The pandemic scare of April/May 2009 is yet again another opportunity to ponder the reality of this our mortal plane. For a little over one year this kid sat in the Pandemic Chair on the now devolved Disaster Services Committee of the Dallas, Texas chapter of the American Red Cross. As a result I have become a passable student of that lowly perceived but critical subject.The current Swine Flu outbreak is an Influenza A virus, a virtual “old friend” and descendent of the subtype H1N1 virus which prompted the Spanish Influenza - the deadly outbreak of 1918-19 that killed up to 100 million folks worldwide. There are some differences, though, and this is not to be confused with seasonal flu that kills an average of 36,000 Americans every year.
For the last several years the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have been concentrating on the potential of an Avian/Bird Flu outbreak and fighting this critter in such venues as China, Vietnam, India and other third world countries trying to keep it isolated and away from the population centers of the world. To date they have been successful or, more than likely, the sometime human to human jump the bird flu has taken has hit a dead end each time. So now comes this clone of the Avian, Swine and Human Type A Virus and we, for want of a better term, call it what it has been, the Swine Flu (more later).
What is interesting is how we have coped or handled this situation so far. Folks at the CDC and WHO appear to be doing an admirable job along with many local municipalities to include both Fort Worth and Dallas, Texas. Since that ten year boy (Patient A) from southern California infected with the virus stopped in Texas several weeks ago, it appears that we are the epicenter of the Swine Flu activity. We should note that he has not been associated with any of the local outbreaks but did, indeed, trigger the pandemic alarm in Texas.
While the CDC engaged and then later relaxed school closing recommendations, the school system in Fort Worth along with Lewisville, Ponder, Denton, Decatur, Chico, Lake Dallas and Cleburne in north Texas; New Braunfels, Schertz-Cibolo-Universal City and Comal in south central Texas and Brownsville in south Texas literally shut their doors for up to ten days after several cases of this new virus surfaced in their student populations. Houston closed two of its schools while Dallas, Birdville, Plano and Richardson opted to stay open though many athletic and other congregate activities and some individual schools were closed after students fell ill. Though some may perceive this as closing the barn door after the horses have left, it was better than no response at all.
The organizers of Fort Worth’s wonderful Mayfest cancelled their 2009 event and now threaten because of the huge financial shortfall, that they may never again hold that event (any benevolent souls out there?). These have been incredibly tough but admirable decisions as the universal response to pandemic or the potential of same is always to limit congregate activities – take the fuel away from the fire. The big challenge in managing virulent human to human illnesses appears to be the balance against apathy and no action against overreaction.
Its been interesting to watch the behaviors that have manifested during this crisis. In an ever more increasing politically correct (PC) world I continue to be amazed at what lengths we will go to assuage, pacify and mollify those who are, maybe or might be offended by any action, however legitimate. Witness the consideration by some US officials with the National Institutes of Health (NIH) and some folks at the CDC who are now calling the current H1N1 virus as “swine like”. WHO has also threatened to stop labeling the current flu as the Swine Flu because “it was misleading and triggering the slaughter of pigs in some countries.” Indeed, in Baghdad, misguided Iraqi officials killed three wild boars at Baghdad's zoo because of swine flu fears while equally ignorant Egyptian authorities were preparing to slaughter their pig populations.
Understandably, the National Pork Board has apparently weighed into this nonsense. Seems that the sale of pork is off due to fears and outright quarantines (unjustified) and they don’t want the image of their product tainted further so they want to rename the disease. By the way, I am eating a pork Bar-B-Q sandwich as I write this post – delicious! It is a known fact that eating properly cooked and prepared pork will not prompt the virus. This proves once and for all time that it all comes down to money and that may be our ultimate downfall. We can't reinvent science because of some ignorant folks.
Scientists including some of the top virologists on this planet tell us that with a "mud on the snout" mentality it is what it is; that scientifically it is the “Swine Flu” and any attempt to call it anything else is, “absurd”. Nonscientifically if it squeals like a pig, roots like a pig and smells like a pig; it’s probably a pig uhhhh Swine.
We have also heard of patent discrimination against Mexican nationals and even some people who are referring to the virus as the “Mexican Flu” drawing a quick retort from some grossly offended Mexicans who suggested that perhaps it should be called the “North American Flu”. One tongue-in-cheek good Friend with Canadian roots has suggested calling it the NAFTA Flu?
We need to note some of the clueless and irrational behaviors that have accompanied this outbreak. With the closure of the Fort Worth schools we have witnessed in some parents an understandable but short sighted reaction that could ultimately put us all in jeopardy. Local media has documented angry parents foaming at the mouth because their children cannot attend their proms or go to/participate in local sporting events. Would they rather see the ultimate health and welfare of their children compromised by such superficial issues? In a non scientific survey almost 63% of folks in Dallas feel that the closures represent an overreaction. We obviously have to expand and ratchet up the educational process.
Then you have the real yahoos such as one Hispanic named individual on a local post who proclaimed that this was all “artificially created” to “harm Mexico.”
Many working parents are now scrambling to figure out what to do with their kids while they work? While Friends and Family (lots of grandparents) have been called in to do child sitting duties, their efforts have not been enough. Many employees have been forced to stay at home as child care facilities are also closed or not taking on any more children. While some companies have been responsive, many still appear unwilling to let their employees, when reasonably possible, work from home thereby defusing that concern.
And what about those surgical and/or dust masks that the Mexican government has been distributing to their citizens? The CDC has not recommended their use by the general public and states that there is little evidence that they do much good. Truth is that while they are a “feel good” patch, they probably cause more harm than good and prompt people to take unnecessary risks in crowded environments where the spread of the disease is most likely.
The CDC indicates that N95 and P95 respirators or better may offer some protection though they should be used in specific situations and in conjunction with other precautions that include frequent hand-washing, covering coughs, seeing our physicians and staying at home if ill and at all costs avoiding crowds or really any congregate activity (six foot rule). Above all we need to listen to our health officials, respect their very difficult decisions and follow their directions to the letter. Please surf on over to http://www.cdc.gov/Features/MasksRespirators/ for some good advice on the definition of and recommended use of masks and respirators. One of the best sources for education on this or any other pandemic issue can be found at pandemicflu.gov.
While this initial outbreak has been fairly mild, we still aren’t out of the woods yet. We need to clear away the fuel that could prompt an antigenic shift and mutation (that’s what it does) that could, in a second wave where we would have little or no immunity, be far more devastating.
Well, I certainly do hope and pray that all this really is an overreaction and that any (just one) of the steps we have taken to date haven’t really been necessary. We need note that this scenario could also validate the effectiveness of the precautions already taken. If one child has died as a result of apathy and/or the failure to properly prepare for the potential of an highly virulent epidemic/ pandemic disaster, then we obviously haven’t done nearly enough. Even if this remains a mild outbreak it still proves that, subject to the whims of nature, the Bird Flu or another virus with an even higher mortality rate is still sitting and waiting for that right opportunity. Again, that's its nature.
One Emergency Preparedness Coordinator from the State of Minnesota said it all for me, “I think that the key thing for us is we don't know what it will evolve into. Whether it will go away or whether it will turn into something significant." We must remain vigilant. We can’t be tainted or see our judgment fail because of any self serving issues. As Leonard Crane, author of Ninth Day of Creation states, “The next influenza strain that ravages the human population will probably not be the one we were planning to encounter.”
The bottom line is that we have to do something when we encounter viruses that have the potential to become deadly pandemic. Some feel, and I agree, that even when their presence is confirmed, it appears that we will always be reactive and "behind the curve" hence our present conundrum. It would appear that this is just a practice run...
Aye,
Ned Buxton
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