Friday, May 29, 2009

Musings about the Swine Flu

Swine flu is no longer breaking news material and seems to have become 'another flu' just like bird flu. We know it's there but we don't think about it much, even though we are anticipating the second deadly wave around autumn.

I remember at the beginning when it looked like it was going to be something bigger than bird flu or even SARS how I used to read testimonies from all over the world to evaluate the situation of the outbreak. A family's ordeal in the UK struck me as something like a movie script...

"My partner and I returned to Birmingham from Cancun yesterday morning at 08:20am. There were no members of the health department there to meet us, over 400 people passed through without help or advise being offered.
We returned home to our seven-months-old daughter and in-laws. Last night we developed many of the symptoms listed.
I contacted the NHS Direct and after several hours we were asked to go to the hospital ourselves. We had to wait in A&E before being seen by doctors dressed in masks, aprons and gloves.
We have high temperatures over 38 degrees, aches, coughing and sneezing, diarrhoea and nausea. The hospital prescribed us both with Tamiflu and told us to drive to a chemist in Coventry, we waited for 15 minutes surrounded by other people before we had the Tamiflu.
The chemist informed us that they only had one dose available and that we would need to return the following day. This morning we were contacted by the HPA, we informed them of the situation and they told us that under no circumstances should we leave the house.
We are waiting the results now, we are very concerned about our daughter and family around us as it looks like we have now infected them. "
Richard Cook, Nuneaton, UK

The pandemic scenario painted by the WHO means that what happened to the family above could have resulted in a much worse situation and that maybe a few basic rules had been flaunted.

(1) no members of health department at the airport
(2) no one offering advice
(3) they contacted the NHS who asked them to go to the hospital => so putting many people at risk on the way !
(4) they had to wait at the ER => more contact with people
(5) they had high temperature and were sneazing
(6) they had to go on their own to get the medicine from the pharmacy => putting more people at risk on their way
(7) they were asked to return the second day to get more Tamiflu.

Only 3 days after they returned were they contacted by the equivalent of the CDC and asked to stay put. I don't know what happened to them but I expected this to happen in an non EU OECD country, like Libya for example. How safe are we really and is it realistic to expect that people will watch their borders as closely as we imagine or does that only happen in movies?

I had the opportunity to experience first hand and compare when I recently travelled to Britain.

Upon boarding the flight to London from Tripoli international airport, there were a number of medical staff at the gate, the tube to the airplane has obviously been cleaned and sprayed with something similar to Dettol- so I assumed this was a request by the country of destination so that travellers do not bring any germs in the sole of shoes or something.

My flight landed about the same time as a flight arriving from Mexico, and my luggage was on the conveyor belt right next to the one of the Mexico flight. I saw no body with face mask or from any medical body and that area was quite crowded. It was just business as usual. I retrieved my baggage very fast and proceeded to the customs and the way out.

When I returned to Libya, we were greeted at the gate by medical staff with masks and gloves who proceeded to screen travellers by checking their forehead temperatures. I realise it may not be much and I'm not that knowledgeable medically but I guess that someone with fever was going to be asked to step outside into another area. I think Hong Kong had already been using sophisticated thermal scanners since the bird flu alert, we have nothing like that in Libya but I was happy at the effort deployed no matter how insignificant or ridiculous or annoying some people were thinking it was.

So far Libya and the rest of the Maghreb as Swine flu free. For the naysayers and negative people who see always only the bad sides yes we do have lots of other problems but it's good to know someone has thought about this virus because if it is as dangerous as they say then our health system cannot deal with it, so an ounce of prevention goes a long way.

Our neighbours in Egypt had decided to cull pigs - I'm not sure that's such a great idea because the waste generated is above their capacity to clean up and could probably cause an outbreak of something else besides Swine flu. I mean they still have cases of bird flu as recently as last week.

The Swine flu or Mexican flu as some people call it (unfairly) has also brought a number of questions to my mind it has now spread into over 42 countries. ( see map here for confirmed cases and deaths). So why many of us would hesitate to go to Mexico even though we know now it is a mild strain - and yet would travel to the USA or to Europe without any second thoughts?

Another idea to ponder on is that human greed is the cause of all disasters and similarly to Mad Cow Disease, Swine flu also seems to have a human mismanagement component in farming. When we mess with nature it always backfires.


Brave Heart said...

The school near my house (Birmingham) is affected by the flu. I think people gave it more attention more that it should be, some expertise said miliions could die but I cant believe that, people in africa live acient life without any medication and still exist.
Egypet took the wrong decision it is really clear for everyone, and they did it be4 with brid flu as well, actually egyption they do wrong things these days.

u were in london, thats good new, hope u enjoyed.

Highlander said...

I most certainly enjoyed London very much. Have not been there for a while so it was great to walk in the parks again :) Brave Heart.

programmer craig said...

Interesting post, Highlander. Seems like a fair presentation too. I'm always disappointed when the much-touted efforts to safeguard the public end up being purely superficial, but that seems to be teh case more often than not :(

Maya M said...

I think you are quite right about Egypt. The "swine flu" strain initially emerged in pig but now is transmitted human-to-human. Pigs don't take international flights, so how could Egyptian pigs be a hazard of any sort? I strongly suspect that for some people in Egypt each occasion to destroy pigs is welcome, so I suggest some educational/ humanitarian aid for this country, e.g. send each Egyptian child the booklet "Three Little Pigs" plus a stuffed Piglet :-).
I think the name "Mexican flu" is fair because the current strain originated in Mexico. I don't think it is offensive in any way. There are so many names of this sort, e.g. the parasites Schistosoma japonicum and Necator americanus.

Mitchell said...

I think what has happened is that swine flu is "just another" influenza strain, but because of the early fear that it would be the end of the world, the whole media is following its spread in a way that usually only specialists do.

Now I'll try to explain my comment.

Every year there are new strains of influenza. It is a common disease and it even kills thousands of people every year, especially people who are old, ill, or already weak. But because it is always there, it is in the background, like cancer or heart disease, which also kill thousands of people every year. There must be people whose daily job is to keep track of new influenzas, just as there are people who study cancer or people who study traffic accidents, but the news from their profession is not normally the news for everyone else.

Then, in the contemporary world, we also have the fear of deadly global epidemics: HIV, SARS, bird flu... So what happened is that because of the unusual number of deaths reported in Mexico from the new strain of flu, for the first time the cultural and political response to "possible global epidemic" was applied to a new strain of flu - and remember, there are new strains of flu every year. But swine flu is proving to be relatively harmless, like most forms of flu (deadly for a few unfortunate people, but not killing half the human race). So all that's really happening is that for a while everyone gets to see the world as the flu experts do.