Notes in a Time of H1N1 Flu

Pandemic Pandemonium?

From the most mundane event to the greatest crisis, rumors get mixed up with facts. Science events are more complicated than other events, thus swine flu pandemics are more confusing to sort out than, say "two men argued on the corner". Proteins, RNA, viruses, human patients, birds, pigs, nations, doctors, hospitals, and of course media and politicians mix it up. Welcome the smorgasbord of facts, half-truths, rumors, and lies, all served up with mixed intentions as news.

Although there are those politicians who truly want to blame a virus on immigration, fortunately most communications to not stem from ill-intentioned motives. However that's not to say they don't often end up muddled, despite good intentions. The great response of much of the world political leadership to the recent H1N1 shows how communication and management remain can be as challenging to emergency response as science.

Perhaps pandemics are too big not to be confusing. As Mexico reports that H1N1 outbreak is perhaps easing, the first New York school struck with an outbreak of the virus announces it will reopen, schools are closing down in Maryland, Arizona, New York, California, Texas, and Illinois. In Mexico schools are closed until May 6th. What to make of it?

Pandemic Proving Ground

As days go by the public feels more at ease, since more than 1000 cases of swine flu have been verified worldwide and most of those people seem still alive. Still, there is a pandemic on, and forthright people admit that the outcomes of a contagious, fast changing, undefined virus are impossible to predict. Perhaps there will be a second wave, history teaches us. Unfortunately, such caution doesn't slow the pen of onlookers who feel compelled to say something, as well as energized to criticize public officials trying to orchestrate the appropriate response.

The critics flay on all fronts. Officials got out ahead of the current H1N1 pandemic early, but not early enough some accuse. But get out ahead too early, have the virus turn out to be a mild flu, and people accuse the officials of over-reacting -- many news outlets are up to just that. One New York Times columnist raked Joe Biden over the coals for saying he told family members to stay away from confined spaces. Gail Collins noted sagely: "semihysteria is the easy political path" and provided reasoning beyond cliched characterizations of cool Obama and hothead Biden, fact-like based reasoning such as:

"One recent survey of 1,039 physicians showed that 63 percent believed "that there is some level of risk that the swine flu will result in a worldwide catastrophic pandemic...The real key to the physicians' response is the phrase 'some level.' If you interview a scientist about almost anything, they will tell you there is some level of risk. A while back, I talked to a prominent physicist who carefully explained that although the odds against all the oxygen molecules suddenly racing over to clump on one side of the room were really, really, really high, it could happen. And that if it did, it would be most unpleasant."

Cheekily humorous, to compare the risk of the current swine epidemic with the risk of something more fantastic even than the Cern collider sucking earth into a parallel universe. But "risk" is not "risk", and the two risks are not the same. We truly don't know what the risk of viral pandemics are, especially at the beginning of an epidemic. As each day passes the ensuing outbreaks and emerging science -- like sequence data that can be used to compare the virulence of this virus with others -- make the picture clearer. But pandemic history warns us not to be too cocky.

The CDC advises the public to "follow public health advice regarding school closures, avoiding crowds and other social distancing measures", and Obama himself advised schools with sick pupils to close to be "as safe as possible".

Some adult commenters would diss attempts at public health precautions as quickly as they'd laugh at the high schooler who complains that school officials were 'totally overeacting', although " older kids can deal without seeing our friends, we have FaceBook and Twitter and such". But what happens to public trust when various politicians, officials, and columnists pronounce these cautionary messages "reactionary"? We know what happens -- citizens guffaw the next time officials warn us, and people hunker down before the storm and tell the press belligerently that this hurricane will be no worse than all the others they were warned of.

Does anyone really think the Obama administration (Biden included) isn't acutely aware that over-precautionary social distancing would further exacerbate the dire economic situation? Prudent caution has a tremendous economic cost -- do people think Obama et al. became numb overnight to economic costs?

Pandemic Nationalism

If nations struggle to mount a unified response to a pandemic, the world too, has had a less than a coordinated front in the current outbreak of H1N1. Nation states will never truly get over themselves (nor should they), and if globalization didn't prove that pandemics will. So while the all nations make pronouncements about working together, the US warned tourists off of Mexico and Europe warned tourists off of the US. The US said that such a travel warning is unnecessary. France curtailed flights to Mexico. India warned travelers against going to New Zealand, Spain, Mexico, US, Canada, France and UK, and will be screening travelers from infected countries and China is sequestering Mexican travelers somewhere in Hong Kong. Europe wants the flu to be called the "North American Flu", but some commentators would rather it be called "Mexican Flu". Mexico says the swine flu might will have originated in the US.

Just as we've seen a swine flu before, this response to flu is also familiar. According to a 2005 book: "The name Spanish flu came not from major outbreaks in Spain, but from high mortality among troops in France that for intelligence reasons were attributed to Spanish origins. The highest mortality from the disease occurred after the arrival of American troops in France." In a fact that was lost on most historians, "...General Erich Ludendorff, the Imperial German Army Chief of Staff, concluded that it was the virus, not the fresh troops, that ended the World War."

Adding to the confusion about who started what, mass communication facilitates faulty data transmission that helps confuse the public when caution mixes up with harmful actions on the part of officials. As Acronym Required wrote back in 2005 about the H5N1 avian flu, customs in various countries deals with these pandemics in what is truly alarming over-reaction. For instance now in Bulgaria officers are "checking the luggage of passengers arriving from Mexico, the U.S., Canada and Japan to ensure they are not importing pork products", and Egypt is killing the pigs of Christian farmers as a precautionary measure.

If you wanted to get a sense of how organized the ground response would be in a pandemic, you could have polled your doctors about their knowledge and your local situation a few years ago. Perhaps better for your peace of mind that you didn't, nor even wondered about other nations responses. Needless to say we would all be relieved if this H1N1 were only a drill -- we could use some practice runs.

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