Flu scare abates, Mexico gets back on its feet
As the flu pandemic tapers off, schools and restaurants in Mexico have reopened, freshly sanitized against the influenza virus.
We gave a sigh of relief that the impending flu pandemic has not happened -- yet. And then we immediately plunged into a more delicious activity -- Monday-morning quarterbacking: Did the health authorities respond appropriately, or did they (with considerable aid from the media) fuel panic? Were the warnings overblown, or did they help avoid a huge death toll? As of May 12, 61 deaths and 5,251 cases had been reported in 30 countries. Authorities say these numbers make H1N1 look about as severe as garden-variety influenza, which kills an average of 36,000 Americans per year.
We saw some panic. Even though eating pork cannot give you swine flu, Egypt slaughtered 300,000 pigs. China quarantined 70 healthy Mexicans who had no flu symptoms. By May 5, just 10 days after the World Health Organization (WHO) declared a "public health emergency of international concern," a USA Today/Gallup poll found a fissure in American sentiment: 45 percent thought the media was exaggerating the threat of swine flu, while 46 percent thought they had it about right.
Before we dive into the real second-guessing, recognize that we may not be off the hook:
Influenza is a shifty virus, constantly altering and reassembling its 10 genes while inside its primary hosts: humans, birds and pigs.
Gradual genetic change explains the need for a new flu shot every year, but if the virus undergoes a radical change, that negates the immunity people have acquired from vaccines and previous exposure to flu. Such a "genetic shift" explains the death toll in the flu epidemics of 1918, 1957 and 1968.
Even a single epidemic can take several forms. The first wave of the 1918 flu, for example, was mild compared to the second, which claimed 50 to 100 million lives -- more than World War I.
Flu season is just starting in the Southern Hemisphere, where H1N1 may infect or intensify before bouncing back north in the fall.
Much ado about something?
The best time to stop any epidemic, especially in this era of rapid travel, is to catch the virus before it reaches global mixing points like New York, London and Hong Kong. That "ounce of prevention" strategy, combined with the shifty nature of the virus, provide the background for evaluating the April reports from Mexico:
Many victims were otherwise healthy young adults. This phenomenon was seen in 1918; the typical flu focuses on the young and the old.
The flu was spreading fast. By May 3, it had already caused 226 cases and one death in 30 American states.
Analyses of the viral coat identified the virus as H1N1, a new type of influenza that carries a strong component of pig influenza (hence the label "swine flu").
So after more than two weeks of 24/7 swine flu media panic, why don't we see more bodies? Did the health authorities avert disaster by getting this one right? Or did their alarms cause needless panic and economic hardship (the capital of Mexico was largely shut down for at least a week, and the travel and tourist industries also took major hits).
The H1N1 virus posed a middling danger, according to an early study published in ScienceExpress this week (see #1 in the bibliography). H1N1 was much less deadly than the 1918 strain, and closer to 1957. That seems small solace; 1957 was one of the worst three flu outbreaks of the 20th century.
The study also described H1N1 as "substantially" more transmissible -- easier to catch -- than a garden-variety influenza.
In the media: Let the fingers point!
So H1N1 is nothing to sneeze at. But why let the facts get in the way of media-circus finger pointing? As the San Francisco Chronicle reported, the epidemic "whet cable TV's bloodlust with what the 24-hour cable news vacuum craves: mystery, death and great visuals that inspire fear. No detail about the flu -- often delivered without context -- has been too tiny to go unreported, which means that cable TV viewers are getting coverage that is moment-to-moment but often not terribly useful."
MSNBC found an expert in Miranda Smith. This student at Cisco Junior College in Texas observed, "Everyone seems to know it's not going to kill you and it's not as deadly as they think. Everybody needs to just calm down and chill out."
Bloggo bloviator Michael Savage put a political spin on the outbreak, first suggesting that it was a terrorist plot, then morphing into an anti-immigrant rant: "How do you protect yourself? What can you do? I'll tell you what I'm going to do, and I don't give a damn if you don't like what I'm going to say. I'm going to have no contact anywhere with an illegal alien, and that starts in the restaurants."
We wonder: So H1N1 can read immigration documents?
An outbreak of politics
Such attempts to use the epidemic for political purposes did not shock David Fidler, a professor of law at Indiana University, who has seen past epidemics become grist for various agendas. "Communities that are worried about immigration from Mexico, or about criminal violence at the border, are jumping on the close-the-border bandwagon," says Fidler. "Or people worry about the WHO [World Health Organization] having too much power, and posing a threat to sovereignty. These concerns have been raised after other outbreaks, so it's not surprising that this is happening now."
Fidler, who says he's been involved in discussions about global health regulation for 15 years, adds that swine flu also amplified a "general protectionistic mood that has grown up because of the global economic crisis." Sixteen countries "have imposed bans or import restrictions on pork," according to the Milwaukee Journal Sentinel. These restrictions, Fidler says, have "no justification, but are an easy way for a country to be protectionist, even if it's just for six months, and justify that by health concerns."
