Allen says, “people think you can get sick from the vaccine, people think because the vaccine was developed quickly that somehow it’s less safe, we know for instance that those two are completely untrue.”

Dr. Philip Totzis of University Hospitals reinforced the effort to squash the misinformation that’s out there. He says everyone, particularly pregnant women and children should get inoculated as soon as possible.

Toltzis says, “all of the current data support that the novel H1N1 vaccine is as safe as seasonal flu.”

Nonetheless, federal agencies like the FDA, HHS, and CDC are stepping up efforts to monitor H1N1 vaccines as they are rolled out. They’ve also set up a group of independent experts, in case the feds miss anything. Officials say this isn’t because of concerns about safety, it’s just to keep tabs, and to allay any public concerns.

Dr. Jennifer Hanrahan is Chairman of the Infectious Health Control Commission at MetroHealth Medical Center. She says the situation is extremely serious, that cases are growing exponentially, and that the flu is threatening to overwhelm medical professionals who are treating the sick.

DR. JENNIFER HANRAHAN: “We’ve had somewhere between 50 and 60 people each day, over the past week. It’s not overwhelming yet. I think as the numbers continue to increase, there is certainly potential for that to happen”

As of Friday morning, 55 of the people treated at MetroHealth have been admitted. Five of them are in the Intensive Care Unit. Additionally, some hospital staffers have become infected, and are home recuperating.

The numbers are just as daunting at the Cleveland Clinic, which reported between 40 and 45 people a day are walking into its’ Emergency Room with flu symptoms. A dozen adults and children are currently being treated in the I-C-U there.

At University Hospitals’ main campus,` 851 people were treated between October 18th and 25th. 263 were admitted for either overnight observation or longer term care.

During that same period, Rainbow Babies and Children’s Hospital admitted 100 children, out of nearly 900 who went to the Emergency Room.

Dr. Hanrahan says while the growth in cases is alarming, a larger concern is that some at-risk people still aren’t trusting that the vaccines are effective.

DR. HANRAHAN: “The H1N1 vaccine is completely safe. People who are at high risk really need to go and get this, because we are seeing pregnant women who are sick, and that’s a terrible thing to see.”

However, supplies of the vaccine remain limited, as only about 16% of what was anticipated to be used - has actually been produced.

Dr. Jackson Wright, who heads the Clinical Hypertension Program at University Hospitals Case Medical Center, says the medical school will be one of five U.S. institutions taking a leadership role in what’s called the Systolic Blood Pressure Intervention Trial - dubbed SPRINT. 

Several other Health Systems will also participate, including Cleveland Clinic, Metrohealth Medical Center, St. Vincent Charity Hospital, and The Ohio State University Medical Center. 

Wright:  “The fact that Cleveland, Northeast Ohio and Central Ohio has a very diverse population makes this an outstanding location to conduct a study such as SPRINT.”

The study will take place over 9 years, and will involve 75 hundred patients.

Wright says it will measure the benefits of reducing systolic blood pressure against risks posed by increased medication and other factors in treatment of hypertension. 

Allen says what little injectable vaccine HAS come in has been used to immunize EMTs and paramedics, along with SOME pregnant women. 

When there’s more vaccine to dispense, it will be taken into daycares, school-based clinics, and some large community clinics.  But the Centers for Disease Control has adjusted down their vaccine production estimates from the producers for October and November, and Allen says that makes planning difficult. 

He says the county is asking people to be patient.

Cases of flu have been on the rise and they’re generally believed to be H1N1, although that’s not confirmed because most people who become ill aren’t tested for that particular virus.  Most cases are no more severe than a typical bout of the flu. 

Tri-Pointe is the first new “from the ground up” hospital to be built in Northeast Ohio in 28 years. 

It will have fewer beds than Lake East, but all rooms will be private, which means that it will actually be able to accommodate more patients, says spokesman Gary Robinson.  And it will have all the latest medical and information technology, something Lake East could not accommodate. 

Robinson:  “In terms of the kind of technology that’s available today, you’re just not able to retrofit that into older buildings.  So with Tri-Pointe Medical center we were able to put the latest digital technology into the facility.”

Painesville had struggled to convince the Lake Health System to build the new facility in Painesville, but it was decided the more natural and spacious Concord site was a better choice.  LakeEast Hospital will be demolished, with plans on the drawing board to fill the space with new homes and businesses. 

Weiss:  “The estimates for availability has been reduced by about 3 percent to about 114 to 115 million doses.  That’s still 4 to 5 million doses than were distributed last year and about half of that vaccine has been shipped.”

