Dr. Tucker Woods is head of the Long Island College Hospital’s Emergency Department. The last time we checked with him there regarding swine flu, or the H1N1 virus, the place was inundated with patients, most complaining of mild flu-like symptoms. For the week that spanned the end of April and the beginning of May, 2009, for example, there were, on average, over 200 patients each day seeking treatment. On May 26, 2009, the E.D. saw an unprecedented 296 patients.

“It was a struggle to get enough staff in every day to handle the load,� Dr. Woods recalls, “but we did it without having to activate our disaster plan.�

Compare the numbers knocking on the emergency room’s doors last spring to last month’s tally. October averaged only162.4 visits a day, Dr. Woods reveals. “Pediatric volume was up 6.7 percent compared to last October,� he said, calling the increase “barely a blip.� And in the adult E.D., volume was up a mere 1.5 percent.

Along with Boston and Philadelphia, New York City is in what Dr. Woods calls “a better position� than much of the rest of the country, which is getting pounded by the disease. Why? The operative word is antibodies. Hard hit by the flu in the spring, many city residents now possess antibodies that are keeping them healthy. Some experts suggest that even with a very mild case of the flu — symptoms that could be mistaken for the common cold — antibodies remain active in the system.

Another indication that New York City is experiencing low H1N1 activity is that the city’s key emergency department personnel are participating in conference calls with the Department of Health once a week. Last spring these phone calls took place daily.

“I actually think, and others think as well, that many New York City residents contracted the flu during the first wave,� reports Dr. Woods, who added that the amount of immunity in a population is called herd immunity. “Some estimate that 20-40 percent of New York City residents got antibodies to H1N1 during the first wave.�

Dr. Woods explains that citywide 50 hospitals are reporting data to the Department of Health. On November 1, for example, out of 49 hospitals reporting, there were 9,451 visits, but only 290 of these were for influenza-like illness.

Fully expecting to have seen a second spike here by this time, Dr. Woods admits that two months ago he was “convinced we were going to get crippled during the second wave� and that the hospital would be “neck-deep in hundreds and hundreds of patients.� Now he is feeling “a bit more positive.�

However, he cautions, the most important lesson that H1N1 has to teach is not to make predictions about its uncanny behavior. Contrary to normal flu virus, for example, it is a young person’s illness in terms of hospitalizations and deaths. Fifty percent of these are people under the age of 25, with only 6 or 7 percent of deaths occurring in people 65 and up. For this reason healthcare professionals are urging parents to get their children vaccinated. “This is the exact opposite of seasonal flu,� explains Dr. Woods. “With seasonal flu, there are 36,000 deaths each year, but 90 percent are people 65 or older.�

Because of the current scarcity of H1N1 vaccine, the Department of Health recently lifted a mandate insisting that, as a condition of employment, all New York State healthcare employees were required to have both the seasonal and swine flu vaccinations by November 30. Lifting the order was good news for some hospital employees, LICH staff members included, who were resisting the vaccine. Before the mandate was suspended, Dr. Woods says, the hospital was “going full throttle� to get the staff vaccinated: “Normally each year LICH does about 40 percent of the staff, but this year our numbers are going to be much higher.� LICH received a new shipment of vaccine two weeks ago and all employees at risk, including the E.D. staff received a shot.

Although he advises against predictions, Dr. Woods was willing to say that he believes that the virus “will produce a lot of mild disease, but I don’t believe that it will mutate or that we will have too many admissions.� Yet he strongly urges as many people as possible throughout the city to get a vaccine, calling it “our strongest weapon against influenza.�

“And you can quote me on that,� Dr. Woods concluded.

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