“Help stop the spread of H1N1flu today! Notify staff if you have a fever and cough.”
I read these fateful words upon entering my neighborhood Paris clinic, gulping hard. After spending the latter part of my month with a congested head and burgeoning chest cold, I had finally decided to see a doctor. It didn’t hurt that I had woken up that particular morning feeling like I’d been hit by a Mac truck, slight fever in tow. But it couldn’t be the dreaded swine flu… could it?
I consider myself an educated person, someone who reads the news and has at least a fraction of common sense. So I am not ignorant of how germs are spread. However, the thought of entering a crowded municipal clinic waiting room with a blue paper mask engulfing my face felt like the modern-day equivalent of attaching a scarlet ‘A’ to my chest. And so, as my internal body heat rose with every step, I willed myself not to cough for the next two hours and walked quietly into the room.
Two hours and two degrees of fever later, my name was finally called. I walked into the doctor’s office, explained my symptoms and awaited the deluge of guilt-tripping as to why I didn’t notify anyone about my chances of being Paris’s next silent killer. To my surprise, my doctor plainly said: “You have a virus.”
“How do I know if it’s the regular flu or the swine flu?” I whimpered. My response was an unenthusiastic shrug. “They’re both the same, then?” I asked. Another shrug.
And so, with my prescription for bed rest in hand, I walked out of the clinic coughing at full force, awaiting my next victim.
Unfortunately, having just a “virus” wasn’t good enough for my workplace, which involves children ages 2-6, and I was instructed to promptly get an H1N1 flu test. The doctor may have thought H1N1 and influenza were interchangeable, but the media has shown us otherwise. My employers wanted proof.
What I discovered on my forthcoming lab test adventure, was that the spread of this illness – whether truly life-threatening or not – is incrementally more likely when no one in France is willing to test those who may be sick with it.
“We take a sample from your nose [called the Rapid Flu Test in the U.S.] and then you’ll find out if you have a flu or not, but not which flu,” said the woman at the lab the next morning. “If we find out that you have a flu, it will be sent out to see if it’s H1N1 or not… but it’s not very accurate.” How inaccurate, I wondered? “If you have H1N1, it often tells you that you don’t, and if you don’t have it, it can tell you that you do. It has between a 10% and 70% accuracy rate.”
Well, that certainly cleared things up.
The other option in France is to take a specific H1N1 flu test, which is 80 euros and not reimbursed by the national health insurance. Only five or six clinics in Paris perform the procedure, much less in other parts of France, and it is only done in cases of critical need – like, say, a pair of Parisian football players awaiting their next televised match against Marseille.
Things in the U.S. are no better. While there are significantly more cases than in France (349,491 confirmed/probable cases in the U.S. versus 25,103 in France, according to FluTracker and Rhiza Labs) the testing and vaccination methods in place are, as of yet, inefficient. Currently, the CDC is only testing flu-sufferers who have been hospitalized or are at high risk for complications. Treatment options won’t change based on results, plus there is simply not enough time or money for all other cases.
Same goes for vaccinations. During the first week of October, the first batch of H1N1 flu-vaccine nasal sprays arrived on U.S. soil. However, out of the U.S. government’s total order of 251 million doses, only 2.4 million were administered. Demand can’t keep up with supply, so health officials decided to send the vaccine over as it was ready, instead of waiting for the entire amount to accumulate. Already, the shortage in New York State alone is palpable, where the government has mandated that all health-care workers be vaccinated. Where does that leave the little people?
As for me here in France, I am finally able to enjoy comprehensive medical coverage – a coverage that hasn’t come as a result of selling my soul to a full-time job like in the U.S. But what good is that coverage if I am forced to self-diagnose.
In the end, I decided not to have the test. My doctor said my chances of having H1N1 were too slim and preferred to save the exam for really dire cases. Ten days later, I still don’t know what I had, and when I go back to the classroom next week my employer will have to be fine with that.
Perhaps, ultimately, I was socially irresponsible. Maybe I should have worn the mask in the clinic, should have insisted on taking the test – if anything, for public conscience’s sake. For now, I have just been telling people I had a “virus” and that it really was no big deal. But when my lingering cough takes off with a start, there isn’t a face in my vicinity that isn’t turned the other way, heading swiftly for cover.
First published in Brit’mag, November 2009