Shipments of the seasonal flu vaccine have been delayed around the country, according to numerous news reports, plus demand is way up this year - probably fueled by outbreak of H1N1 or swine flu.  So as in some past years, people still seeking the seasonal vaccine may have to wait and should keep checking back with their health care providers, as well as pharmacies and clinics that may offer it. 

The seasonal vaccine - which actually protects against 3 garden variety flu viruses - does not include protection against swine flu.  It could have, had swine flu arrived on the scene earlier, but by the time it became a well-established threat production of the seasonal vaccine was well underway.  Manufacturers had to identify and produce a separate vaccine, which is still several weeks away from widespread availability, says Dr. Steven Gordon of the Cleveland Clinic. 

Gordon:  “We have initiated at least getting the vaccine into, as we say, kind of a tiered approach in terms of our health care workers and first responders.  But of course we don’t even have enough vaccine to cover even those groups at this time, our hope is - and it changes every day - that we get more vaccine and more vaccine, and in a few weeks there will be plenty of vaccine for everybody.”

After health care workers and first-responders, pregnant women and people who care for infants are the next priority for swine flu vaccine.  After that it’s all people age 6 months to 24 years and people with chronic heart and lung conditions, then the rest of the population. 

CUDA:  These days you can order pretty much anything on the internet.  Even a copy of your genome – well parts of it anyway.  Anne Wojcicki is co-founder of 23andMe, a 2-year old company headquartered in Mountain View California that aims to make genetics as popular as facebook.

WOJCICKI: You go online you order a kit – it costs 399 dollars --you get a little vial, you spit in the vial, you send it back through the mail and then 2-4 weeks later you actually get an email saying “your genome has arrived.”

CUDA: After logging into the secure website – voila – your very own genome. But what on earth are you going to do with that? Wojcicki says a lot – for example the company will tell you your risk for more than 100 different diseases and conditions like heart attacks, arthritis and cancers, or if you’re a carrier for things like cystic fibrosis.  In addition to providing information about yourself – 23 and me wants to know something about you too --Wojcicki says that clients are asked to fill out a number of surveys that ask all sorts of questions —things like …

WOJCICKI : … when you take Benadryl do you get sleepy , do you get hyper –--things like when you see bright sunlight do you sneeze – and actually there is about 20 to30 percent of the population that when they see bright sunlight they sneeze

CUDA: Wojcicki says they’re looking for a genetic basis to questions like why some people sneeze in bright sunlight, or think cilantro is delicious and others think it tastes like soap. . The hook is that it’s fun she says; people are inherently curious about themselves and how they compare to others - but Wojcicki also believes this information gathering can lead to discoveries about serious conditions like Alzheimer’s or Parkinson’s disease. 

23andMe isn’t the only commercial genetics company on the block.  A company called Navigenics, also in California, is doing virtually the same thing.  Dietrich Stephan is co-founder.  He says when his company got started a couple of years ago it charged 25 hundred dollars for its services.  Today they’re starting package is 400 dollars.  Stephan’s selling point is prevention - by allowing people to have an assessment of their risk for various diseases, they can take action to be healthier

STEPHAN: For example, I’m at extremely high risk for prostate cancer, I’m in the top 5th percentile of risk based on my genes for prostate cancer – and now I know that I should go in for earlier screening, perhaps earlier than the classically recommended age of 50, that I should watch my PSA levels .

CUDA: And Stephan says that if everybody did that –in time – it might change the way medicine is practiced.  In fact, it might even have the power to change the whole health care system

STEPHAN: We actually believe Navigenics is the lynch pin to flipping the whole health care system from reactive and generalized to personalized and proactive.

CUDA:  The sort of personalized medicine Stephan is referring to is what many scientists hold up as the wave of the future – drugs and treatments tailored to an individual because of his or her genes.  Much of today’s medicine is based on studies of outcomes of large numbers of people; treatment that to a degree is a kind of generalized conclusion Edward McCabe is president of the American society for human genetics and a professor at UCLA school of Medicine – he believes the ability to be far more precise in knowing what works for a particular individual is right around the corner.

MCCABE: We’re now to the point where we’ll be able to say, is there 2% of the population that should not take this drug.  But it’s and outstanding drug for the other 98%.  And we won’t just know that there are 2 percent --we will know who those 2% are. 

CUDA: Still some scientists suggest caution is in order. Dr. Rudolph Tanzi studies the genetics of Alzheimer’s disease at Harvard.  He says that selling genetic services directly to consumers does have some merits –but he worries that the science isn’t quite there yet. 

