Tribal Health’s Flu Clinic and Health Fair encourages flu shots, but is also testing disaster preparation

Char-Koosta News 

PABLO — Every year, the Confederated Salish and Kootenai Tribes’ Tribal Health Department (THD) encourages everyone to get a flu shot. To that end THD is holding a Flathead Reservation-wide Flu Clinic and Health Fair to get tribal members vaccinated for flu season. It will also be a test of emergency systems in the area. The Flu Clinic and Health Fair is scheduled for Wednesday, October 23, at Salish Kootenai College.

CSKT Emergency Preparedness Coordinator Tammy Matt says the flu vaccination clinic will test the capability and capacity of the Tribes and other local entities to distribute flu vaccines to a large population in a short amount of time. The drive is win-win: locals can stave off the flu, and emergency response groups will analyze their readiness to deal with an unforeseen health-related disaster.

Director of Emergency Services for SKC Greg Gould says there is an emphasis at federal level to push public health preparedness, and increase capabilities and capacities of the health sector to both immunize through mass dispensing exercises as well as large scale treatments. The state of Montana is conducting similar distribution tests consequently the CSKT decided to test its own capabilities.

Why flu vaccinations?

Despite the apparent ease of getting a flu shot, immunization rates for adults from the ages of 19 to 64 years are usually low. THD Community Health Nurse Christine Murphy says younger people feel that they are healthy enough to fight the virus without a vaccine. 

Murphy says the individuals over the age of 65 will actively seek out vaccines, including shingles and flu. That is good since the older populations have more difficulty fighting the virus and are more likely to suffer complications from flu symptoms.

The younger population will often forego flu vaccinations when offered or when they are locally available. Murphy says that often teens and college students will only get the required vaccinations needed for school entry, but will decline extra vaccinations. Aside from the flu vaccine, they turn down vaccines for Human Papillomavirus (HPV) — which can cause cervical cancer; meningococcal vaccine that protects against a type of flesh-eating disease that afflicts mostly college-age students; or hepatitis A.

While the flu (influenza) may seem like a mere discomfort that requires only an off-the-shelf medication to reduce symptoms, serious health complications can affect people of all ages. 

In 2018, the Center for Disease Control reported that in the U.S. 48.8 million cases of influenza resulted in 900,500 hospitalizations, and 79,400 deaths. In Montana, 13,576 flu cases were confirmed that resulted in 767 hospitalizations and 38 deaths. Also there are likely thousands more individuals who caught the flu who didn’t report to healthcare facilities.

People also don’t run out and get vaccinated because its more or less a common feature of the season and don’t think about it unless it’s known to cause deaths. When the outbreak of H1N1 flu virus caused dozens of deaths of healthy individuals, people couldn’t get immunized fast enough.

Willful ignorance

Murphy says there are reasons why individuals or parents don’t choose immunizations, none of which are sound. “People wouldn’t get immunized because they were afraid of the disease,” Murphy said. “And they’re now afraid of the vaccine.”

She has seen a rise in the number of anti-vaxxers — individuals who believe that vaccines cause harmful effects that debilitate their children’s mental capacity.

Some of the anti-vaxxer parents seek medical and/or religious exemptions of vaccination requirements for school entry. Murphy said that Missoula County saw an increase in pertussis aka whooping cough cases as the number of exemptions grew. Across the country, treatable and preventable diseases like pertussis, influenza, chicken pox, mumps and more are being exempted. The proximity of Missoula County to the reservation puts local children at risk as they can catch these diseases in places where large numbers of people frequent.

The probability of a disease traveling from location to location is not a new one.

You get a disease, and you get a disease, and everyone gets a disease

Every so often, a disease will spread beyond its locality, and infect a large population. When it spreads across a region, it’s called an epidemic; when it spreads across the planet, it’s called a pandemic.

In 1918, the Spanish flu circled the globe, infecting 500 million people and killing 50 million. Murphy says that the mortality rate was so high, guards were hired to keep grieving families from stealing coffins, which were in short supply as there weren’t enough for all the dead bodies needing to be buried.

“Epidemics and pandemics are cyclical throughout history,” Gould said. “Statistically speaking, the US is due for one.”

Pandemics normally took a year to travel across the planet. In 2019, advanced modes of transmission could carry a contagion around the globe in 12 hours. “Our interconnectedness of the globe makes it so that if something happens on the other side (of the world), it can show up on our doorstep tomorrow,” Gould said.

Epidemics can spread from different circumstances such as a natural disaster. The 2010 Haiti earthquake initially killed 1,000 people; in the aftermath, lack of water, healthcare and other strapped services caused a cholera outbreak that killed 80,000 people. “When a system goes down, you don’t realize how vulnerable we are,” Matt said.

Luck favors the prepared

Matt admits they started late in the process to organize and prepare the flu clinic. However the short notice is an added bonus since most wide-area disasters are often sudden and a community’s readiness comes clearly into focus. Are local health and emergency responders ready or not? With this drill, the organizers hope to find out.

This year, the clinic will take place in Pablo at the SKC on October 23. CSKT Transportation will take tribal members and their beneficiaries to the college for the flu immunizations. Schedules for the reservation has been released. 

Matt hopes to do the flu clinic every year. Next year, she hopes to have an immunization ‘pod’ in Pablo and one in Arlee. In the third year, another pod will be added in Polson. The goal is to open more distribution sites and get everybody practiced and prepared so they can get more people through the doors to be vaccinated.

Key to the success of the preparedness plan is making sure the populace is well informed. In a simulation or real-world crisis, getting people accurate information is important. Murphy said a lot of knee-jerk information keeps people — especially anti-vaxxers — from getting kids treated in the fear that they will contract a disease from the vaccine. “There’s a lot of reactionary news we see out there everyday,” Murphy said. “People try to control people by making you scared and you get a lot of the wrong information. It’s really important to stay calm and get the facts.” 

After the drive, all participating parties will meet to analyze weaknesses and strengths: what was good, what was bad, and what could they improve on. Depending on the results, the participants might need to modify the plan, bring more partners to the table, decide who should have been here and who was missing, and more. Regardless of the results, they would need to strengthen the plan and practice it again and again until it becomes second nature or until they get a phone call ordering vaccinations for everyone.

Participating in the flu clinic are the Tribal Health Department, Public Health Emergency Preparedness Program, Disaster Emergency Service, SKC Emergency Response Program, Environmental Health Program at THD; St. Luke and St. Joseph hospitals; Tribal Emergency Response Commission; Polson EMS; Tribal Council, who gave change of duty to for CSKT employees to participate; and Tribal Transportation who are using this opportunity to test their capability. They also invited Sanders County and its DES and Emergency Response Program; Flathead and Missoula counties are resource forming.

Lake County didn’t have the quantity of vaccines to participate and will do its vaccine drive on a smaller scale.

Next year, Matt hopes to include Lake County in the planning and open the flu clinic to everyone in Lake County and surrounding counties that touch the reservation “It’s so nice to have all these key players at the table and hopefully get the word out about how important it is to plan and prepare because in a real event, if we don’t have our ducks in a row, it’s just going to be complete chaos,” Matt said.

“You never know when it’s going to happen,” Murphy said. “The more practice you have, then you’re going to be able to respond in a calm manner because when things happen people panic and then panic feeds on panic and if you have a team that says, ‘Okay, were going to do this, we’ve been practicing this,’ it should go smoother.” 

With enough practice, should the unthinkable happen, the teams could respond quickly and get three pods up and running to stop a disaster from happening.

Getting immunized against the flu can help prevent debilitating complications, hospitalization and even death. Murphy noted, “The flu season is hitting early this year.”

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