At this point, I'm just glad I've already had it (H1N1). For me it came with a nasty sinus infection that I killed with a neti-pot. I guess I'm too old for the worst of it.
Here's a recent research initiative written up in the Lancet that was based on Dr. Fedson's work:
InFACT: a global critical care research response to H1N1
The H1N1 pandemic presents acute care researchers with an extraordinary challenge and an unprecedented opportunity. By early October, 2009, there had been more than 340 000 reported cases of H1N1 infection in 191 countries, with more than 4100 deaths.1 WHO initially projected that up to 2 billion people could become infected with the virus over the next 2 years.2 Although vaccination programmes and other factors should reduce this number, plausible estimates of the number of infected individuals who might benefi t from admission to intensive care range from 200 000 to 10 million. Infl uenza killed at least 50 million people during the 1918 pandemic.3 Today, with antibiotics and antiviral agents, mechanical ventilation, and the supportive measures available in intensive care, most of those deaths could have been prevented. The mortality for H1N1-infected patients admitted to intensive care ranges from 10 to 40% over the fi rst month,4–8 and survivors spend a median of 2 weeks in the intensive care unit. To reduce this toll requires a better understanding of the epidemiology and clinical biology of the disease, and the identifi cation of effective management strategies. New knowledge must be gathered with unprecedented speed and effi ciency. Beyond antiviral agents, anecdotal reports and data from animal studies suggest that illness severity can be attenuated by readily available agents, such as corticosteroids and statins, that can modulate the host’s infl ammatory response.9 None of these drugs has been adequately studied for effi cacy. It is within the intensive care unit that the most severely aff ected patients will be treated. As international leaders of investigator-led clinical research consortia, and as clinicians dedicated to the care of critically ill patients, we have joined together as the International Forum for Acute Care Trialists (InFACT)10 to promote a scientifi cally rigorous, geopolitically inclusive, and academically collegial research response to this challenge (panel). We call on those who share this goal to join us. The InFACT H1N1 research programme incorporates four core initiatives. We have harmonised fi ve regional databases to create a common global registry of critically ill patients with H1N1 infection.6–8 We urge clinicians and researchers to contribute cases. The database will enable real-time study of the epidemiology, natural history, and treatment of severe H1N1 disease. In parallel, we will develop a biobank to facilitate studies of genetic susceptibility and clinical biology. We are starting a programme of collaborative, investigator-led randomised trials of treatment strategies that target both the virus and the host response. Our initial three studies will evaluate inexpensive interventions that are available in both the developed and the developing world: corticosteroids and statins. They use adaptive designs to ensure that results can be quickly incorporated into practice, and that ineff ective treatments are dropped. As measures of effi cacy, they will measure survival of individual patients and the rapidity with which patients can be liberated from limited intensive-care resources. We seek to reduce the consequences of severe H1N1 infection in the developed world, where available research infrastructure is most robust, and in the developing world, where the human toll is likely to be the greatest. To this end, we will catalogue international critical care capacity, and promote, mentor, and support clinical research activities in resource-poor areas. Research during a pandemic poses unique ethical and logistical challenges. Our position paper seeks toreconcile the potentially competing imperatives of a deliberate and conservative approach to the protection of the rights of the individual patient with the societal need to minimise the burden of illness and rapidly determine optimum approaches to prevention and treatment. The H1N1 pandemic transcends geographic, economic, and political boundaries—our response must be similarly inclusive. We have committed ourselves, and the scientifi c constituencies we represent, to a methodologically rigorous and intellectually open collaboration to learn as much as we can and as quickly as we can to reduce the burden of illness of severe H1N1 infection. We call on clinicians, regulatory agencies, governmental authorities, research ethics boards, and funding bodies to support this unparalleled response to an extraordinary global challenge. The InFACT Global H1N1 Collaboration* St Michael’s Hospital, Toronto, ONT, Canada M5B 1W8 marshallj@smh.toronto.on.ca