Not as Deadly as Suspected

The Bad News: The new H1N1 flu virus continues to spread.

The Good News: Scientists think that it's not as deadly as its older cousins.

The flu chief for the Centers for Disease Control and Prevention, Dr. Nancy Cox, said Friday the latest swine flu virus lacked traits that made the 1918 pandemic strain so deadly.

During the 1918 Spanish Flu epidemic, there were reports of people leaving to work feeling fine, and falling terribly sick within mere hours; or patients turning blue out of their difficulty to breath, and other horrible accounts worthy of a Stephen King novel —one of the reasons some people jokingly began to refer to his new flu strain as Captain Trips!

But then, how do we explain the deaths in Mexico, particularly in Mexico city?

At this time, I'm willing to consider that there's a combination of 4 factors that might —keep in mind that when reading the next list— have increased the risk in the Mexican patients:

• A slow response to assess the reality of the outbreak from the Mexican Health Department: I've written about it and I still insist on it, that it's my belief the Mexican authorities were slow to add 2+2 and see the problem they have on their hands until it was already too late. The authorities showed a lack of coordination, that is evident when reading about a comment from the director of the National Center of Epidemiologic Vigilance & Disease Control in Mexico, Miguel Angel Lezana, who in an interview with AP told that on April 16th he informed the Panamerican Health Organization (a branch of WHO) that there were an alarming rise in flu cases in Mexico, and that WHO failed to take any measures until April 24th. The officials of WHO emphatically deny this, and say that it was on April 23 when the CDC confirmed that they were dealing with the same strain of flu on both sides of the US-Mexico border; this is also the same position taken by Jose Angel Córdova, head of Mexico's Health Dept —so why are these two Mexicans contradicting each other? (This 'whodunnit' game is really pissing me off by now).
• Patients' tardiness to seek medical attention: The early victims of the outbreak thought that they were sufering from a common seasonal flu, and weren't quick to seek medical attention until the symptoms of the disease were too aggravated. We need to understand that self-medication is a very commnon occurrence among the Mexican population, and that medicines that would need a signed prescription in a US pharmacy are more easily obtained without one here in Mexico; that's one of the reasons why people prefer not to see a doctor until they have very strong symptoms.

  But then, when the first victims of the flu did go to see a doctor, since the doctors hadn't been informed about this new outbreak yet, they also didn't recognize what they were dealing with, and in some cases gave a wrong prescription to the patients, sending them home and assuring them that they would be fine in a couple of days —such was the case of a 24-year-old man who went to the doctor and was told he had a stomach infection, and after the existence of the swine flu was confirmed was once again admitted to the hospital when it was already to late to save him.

  Quote:

  "The worst part was thinking it was ordinary flu ... then going for medical help and suddenly realizing the problem is in your lungs and you're going to be placed in intensive care," [Manuel] Camacho Solis, now recovered but with a severely reduced lung capacity, told Reuters. (read more here)

  Since the epidemic alarm was officially raised, citizens were encouraged to seek medical attention during the first 48 hours of showing the symptoms of the flu, specially if high fever was present; the reason for this is that the anti-viral administered by the medical personnel (the famous Tamiflu) lost a lot of its effectiveness after 48 hours had passed.

• The inefficiency of the Mexican medical services to treat the patients as swiflty and propperly as possible: After the public was informed of the outbreak, thousands crowded the hospitals in the city, having to endure long waiting hours to see a doctor. The Health Dept issued the order that any person could be treated on the hospitals run byt the Mexican Social Security Insitute, even if they weren't registered with a Social Security number; but despite of this there were some scarce reports of people being denied of treatment, some patients complained that they had to give bribes in order to be admitted, and of paramedics refusing to transport a sick patient for fear of contagion —these reports were scarce thankfully, but they are evidence of the serious flaws of the health care that Mexican citizens of low income have to suffer.
• Atmospheric pollution: Bear in mind that this is a speculation on my part; but I do think that the high levels of smog and suspended particles that you can find in Mexico's central valley —where the city resides— might have been a factor that decreased the patients' chances to survive the flu. In that case, people living in more healthy environments free of smoke have less to worry about from this flu, while the inhabitants of polluted cities like Beijing should better watch their backs.

A final possible reason might be that the virus 'watered down' its aggresiveness when it began to spread to other areas. Something not unheard of in the evolution of diseases (but once again, this is to be taken as pure speculation on my part).

So, was it all a global overreaction? It may be too early to tell. For starters, we have to remember that it was also the CDC the ones who claimed that this new virus had elements of pig, avian & human strains —something hat was later dismissed by other geneticists that tested the strains, but managed to spawn a lot of improbable conspiracy theories re. the possible artificial origin of the flu as an evil bio-engineered weapon— My point is that if the CDC was wrong about the nature of the virus, they could be wrong also about its aggresiveness at this point. A big 'could' to be absolutely fair.

But we have to look at the numbers: So far it seems that there has only been one confirmed death of swine flu outside of Mexico — that of a 2-year-old Mexican little girl that died in a Texas hospital— so there's a strong indication that early detection of the symptoms and fast medical treatment renders the chances of dying of this bug null.

In other words: Calm down, but remain alert.

And if you hear of cases of swine flu appearing near you neighborhood, don't rush to put on your Hazmat suit! Just wash your hands more and go to the doctor if you feel you have a high fever —and be thankful that we're living in 2009 and not 1918 :)

In the end, this swine flu might serve as a drill exercise to propperly prepare for a probable avian flu outbreak in the future, which could turn out to be more serious. Otherwise the poor men & women who lost their lives might have done so in vain.

PS: and we could certainly do something about the way we grow the animals we eat as well! It strikes me as incredibly unfair how few people are able to afford the purchase of pork, and yet when an outbreak begins, everybody has to share the risks. don't you find an interesting similitude with the current Economic crisis?