TANZI:  I think it’s dangerous to eat a meal when it’s not cooked.
CUDA: So are you comparing this to an uncooked meal?
TANZI: Absolutely.  This is raw meat. 

CUDA: Tanzi argues that the science behind assigning a definitive information to individuals about their particular health risks is still imprecise and prone to misinterpretation. Many leading scientists agree with him.  This week a paper in the journal Nature compared the results of Navigenics and 23andMe for five individuals.  They found that for seven different diseases they agreed less than half the time.  Evidence to Tanzi and others that companies in the business of selling this information to consumers need to be very circumspect in the way they present the facts.

TANZI: You have to do this in a medically responsible way. You need to be very, very honest with incredible caveats and limitations – and the information should be delivered in such a way that doesn’t indicate hard science or numbers – because we’re not there yet. 

CUDA:  Another caveat is privacy. Recent federal legislation prevents your genetic information from being used to deny an individual health insurance or a job but it doesn’t protect discrimination by life insurance companies or long term care – and the new protections haven’t been tested in the courts yet.  If you share it with your doctor –as both companies selling genome sequencing suggest you should – it’s likely to become part of your medical record – and then insurance companies automatically have access to it. Harvard’s Rudolph Tanzi says that’s too big a risk for him – and he’s in the field.

TANZI : Until the amendment “cannot discriminate according to race color and creed” changes to “cannot discriminate according to race, color, creed and DNA sequence,” I wouldn’t want to have my DNA sequenced anywhere. 

CUDA: But 23 and me is betting that today’s Facebook generation isn’t concerned with privacy at all.  Their service includes a social networking component for those who ready to share and compare…not just with their doctor but on the internet.  And one final footnote to this story - The future may be written right here in Northeast Ohio.  Both 23 and me and Navigenics are discussing a research partnership with the Cleveland Clinic. Gretchen Cuda, 90.3

Elmwood Elementary School in Garfield Heights was closed on Tuesday but reopened Wednesday.  And Avon Lake in Lorain County has upwards of 200 high school students out sick, but Superintendent Robert Scott says there are no plans at this time to close the school. 

Allen says districts are encouraged to stay open, but they make those decisions at their discretion.  He says parents of schoolchildren should plan ahead for their child possibly becoming ill. 

Allen:  “Certainly they should be making contingency plans, and we’re also hoping that employers understand that there may be a need for parents to be there for their children, and to be part of the solution in trying to prevent transmission from expanding in the community by allowing them to stay home when they’re ill or when their kids are ill.”

Allen says flu viruses are unpredictable, but there’s one thing that’s known for sure:  this flu season is going to be far longer than usual. 

Bill Rice, 90.3. 

10. Whole-Slide Imaging for Management of Digital Data In Pathology: A technology for creating digital pathology slides with excellent image quality that can be viewed, stored, streamed over the Internet, and analyzed on a computer.

9. Devices for Occluding Left Atrial Appendage to Reduce Stroke Risk: Device alternatives to long-term warfarin use that can prevent clots from developing in patients with atrial fibrillation.

8. Oral Thrombopoeitin (TPO) Receptor Agonist That Stimulates Platelet Production: A recently approved drug that stimulates production of cells in bone marrow that form platelet cells in the blood.

7. Outpatient Diagnosis of Sleep-Related Breathing Disorders: Self-contained, reliable, at-home sleep-monitoring devices for screening, diagnosing, and treatment assessment of sleep-related breathing disorders.

6. Forced Exercise To Improve Motor Function in Patients With Parkinson’s: Pedaling at 90 RPMs on a tandem bike to dramatically improve motor functioning of patients with Parkinson’s disease.

5. Fertility Preservation Through Oocyte Cryopreservation: A rapidly-improving technology that allows eggs of a healthy woman to be safely frozen and stored, ready to be thawed and fertilized at a later date.

4. Non-Vitamin K Antagonist Oral Anticoagulants: Predictable and well-tolerated alternatives to the oral anticoagulant warfarin that provide a more convenient—and safe—way for patients to dose themselves and prevent blood-clot formation.

3. Continuous-Flow Ventricular Assist Devices: Tiny 3-ounce devices surgically attached alongside the heart that quietly and effectively take over the pumping ability of the heart.

2. Low-Volume, Low-Pressure Tracheal Tube Cuff To Reduce Ventilator-Associated Pneumonia: A device that dramatically reduces the risk of ventilator-associated pneumonia and death in the hospital ICU by providing continuous effective airway seals.

1. Bone Conduction of Sound For Single-Sided Deafness: A new non-surgical, removable hearing and communication device designed to imperceptibly transmit sound via the teeth to help people with single-sided deafness.

