If this mutates into a more virulent flu, we're in trouble - because we just don't have enough ventilators to treat a major pandemic:

A new government study shows that one quarter of Americans who were sick enough to be hospitalized with swine flu last spring wound up needing intensive care, and 7% of them died.

Health experts say that is a little higher than with ordinary seasonal flu. They say the biggest difference is that nearly half of those hospitalized with the new swine flu have been children and teens. Flu usually strikes hardest in the elderly.

The U.S. Centers for Disease Control and Prevention did the study, with local and state health departments. Results were published online Thursday by the New England Journal of Medicine.

Researchers identified 272 patients hospitalized for at least a day from April through mid-June, when the novel virus caused its first wave of cases. That's about one-fourth of the total hospitalizations for swine flu reported during that time, but researchers only studied lab-confirmed cases and patients who agreed to be part of the study.

Three-fourths of these patients had other health problems, such as diabetes — typical of seasonal flu, too. However, only 5% were 65 and older; ordinary seasonal flu usually hits hardest in the elderly.

We're already seeing problems in other countries:

Oct. 9 (Bloomberg) -- Swine flu drove a 15-fold increase in intensive care admissions for viral lung inflammation in Australia and New Zealand, especially among pregnant women, the obese and people with chronic lung disease, a study found.

During the peak of severe illness, patients with the new H1N1 influenza strain filled 8.9 percent to 19 percent of all intensive-care hospital beds in each state of Australia and New Zealand, according to the study published yesterday in the New England Journal of Medicine. Almost 65 percent of intensive-care H1N1 patients required mechanical ventilation.

The Southern Hemisphere’s winter flu season, studied from June 1 to Aug. 31, may give health officials in the Northern Hemisphere an indication of what to expect in coming months, the researchers said yesterday. The pandemic filled all available beds in some units and prompted doctors to postpone nonessential surgery, New Zealand’s health ministry said in July.

This seems like a pretty good system. By handling the bulk of inquiries online or over the phone, the British government is keeping swine flu sufferers where they belong: at home and in bed - which lowers the risk of contagion. Unless I've missed it, I haven't seen similar plans for the United States this fall:

More than 5,500 people received anti-viral drugs for swine flu on the first day of England's National Pandemic Flu Service, the government has said.

The telephone hotline and website were launched so patients could obtain treatment without a GP's prescription.

The system was "working well", Health Secretary Andy Burnham said.

Sufferers are advised to select a "flu friend" to pick up medicine for them. Critics say the system is open to abuse and should be staffed by experts.

And the Conservatives have argued the service should have begun earlier, when a global pandemic was declared, as it was now "too little, too late".

There are now 1,031 locations across England where the drugs can be collected, up from 330 on Thursday, when the service began.

People who think they have swine flu can complete a questionnaire online or over the telephone.

Among the symptoms listed are fever or temperature over 38C or 100.4F, coupled with two of the following: unusual tiredness, headache, runny nose, sore throat, shortness of breath or cough, loss of appetite, aching muscles, diarrhea or vomiting.

If patients are diagnosed with the virus, they are issued with a unique reference number which must be given when the drugs are collected.

However, patients are still being advised to contact GPs if they have serious underlying illnesses, are pregnant, have sick children aged under one, their condition suddenly worsens or continues to worsen after seven days - five for a child.

More than 100,000 people in the UK are estimated to have caught swine flu in the past week along, while 30 people have died after contracting the illness.

There was a huge rush to access the government website when it went online on Thursday, with reports of it receiving initially 2,600 hits a second, or 9.3m an hour.

More than 58,000 assessments were completed that day, 89% of them online.