Swine Flu: Assessing the Pandemic

For media, covering epidemics and pandemics is a tricky business, or at least it should be; and there is a certain amount of responsibility that goes along with the task. For the mainstream media, there is always the temptation to increase a story’s attractiveness, a penchant to dramatize.

With the onset of the world’s most recent pandemic, the swine flu, officially known as the A(H1N1) virus, however, the media has met a rather complacent public. Despite the headlines and what is clearly a growing pandemic, people around the world are in no way panicking. Hundreds of new cases of swine flu are reported almost daily, yet the response is fairly muted.

There are perhaps a number of reasons for this, not the least of which could be the exaggerated predictions of a bird flu pandemic not so long ago, which have apparently instilled a bit of panic-reluctance among the public and a fear among the media of getting things wrong. It is also in part because the World Health Organization (WHO) has managed the situation well. The alarm bells the WHO continues to sound are both necessary and appropriate; and rather than creating a global pandemic panic, they have led to the systematic monitoring and treatment of what is, essentially, a new strain of the flu that can be easily cured if properly treated.

Rational fear

As of 6 July, the WHO said there were external pageover 99,000 reported cases of swine flucall_made, resulting in a global total of 476 deaths. And, according to media reports since then, these numbers have risen exponentially. Last week, the WHO said that the swine flu death toll was now at 700 – a major increase since only earlier this month.

Children and the elderly are the most vulnerable to swine flu, which is believed to be a type of bird flu which mutated in a pig and was then passed on to humans.

These are serious figures that are putting serious strains on countries’ health care systems. But still, they must be put into perspective.

In the US, ordinary seasonal flu kills on average around 36,000 people every year (in a population of 300 million).
Most experienced mild flu-like symptoms, according to WHO data, and some patients have recovered fully without any treatment at all.

On 16 July, WHO announced it would stop tracking pandemic H1N1 cases and deaths around the world, due to the rapidly increasing numbers of infected.

“At this point,” WHO said, “further spread of the pandemic, within affected countries and to new countries, is considered inevitable […]. The 2009 influenza pandemic has spread internationally with unprecedented speed. In past pandemics, influenza viruses have needed more than six months to spread as widely as the new H1N1 virus has spread in less than six weeks.”

Global snapshots

In Mexico, where the virus originated, the pandemic has taken its toll, with the latest WHO data showing over 10,000 cases and 119 deaths.

In the 6 July report, the highest number of cases, over 33,900, had been reported in the US, with 170 corresponding deaths. Already on 17 July, the US Centers for Disease Control and Prevention put the number at roughly 40,500, with 263 deaths.

In the Middle East, pandemic fears have led Arab health officials to curtail the annual hajj and umrah pilgrimages, banning the elderly, young and chronically ill from making the holy journey. The decision comes as Saudi Arabia and Egypt report their first swine flu-related deaths. But in general, the public’s attitude concerning the swine flu is low key.
“While swine flu is a concern for regional states and their citizens, the issue tends to pale  in comparison to pressing security and/or socio-economic needs,” Dr Dominic Moran, ISN Security Watch’s senior contributor in the Middle East, says.

In the Balkans, where the numbers of infected continue to rise, the attitude is also subdued, with most people tending the view the epidemic as simply another version of the flu and easily treated. Though the situation is changing somewhat, health officials in the Balkans have been quick to point out that most of those infected have come from abroad for the summer tourism season or have been infected by contact with someone coming from abroad.

In Western Europe, there is likely to be more panic about the use of a fast-tracked vaccine than the swine flu itself. Though the number of cases continues to rise at an alarming rate, treatment has been highly successful.

In Southeast Asia, the public response appears to be less muted. Last week, Malaysia confirmed its third swine flu-related death and has seen over 1,200 cases since May. In total, the WHO Regional Office for South-East Asia (SEARO)  has 7,358 recorded cases, and 44 people have died across the 600 million population region.

According to ISN Security Watch's senior correspondent in the region, Simon Roughneen, "Here in Bangkok, where it seems every second person is wearing a face mask, to either prevent infection, or cope with the city's heavy air pollution, Thailand's tourism promoters are working overtime to counter the impact of swine flu, which along with recession in the west and a somewhat tarnished public image due to recent political instability, has seen much-reduced tourist numbers. Thai Airways is offering free domestic flights to anyone who books a long-haul trip to the country, in a bid to boost numbers."

Treatment and prevention

Now that treatment, in the form of the anti-viral medication Tamiflu, has been successful, as the numbers of infected continue to rise, talk has moved to vaccinations.

In Europe, many governments are discussing the fast-track testing of a new vaccine, though some experts have questioned the safety of such a vaccine. Some European countries (France, the UK, Greece and Sweden) have said they might start using the vaccine as soon as it’s been given the seal of approval, which could be in the coming weeks.

But the idea has drawn its critics, or at least its cautionary voices. The WHO’s flu chief, Dr Keiji Fukuda, told the Associated Press that the vaccine held potential dangers, especially if testing is fast-tracked. Many experts feel that fast-tracking the testing of a new vaccine – which would allow companies to skip testing in large numbers of people before approval – is a big gamble. A main concern, they say, is that fast-track testing could result in the wrong level of dosage.
The European Medicines Agency is pushing hard for the vaccine, hoping to make sure it’s available before the winter season sets in.

In the US, the government rounded up several thousand volunteers last week to test the new swine flu vaccine. Tests will begin in August and officials hope the vaccine will be ready for use by October. European countries may start using the vaccine before October, before the results of the US testing are made available. In addition, experts say, the US and European versions of the vaccine differ.

Pandemic privilege

But while the West has its stocks of Tamiflu and will likely be able to get its hands on plenty of doses of the new vaccine, Africa, Asia and Latin America will not be so lucky, health officials say.

“The lion’s share of these limited [vaccine] supplies will go to wealthy countries. Again we see the advantage of affluence. Again we see access denied by an inability to pay,” media quoted WHO Director Margaret Chan as saying earlier this month.

As far as current treatment is concerned, poorer countries have had a more difficult time ensuring stocks of the drug in the face of a rising number of infected.

Pharmaceutical maker Roche Holding AG on 22 July that it was undertaking measures to ensure that poorer countries can purchase Tamiflu at lower prices. The initiative, which Roche has labeled the Tamiflu Reserves Program, will ostensibly produce and ship the drug to developing countries at a “significantly reduced price.”

The normal rate, at least in the US, is said to be around $100 for five days of treatment for a single patient. Roche said it would offer poorer countries a $16 treatment rate.  Roche has also given approval for two companies - one in China and one in India - to produce Tamiflu generically.