It's time to announce the annual awards for Bay Area performances in this year's Winter Flu Olympics!

Even though the California flu season is not yet over, the competition to date has proved fierce, particularly for Most Atrocious Coughing Technique, and Worst All-Around Performance during a flu season.

And it's hard to imagine anyone able to top my current choice for Lousiest Long Distance Sneezing, even if the existing flu season were to continue through May -- as it just may.

That award goes to the sickly man who last November repeatedly blew his nose while standing behind me in a slow-moving hospital cafeteria line. When his nasal gusts began registering on my neck, I turned toward him with a public health message in mind.

But then it all happened so fast, before I could say a word or shield myself and my cold shepherd's pie. In an instant, the man's body stiffened, his head flung back and forth, and he let loose a Goliathan sneeze that dampened more than my spirits.

Every person and so-called "daily special" within spitting distance was similarly showered. In consideration of the enormous number of people he may have infected, he was additionally awarded a dishonorable mention in the Worst All-Around.

This year saw a repeat winner for Irony in the Time of Influenza: the same Bay Area doctor whose waiting room (still) contained an empty Purell hand-cleansing dispenser that kept attracting sick patients in search of hand hygiene.


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Within a 20-minute span, I saw eight of her patients add their germy touches to the useless dispenser, converting it into a genuine fomite that would contrarily help to spread infections throughout the waiting room.

I always find the flu season painful. It's hard to witness casual disregard of unchecked coughs, sneezes and Purell bottles in public settings because I've watched too many people suffer and die from flu and its complications.

On a national level, the associated mortality rate ranges between 3,000 to 49,000 deaths each year, and the morbidity rate is exponentially higher.

On a more positive note, three candidates at a chain restaurant in San Jose made it to this year's finals for "Best Individual Performance in a Flu-like Condition." It was heartening to watch their masterful executions of proper mouth and nose coverage while coughing and/or sneezing. Each one used an effective barrier -- the crook of their arm, the underside of their coat, a tissue -- in attempting to contain their germs.

Ultimately, however, two candidates dropped out of the race during their follow-through, losing critical points for ... well, missing the critical point. That is, one candidate left used tissues on her table and seat, while the other subsequently wrapped his moist arms around his girlfriend's bare neck.

And while no competitor in this year's Flu Jeopardy knew how many flu viruses could dance on the head of a pin, all entrants knew that a flu vaccination provided the best odds of protection against getting the flu. The majority also knew that flu vaccinations were recommended for pregnant women and most people over 6 months of age.

As the Jeopardy competition progressed, a smaller handful correctly identified the flu vaccine's two accessible formulations: as a nasal spray and as an injection. Those who reached the semifinals knew that it could take up to two weeks for the vaccination to become protective, providing a rationale for getting the vaccination as early as possible in the flu season.

But only half of the semifinalists could subsequently identify the common symptoms of the flu: fever, fatigue, sore throat, cough, runny or stuffy nose, muscle or body aches, and headaches.

By Final Jeopardy, two candidates knew that prescription antivirals (like Tamiflu or Relenza) might be helpful if used within 48 hours of becoming sick, especially for people with underlying medical conditions.

But a finalist pulled into first place after identifying the website that could help people locate their nearest vaccine provider:http://www.flu.gov/prevention-vaccination/vaccination.

As of end of January in the current flu season, California officials were already attributing 146 deaths in the state to flu-associated illnesses (95 have been confirmed, while 51 remain under investigation). That's raised concern about the severity of this flu season because, in comparison, the entire state death toll for all of last year's season was "only" 106.

And still, as concerning as those numbers may be, it's important to realize that they grossly underestimate the scope of the problem. Foremost as example, our state monitoring does not track flu-related deaths in people age 65 years or older. Also, state reporting of flu mortality is generally lags because the data must first be collected and analyzed at local county levels before being sent to the state.

In the end, the real winners during any flu season are the people who don't get the flu, and those who don't have to watch their loved ones suffer from it.

While some rely solely on luck, others take precautions to limit their risk and protect others because they know that flu can place human lives in actual jeopardy.

Kate Scannell is a Bay Area physician and the author most recently of the novel "Flood Stage."