“Cleveland Clinic is known for its tradition of innovation, and this Top Ten list reflects the hospital’s continuing commitment to exploring new ways to treat illnesses and to develop new therapies,” said Christopher Coburn, Executive Director, Innovations, the Cleveland Clinic’s corporate venturing arm.

Four major criteria served as the basis for qualifying and selecting the Top 10 Medical Innovations. Nominated innovations were required to:

* Have significant potential for short-term clinical impact (either a major improvement in patient benefit or an improved function that enhances healthcare delivery).
* Have a high probability of success.
* Be on the market or close to being introduced.
* Have sufficient data available to support its nomination.

The Top 10 Medical Innovations for 2010 were announced today at the seventh annual Cleveland Clinic Medical Innovation Summit. In developing the Top 10, Cleveland Clinic enlisted the expertise of AlixPartners, LLP, an independent international management advisory firm. AlixPartners led the process to probe the opinions of Cleveland Clinic physicians and researchers, create a field of nominated innovative technologies for consideration, and develop a consensus perspective on the Top 10 Medical Innovations for 2010.

For more information about this year’s Medical Innovation Summit and the conference agenda, visit http://www.clevelandclinic.org/innovations/summit/default.htm

Carroll: Healthcare workers, emergency services personal. We don’t know the exact number of doses that are coming in but that’s the first batch and then we hope every couple of weeks there will be different types of vaccine coming to us.

Carroll says the first doses of the anti-viral medication will be in the nasal spray form and given to healthcare workers since they are at the highest risk of both contracting H1N1, and spreading it on to their patients. Next on the priority list are children, pregnant women and anyone with an underlying condition like diabetes or a heart condition.

Wainwright:  “Motor vehicle emission are less, people drive less, the truckers are moving less freight, the two railroads that cross Northeast Ohio are moving less freight, and I think it absolutely had a big impact on air quality.  It’s sad to say that the economy took a downturn, but pollution took a downturn along with it.”

The economy might even better account this year for lower particulate pollution this year - soot from diesel engines, power plants and other industrial sources - which occurs regardless of temperature. 

For years, Northeast Ohio has struggled and failed to meet federal pollution standards.  It almost succeeded last summer for ozone - but just as it became evident that the summer readings would put the region into compliance, the U.S. Environmental Protection Agency tightened the standard. 

McGivern:  “It’s been recognized for quite some time that physicians and their staffs were spending an unnecessary amount of time in these basic office tasks, such as calling up health insurers and checking on the status of the eligibility of the consumer standing at their desk, or trying to figure out what the co-payment is, or what the statuses of their claims were.”

The Availity portal would provide a single source for that information.  There is no charge for physicians to use the system. 

In Ohio, most of the major insurers are participating.  Those that aren’t may join later as their computer systems are upgraded.  Medicaid and Medicare are not part of the system yet. 

Improvements to the system will be on-going, and after a year it’s hoped that it can be implemented in other states, and possibly nationwide. 

Eileen Guttman is supervisor for health and wellness services at Cleveland State University. She says the best thing to do right now is to focus on prevention.

Guttman: Hopefully and this is where all schools, at least in the Ohio, especially Cleveland area are in a race against time are to get our students and high risk individuals vaccinated before it gets here because it’s coming and it’s coming quickly.

But the University isnt’s likely to have any swine flu vaccine for a few more weeks. Guttman says that since CSU is primarily a commuter campus, they don’t have the same concerns as schools where a lot of students live in dorms. However, they do have to deal with a more diverse group of students, many of whom have children, which means more ways to bring the disease on to campus.

At John Carroll University, where many of the students live in dorms, a space has been set aside in case there is a widespread outbreak. Sherri Crahen is dean of students at John Carroll.

Crahen: We have a floor in a residence hall that we can use that would be away from the other students. And it would give the sick students a place to recover in a quieter area and we would deliver meals to them and the nurses would check in on them.

Some schools, like Emory University in Atlanta, Georgia, have gone so far as to set aside an entire building for students who get H1N1; they’ve dubbed it the Swine Flu dorm.

Frank Esper is an infectious disease specialist at University Hospitals Case Medical Center. He says segregation may not be helpful.

Esper: I have a feeling that the influenza’s going to be so wide spread that isolating the students to one dorm on campus is probably not going to make too much of a difference when you’ve got influenza widespread throughout the community.

But there is some good news…sort of. Amy Ray is also an infectious disease specialist at University Hospitals.

