Some H1N1 questions that still puzzle me

Not to sound ignorant, but as I read and write about the H1N1 virus, I find that there's lots and lots of questions that I can't seem to answer for myself. In fact, I'm not sure the healthcare industry has a handle on these issues, either--though you may prove me wrong shortly.

Perhaps the top questions on my list are as follows:

* Why, if all but the sickest patients can be cared for at home, aren't hospitals investing in programs to send nurses and mid-level professionals out to do house calls? Sure, that's an expense, but wouldn't an absolutely paralyzed ED be worse?

* If health and emergency services personnel are one of the top five groups at risk for H1N1, why aren't they at least required to wear a respirator mask if they haven't been vaccinated? To my knowledge, that's not required.

* Hospitals have made big progress in controlling MRSA by testing everyone who enters the facility for the presence of the bug, and isolating those who test positive. Would that approach work in avoiding in-hospital outbreaks?

* Since diabetics (one of the high-risk groups) visit their physicians frequently to keep up with ongoing management, why aren't doctors administering the vaccination to them as part of their routine treatment? (with consent of course)

* Same question for pregnant women: Shouldn't OB/GYNs be stocking up on the vaccine and offering it to pregnant women at their first opportunity?

* Couldn't primary-care doctors do more to educate patients--especially high-risk patients--on the need for vaccinations? I'm talking about, for example, ongoing training of front-office staff, who can share info with patients as they arrive and depart. Brochures and posters just don't cut it.

Well, folks, do you have responses to any of these questions? Do you have more to add or areas in which you disagree with me? Let's get a good ol' rollicking conversation going here...it's definitely now or never. - Anne

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