Thursday, May 7, 2009

Swine Flu ain't over till it's over

Right, a factory worker at a mask factory in the Philippines where production has tripled in the last few weeks.

Swine flu (H1N1) is still with us despite the sharp fall off in media interest. Yesterday, I had to watch main news channels for ten minutes or so before the pandemic was mentioned, if at all. One news editor told me he instructed his journalists to ‘give up on swine flu. It’s a story that’s going nowhere’.

I have heard doubts and even criticism expressed from some quarters on ‘scare-mongering’ or ‘crying wolf’. What is it about human nature? Do we really want the ‘proof’ of a lethal pandemic before our eyes till we truly kick into action? Is it not in our DNA make-up to tackle life-threatening events before they happen if we are lucky and wise enough to act early based on clear warning signs?

Deliberately or not the media has contributed to a misperception that the threat has faded. This shows little respect or understanding for the nature of pandemics and could even undo all the good prevention and mitigation work that has taken root in many countries up to now.

A real and present scenario is that the current strain of H1N1 will go underground and reappear with a vengeance during the northern hemisphere’s winter influenza season in a few months time. There are many other equally unappealing scenarios.

It seems now that pigs are basically Petri dishes for the virus and not just direct transmitters. The case in Canada where infected humans passed the virus to pigs and back again proves this. What will be the scenario if this happens in Asia where avian influenza (H5N1) is still very much around. What mutant scenario will we get if these two hook up? 

In the hard-fought business of preventive health you have to base your reasoning on a whole range of scenarios. We do not have the luxury to wait till our scenarios play out, say “Told You So” and head home to wait it out in a bunker.

Now is the time to take action. We don’t need to sit around to see ‘what if’. We are programmed to prevent ‘what if’ and that is a good strategy (and a good investment) even if at times the highly unpredictable out-maneuvers us or evaporates into the ether.

Understandably, Mexico, which has absorbed a lot of media inquiry and its fair share of bad press, is keen to portray a return to pre-outbreak stability. But we are not there yet. All you have to do is look at the figures. The number of confirmed cases has more than doubled around the world since last week, as has the number of countries where swine flu (or H1N1) is now prevalent. In Spain there are some 80 confirmed cases and the UK is not far behind. In all probability these numbers are far higher. Why? Because confirmed cases are based on the capacity of laboratories to diagnose, not on the reality as such.

 Swine Flu about to “take off”

The renowned medics at International SOS had an interview with Professor John Oxford yesterday. He confirmed that, over the last 2 days, the influenza H1N1 virus has been behaving in the UK as predicted by previous mathematical models. That is, the virus is scattered over the country due to multiple introductions. 

In keeping with those models, he expects that the virus will suddenly "take off" in the UK in about 5 weeks. On the issue of severity, Professor Oxford believes that it is likely to get worse, not better. He does not think that it will "peter out". The Professor’s credentials are also worth noting. He is Professor of Virology at St Bartholomew's and the Royal London Hospital, Queen Mary's School  of Medicine and Dentistry, and is Scientific Director of Retroscreen Virology (pictured above, a ballet class in Hong Kong).

Meanwhile, today in Paris, far from the media glare, leaders from more than 30 Red Cross societies from all over the world met to discuss the current influenza outbreak and seek ways to better prepare and respond to the threat of a global pandemic. They were joined by representatives from partner organizations, including UN agencies.

Our Secretary General, Bekele Geleta stated clearly that “it is too early to claim victory over the H1N1 virus and we must remain vigilant, especially in case the virus comes again in a few months with renewed strength. We can never be too prepared to face such a threat.” 

Another colleague, an expert in pandemics and health emergencies said it another way: It ain't over till it's over. So, when it comes to pandemics, its Head Down Eyes Open all the way to the winning vaccine.



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  2. People with regular exposure to pigs are at increased risk of swine flu. More than 1100 people worldwide have died from swine flu since it emerged in Mexico and the US in April, according to the latest figures from the World.