State of Grace

by Admin on May 19, 2009


The Centers for Disease Control (CDC) came out with it’s latest updates on the H1N1 Swine Flu outbreak today, citing the following facts:

  • 5469 Confirmed cases of the novel H1N1 Swine Flu.
  • 6 Deaths in the US.
  • 48 States now affected by the outbreak.

This strain of the influenza virus continues to be mild, even compared to the seasonal flu virus outbreaks that occur annually. Unfortunately, there is no way to know how long this state of grace may last.

Dr Margaret Chan, Director-General of the World Health Organization, urged global cooperation and coordinated action in addressing what she said was the very real prospect of a flu pandemic.

“This virus may have given us a grace period,” Chan declared, “but we do not know how long this grace period will last. No one can say whether this is just the calm before the storm.”

“As we are seeing right now with H1N1,” Dr. Chan remarked, “ any city with an international airport is at risk of an imported case.” The effect of rapid international travel is still a major unknown in the event of a global influenza pandemic such as those that swept the world in the 20th Century.

The radically increased interdependence of countries amplifies the potential for economic disruption, she added.

Dr. Chan also addressed the  criteria that the WHO is evaluating for a move to Phase Six.  One critical factor  is likely to be the spread of the virus in Japan, where, according to the Japanese health minister at least 176 people have the virus already, apparently indicating the rise of community wide outbreaks in a region outside North America for the first time.

An escalation of the pandemic alert level might entail far more stringent international trade and travel restrictions including border closures, airport screenings and quarantines.

Dr. Chan also called for prudence in the distribution and use of anti-viral medications.  “Manufacturing capacity for antiviral drugs and influenza vaccines is finite and insufficient for a world with 6.8 billion inhabitants,” remarked Chan. “It is absolutely essential that countries do not squander these precious resources through poorly targeted measures.”

“The developing world has, by far, the largest pool of people at risk for severe and fatal H1N1 infections,” she said.

Chan added that a striking feature of some of the current outbreaks is the presence of diarrhea and vomiting in as many as 25% of cases, an unusually high number.

If virus shedding is detected in fecal matter, this would introduce an additional route of transmission for the virus, and put the urban ghettos and shanties of many African countries at particular risk.

Given that most of these people live in countries where health systems are already overburdened, understaffed, and poorly funded, she said, “What will happen if sudden surges in the number of people requiring care for influenza push already fragile health services over the brink?

Even in developed nations, such as the US, the surge capacity for most urban hospitals is very low. We have applied our “just in time” business models beyond their roots in retail into all areas of our lives, including health care. Few hospitals stock more than a few days supplies of critical medications, and a pandemic would also put great stress on the transportation industry to continue deliveries.

The H1N1 Swine Flu outbreak may be remembered not as the “big one” but rather as the wake up call. It’s clear that health care experts are taking it seriously. Let’s hope that translates into concrete actions in a number of sectors.

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