April 28, 2009 -- Doctors battling swine flu must walk a tightrope between informing the world so people can protect themselves, and sending people to the hospitals with an anxiety attacks instead of the flu.
But as reports of a few cases in California and Texas on Friday turned into hundreds and the World Health Organization issuing a pandemic threat level of 4 on Monday -- some otherwise healthy people feel on edge.
"I'm pretty much freaking out," said Brandon Syms, a freshman at Boston University who just received an e-mail from the school detailing the spread of swine flu. "I've gotten a cold or something a few days ago. I've been coughing a lot, and I've been getting a sore throat."
Syms, who claims he normally isn't a "germaphobe," said he's been obsessing about the possibility of his cold being swine flu for the past 24 hours -- yet he said he's too afraid to go to the doctor and hear the bad news if he does have it.
"I wonder if there are a whole lot of people who don't want to find out and they have it and they're spreading it around," said Syms. "Now I'm thinking about it all day long."
To make matters worse, he can't stop biting his fingernails so he's worried he's putting the virus in his mouth at every turn.
"It makes me nervous," he said. "What would calm me down right now, other than my mom, would be if they would talk more specifically about what this is, how it affects the body."
Despite the rising threat, and the rising numbers, many public health experts say they aren't too worried for now.
The following are doctors' top reasons why the public shouldn't panic about the swine flu -- yet.
Reason 1: The Low Numbers… For Now
"It's just a handful of cases. It is spreading but it's still quite early," said Dr. Martin Blaser, chairman of the Department of Medicine at New York University Langone Medical Center in New York City.
"In most cases, it's just regular influenza -- it's something that happens every year all the time," he said.
Although he expects the numbers to rise this week as labs catch up to diagnose current cases, Blaser said the public should bear in mind their own strength in numbers.
Numbers Keep Swine Flu in Perspective
On Monday the CDC reported 42 confirmed cases in the United States, a country with more than 300 million uninfected people.
Those numbers are exactly why Steve Catoe, a blogger with a congenital heart problem, has decided he's going to put his worry on the back burner for now.
"From what I understand that's just really odds now," said Catoe. "It may be panic-worthy now, but I'm just too dumb to realize it."
Catoe has always had to worry more about infections than the average person. Tricuspid atresia, meaning he is missing one of the connective valves in his heart, has left Catoe's blood oxygen level so low that his fingertips are perpetually blue.
"I'm up close and personal with what can happen if you don't take care of yourself," said Catoe, who has lingered in the hospital for a whole summer with infections that most people could overcome in a week or two. Simple colds can knock him out and give him insomnia for days.
"I am a vulnerable person and swine flu needs to be kept an eye on, but it's not something I'm going to change my lifestyle for," said Catoe.
Reason 2: How Deadly Swine Flu May Be….
Doctors worry most about people like Catoe, children and the elderly and others with weak immune systems during a flu outbreak.
While that still holds true with swine flu, those who study outbreaks say that A(H1N1) isn't the deadliest strain out there.
"A thing to keep in mind is the case-fatality," said Ed Hsu an associate professor of Public Health Informatics at the University of Texas School of Health Information Sciences in Houston.
Case-fatality is a simple way to measure how deadly a disease can be: the percentage of people who got the disease and did not survive. Hsu said case fatality for severe acute respiratory syndrome (SARS) reached more than 15 percent, while bird flu reached 60 percent.
"What we're seeing in Mexico case fatality is about 10 percent, and some of those are not confirmed," said Hsu. "Compared to bird flu it's relatively mild."
More Information, Science Will Help Doctors Fight Swine Flu
As of Tuesday evening, Mexican Health Officials report they have 20 confirmed deaths from the swine flu virus, while the World Health Organization says their current laboratory-confirmed total is seven.
Reason 3: Swine Flu Meet Tamiflu… For Now
Although doctors don't have a vaccine for the new strain of swine flu, Blaser said there is hope in our medical arsenal.
"At this point the strain is sensitive to flu medication such as tamiflu," said Baser, who is also the past president of the Infectious Diseases Society of America.
Tamiflu can subdue many flu infections if taken within 48 hours of the first symptoms. The current federal Public Health Emergency declaration has allowed the federal government's to stockpile and allocate flu medication to areas that need it most.
But Blaser warns people not to take flu medication without a prescription -- especially if they have not had any symptoms.
"If enough people do, the virus will become resistant and it [the medicine] will not work," said Blaser.
Although mommy-blogger Amy Anaruk, author of theasthmamom.com, hasn't run out to get Tamiflu, she did get children's acetaminophen, found doctors for her family just in case, and then spent the better half the weekend calming down.
"I've gotten to the point of feeling sane about it -- you just can't live your life that way," said Anaruk. "When you see health officials who say 'prepare, prepare, prepare,' you start to think that it's inevitable -- especially if you have child with a chronic health problem."
Certainly declarations of public health emergencies have led such worries, but experts say it's a sign that governments are better prepared for pandemics than ever before.
Reason 4: Governments, Scientists Have Learned their lessons
"In terms of quarantine and travel rules -- we are much better prepared," said Hsu. "This is a great, great, improvement and this is a lesson learned from previous outbreaks."
Although it scares most people that swine flu cases are popping up all over the globe, to Hsu it shows governments aren't trying to cover up a disease.
Honest Swine Flu Reporting Will Help Potential Pandemic
"It is a good sign, which is the transparency of reporting," said Hsu.
Blaser concurred on the government's responsiveness -- not only with the speed at which they declared a public health emergency but with the money and work put behind finding a new vaccine.
"Work on developing a vaccine for this flu is already underway," said Blaser. "The Centers for Disease Control, the federal government, the World Health Organization --- they all have this on their radar screen, which is good."
Reason 5: Watch Out Flu, It's Springtime
As the numbers of swine flu cases climb, Hsu said he and his colleagues are keeping a close eye on the disease trends.
Based on his past work with the bird flu and SARS, Hsu said most infections decline in the summer months. If swine flu follows suit, then there are good signs a pandemic has been avoided.
"Looking at the trend, the flu data the flu trend should be declining in May," said Hsu. "The next few weeks should be important."