Ray: It’s important to remember that the CDC projects that more than a million people so far in the U.S. have been affected; I’d think at this time that’s probably an underestimate, so the overall mortality rate for this virus is less than 1 percent.

The threat seems pretty mild on campuses so far. The American College Health Association found that out of over 27,000 reported cases of flu at US colleges, only 48 people have been hospitalized. None of those students have died directly from the flu.

And one more thing - to the dismay of many students, most colleges have no intention of canceling classes because of the flu. But some are urging professors to put more course work online so students can keep up, if they do get sick.

HELEN, EUCLID: “I DO MOST OF MY EXERCISING AT HOME.  I’M A WIDOW, I LIVE ON A VERY CLOSE BUDGET.  I GO TO MARCS, I GO TO ALDI’S.  THERE ARE PLACES… I STAND IN LINE BEHIND PEOPLE WHO ARE BUYING POTATO CHIPS, YOU KNOW, YOU KNOW WHAT I’M TALKING ABOUT.”

Rachel in Shaker Heights, on the other hand, believes bad behavior is more of a matter of degree. 

RACHEL, SHAKER HEIGHTS:  “IF WE MAKE PEOPLE RESPONSIBLE FOR THEIR OWN UNHEALTHY BEHAVIORS, WHERE DO WE DRAW THE LINE?  FOR EXAMPLE, I AM A STRICT VEGETARIAN BUT OCCASSIONALY I LIKE TO HAVE A GLASS OF WINE.  MY GOOD FRIEND DOESN’T DRINK OR SMOKE AT ALL BUT HE LIKES TO EAT RED MEAT.”

Jessica Berg, a professor if Bioethics at Case Western Reserve University agrees that it’s frustrating when people deliberately do things that are unhealthy and don’t take advantage of opportunities to improve their health.  But she doesn’t think penalizing people financially is a good solution. 

BERG: “ FROM A SYSTEM LEVEL IT’S NOT CLEAR THAT WE HAVE THE ABILITY TO DIFFERENTIATE BETWEEN DIFFERENT ACTIVITIES OR EVEN THAT WE SHOULD IN SUCH A WAY THAT WE’RE PENALIZING THESE PEOPLE BECAUSE FOR EACH INDIVIDUAL YOU’RE NOT SURE WHAT IT IS THAT’S CAUSING THAT UNHEALTHY BEHAVIOR.”

Berg believes there’s a more sensible way to coax people toward developing healthier lifestyles, expressed in this exchange with Sound of ideas Host Dan Moulthrop. 

BERG: YOU KNOW IT’S ALWAYS I THINK IN SOME SENSE MORE PALATABLE TO SAY IT’S AN INCENTIVE THAT WE’RE GOING TO GIVE YOU RATHER THAN A PENALTY THAT WE’RE GOING TO IMPOSE.

MOULTHROP:  “HERE’S AN INCENTIVE, YOU GET TO KEEP YOUR JOB!”

BERG: WELL, HERE’S AN INCENTIVE, WE WILL SUBSIDIZE YOU IN THAT WELLNESS PROGRAM.  WE WILL SUBSIDIZE YOU IN THAT SMOKING CESSATION PROGRAM.”

A caller named Tracy from Rocky River said his employer’s wellness program offered a large cash prize to employees for reducing their body mass index.  He’s lost 20 pounds.

While that may have worked for Tracy, J.B. Silvers, a professor of Finance and Healthcare at Case Western Reserve University doesn’t condone offering financial incentives.  He says people can’t be bribed into good health.

SILVERS: “They’re into good health because they’re educated, because they have - socio demographics are good, because they live in good neighborhoods, because they get to go to schools.  It’s a much broader framework than just a few incentive dollars that are thrown out there.  That moves you to the right direction, it’s not going to be enough to get you there.”

Carl Biats, President of Morningstar Insurance and Financial Services says work wellness programs have not been well attended and most employers are just trying to keep their heads above water.

BIATS: “MOST EMPLOYERS RIGHT NOW ARE TRYING JUST TO KEEP THEIR HEALTH PLAN.  I MEAN THEY’RE UPPING DEDUCTIBLES, THEY’RE UPPING CO-PAY, THEY’RE DREADING THE RENEWAL.”

As far as reducing risk based behaviors, Katy sent an email describing herself as a healthy 39 year old woman with great blood pressure, who exercises regularly, but weighs 254 pounds.  She wrote “For those who wish to penalize behavior, I’ll make a deal with you:  I’ll develop bulimia to help control my weight, if you promise no knee replacements for marathon runners.”

For 90.3, I’m Bridget De Chagas.