they have either been vaccinated or have been infected during this pandemic. But that still leaves millions susceptible to catching it. I cannot stress enough how important it is to get the H1N1 vaccination. There is a huge cost associated with not getting immunized with the H1N1 vaccine. Even if you are not personally worried about getting H1N1, for the sake of others around you as well as your loved ones, please get your H1N1 flu shot. You’ll be doing your part to reduce the level of infection in the community and protecting those around you.

Thank you. Merci.