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Learning From Swine Flu

August 15, 2010

Saudi Arabia this week announced that it considers swine flu no longer to be a threat to public health in the Kingdom. That’s good news, as is the World Health Organization’s announcement that it the pandemic is over.

I was living in Riyadh when the virus first started gathering pace. At that time few people locally seemed too concerned, and I was able to get supplies of Tamiflu over the counter at one of the pharmacies near my office. My main concern was to protect my family, since at that time the virus seemed to be affecting the young,  and those with “pre-existing medical conditions”. I encouraged colleagues to do the same.

As things turned out, the virus did spread rapidly, just as its distant relative did in 1918-1920, when it carried off millions of people around the world. The 1918 outbreak was exacerbated by the circumstances of the time. The First World War was still raging. There were millions of young men still in uniform, living in sub-optimal conditions. The virus targeted the young and the relatively healthy, and it ripped through the army camps before it spread to the cities of the world, perhaps carried by returning soldiers.

In 2009, the conditions for the spread of the virus seemed even more suitable. Air travel, which was not a factor in 1918, greatly increased the chances that the Mexican outbreak would quickly spread. And remember that in Mexico, the initial concern was sparked by the large number of fatalities. So it seemed that we were in for a pandemic that could cripple fragile economies and put young people around the world at risk. In Saudi Arabia, the advent of the Haj, which annually brings millions to Mecca for the pilgrimage, seemed the perfect opportunity for the virus to cause mayhem and death. The Saudis had to contend with the nightmare scenario of people in their thousands falling ill in the Holy Places, and stretching its healthcare facilities to the limit and possibly beyond.

In the end, the worst didn’t happen. The Haj took place largely unblemished by infection, though the virus did cause considerable disruption in the region. Residents of the GCC will remember the delays in the opening of the schools for the autumn term, and the heat sensors set up at airports to detect passengers arriving with high temperatures and other possible symptoms of swine flu. But fortunately it turned out to be much milder than anticipated.

In many countries there were mass vaccinations, but not before large numbers of people, including one of my daughters, came down with the flu. But as things turned out, less people died through swine flu in proportion to the population than did in earlier flu pandemics, such as those in 1957 and 1968.

What lessons should we learn from swine flu? Should we blame the experts whose predictions scared the life out of us? Should we congratulate the WHO and government health authorities for their swift action in taking preventive measures and communicating effectively with the public? To the first question, no, because nobody knew how the virus would develop – flu viruses are notorious for mutating rapidly, so mild could easily have turned to virulent in short order. To the second question, yes. Governments learned lessons from the SARS epidemic, and by and large took effective measures this time round.

Apart from the fact that the virus did not have the effect that many feared, we should be pleased for more than one reason. We have effectively had a dress rehearsal for the next pandemic, which may not even be of a flu virus. What we have learned from swine flu will help us prepare better for an outbreak that turns out every bit as bad as predicted. Also, the pandemic resulted in breakthroughs in the development of vaccines that offer the hope of a single vaccination that will protect us from all future variants of flu. The result could be hundreds of thousands of lives saved in the future.

These comments come with a big health warning. I’m not a doctor, nor am I an epidemiologist. But it seems to me as an interested observer that the world is a safer place thanks to swine flu.

The obvious danger is that next time a pandemic occurs, we will remember the relatively mild outcome of the swine flu episode, and not take future warnings seriously. As I write this, there is growing publicity about a nasty little enzyme called NDM-1 that attaches itself to common bacteria and renders them resistant to all antibiotics. See http://www.bbc.co.uk/news/health-10930031.

Mother Nature often finds a way of defeating man’s best endeavors.

From → Middle East, Social, UK, USA

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