State health officials say the H1N1 flu may be peaking in Virginia and could now start to decline. Swine-flu vaccine continues in short supply, emergency rooms are being flooded with sick and worried people, hospitals are restricting visitation, and school absenteeism is running well above normal in the state.

CLASSES “Lift Your Chest” pump class by Virginia Commonwealth University School of Pharmacy’s Kappa Epsilon in honor of “Pinktober,“ Breast Cancer Awareness Month, 8 a.m. and 2 p.m. tomorrow, Gold’s Gym, 1601 Willow Lawn Drive. Free. All donations will go to Susan G. Komen for the Cure.  SEMINARS “How to Train Your Brain,“ 4 to 4:45 p.m. Thursday, Circle Center Adult Day Services, 4900 W. Marshall St. Details: Molly MacBean, (804) 355-5717 or .

An Amelia County child has died of causes related to swine flu. Meanwhile, a private elementary school in Henrico County continues to remain closed today because of the spreading illness. Heaven Wilson had tested positive for the H1N1 virus, the state Department of Health said yesterday, and she had no known underlying high-risk medical conditions.

An Amelia County child has died of causes related to swine flu. Meanwhile, a private elementary school in Henrico County continues to remain closed today because of the spreading illness. The girl, who was not identified, had tested positive for the H1N1 virus, the state Department of Health said yesterday, and she had no known underlying high-risk medical conditions.

Area emergency rooms are seeing an increase in patients with flu symptoms as the swine flu continues to cause unprecedented levels of illness nationally and the supply of vaccine rolls out slower than expected. Local hospitals are taking steps to restrict visitors and prepare for the possibility that emergency rooms at some point may not be able to handle a crush of patients.

Glaucoma often not detected until severe Today and tomorrow, people can get free glaucoma screenings. (See Health Notes below.) According to the Glaucoma Research Foundation, as many as 4 million Americans have glaucoma, but only half know it. High-risk groups, according to the National Eye Institute, include African-Americans over 40; everyone over 60, especially Mexican-Americans; and people with a family history of glaucoma.

MEETING Richmond Chapter of the National Ovarian Cancer Coalition, 6 p.m. Monday, Panera, 11703 W. Broad St. Details: Mary Burke, (804) 330-3340 or Mary Gill, (804) 740-2336.  SEMINARS Less Is More: Minimally Invasive Surgery, 6 p.m. Monday, Orvieto/Florence Room at Bon Secours St. Francis Medical Center, 13710 St. Francis Blvd. Register: (804) 359-9355 or http://www.bonsecours.com/calendar.

Getting a colonoscopy at a freestanding surgery center instead of a hospital outpatient department can shave $371 off the price. How much private health plans in Virginia pay providers for doing colon-cancer screenings and 30 other medical procedures can vary five-fold or more depending on location of the service. The numbers are available on the Virginia Health Information Web site in a new section on price transparency.

It is open-enrollment season at your work. Take some time to educate yourself about the various health-plan options your employer offers. When selecting a plan, according to the Agency for Healthcare Research and Quality, compare:

• Premiums. Avoid basing your decision only on the premium. Lower premiums typically mean care comes with higher out-of-pocket costs through deductibles, co-insurance or co-payments.

The economic downturn has prompted people to scale back in a lot of ways. There has been speculation that baby-making might just be one of them. No one wants to think having a baby boils down to money, but for families worried about finances and the future, it’s a consideration. As Zeiss and Tracy Thessen planned for their first child, the economy was continuing in a nosedive. Their financial situation was not the best it could be, Tracy said in August, a few weeks before she was due to give birth.

If such terms as deductibles, health savings accounts, flexible spending accounts and preferred provider networks are swirling in your head, then it must be open-enrollment period at work. Most jobs that provide health-insurance benefits give employees a chance annually to change health-insurance plans or health-plan options. Fall is that time for many companies with the new benefit year starting Jan. 1.

Co-insurance: Portion of incurred medical expenses, usually a fixed percentage, that the patient must pay out of pocket. Co-payment (co-pay): The flat rate that managed-care subscribers pay for a provider’s medical service. May also refer to a percentage of a cost that the patient must pay under an indemnity plan. Deductible: Amount of covered expenses that must be incurred and paid by an insured (enrollee/member) before benefits are payable by the insurer.

When responding to a call, paramedic Thomas Barrett, 44, protects himself with a face mask if he encounters a patient coughing and sneezing. So it was a no-brainer to get vaccinated against the H1N1 swine flu yesterday. The Richmond Ambulance Authority employee followed registered nurse Jatori Robinson’s instructions to sniff after she squirted vaccine up each of his nostrils yesterday.

CLASSES Yoga Anatomy for the Upper Body, 10:30 a.m. to 2:30 p.m. today, Glenmore Yoga and Wellness Center, 10442 Ridgefield Parkway, to learn which postures to include in your yoga practice. Cost: $50. To register, call (804) 741-5267. Introduction to Yoga, 10:30 to noon next Saturday, Glenmore Yoga and Wellness Center, 10442 Ridgefield Parkway. Cost: $17. Registration: (804) 741-5267.

Q:I was in the military in 1976 when we were required to get a swine-flu vaccine. But now I hear that there is a new swine-flu vaccine. If I was vaccinated back then, am I protected from the current swine flu? Answer: The strain of swine flu that was circulating in 1976 is different from the swine-flu virus circulatingnow, according to the U.S. Centers for Disease Controland Prevention.