Swine Flu (Update 3)
It seems that the 3 students from Northcote college who were on flight NZ5 have just caught colds and don’t have Swine flu. This is great, but it does illustrate one of the major difficulties New Zealand’s health services will face if this disease turns pandemic. We are about to go into our busiest time of year with health services normally being pushed to the max by respiratory illnesses. Add all the possible swine flu sufferers and you have a recipe for a completely overwhelmed health service. Add everyone with cold and flu symptoms (understandably) panicking and trying to access the heath system to find out whether they have the disease or not and we have all the makings of utter chaos. Note that this chaos is likely even if it turns out that Swine Flu is not as dangerous as the Mexican situation indicates.
Currently the MoH guidelines suggest that every respiratory illness with a history of travel to Mexico and Los Angeles and their contacts should be considered potential Swine flu. This will have to change if the disease is not contained (a likely scenario, unfortunately). People will have to be told to stay at home and only access the hospitals if they are short of breath or spiking a high fever. Of course, this will mean that everyone with mild cold symptoms will stay at home. Expect the recession to last a bit longer than originally anticipated. Nice timing, Eh?
And talking about timing, WHO have increased the alert on this from level three to level four. Way to go guys! This should have been at level four days ago, when the first case outside of Mexico was confirmed. The difference is that a level 3 alert means that countries should prepare for a pandemic, monitoring the situation. Level four means that active containment measures should be taken. Except that now it is almost certainly too late.
Not that WHO pandemic phases ever made a lot of sense to me. Vaccine manufacturers only get shifted into making a vaccine for the pandemic strain at level five (when it is actively spreading in at least two countries). Yet the only way vaccines can be effective is to give them well ahead of the virus wave. It would seem prudent to start making the damn thing at this stage, but then, someone might get left with a huge pile of useless vaccine if the pandemic does not eventuate. [Update: apparently the CDC have already started the process of manufacturing the vaccine]
For those of you who recall the disastrous vaccine campaign for the last outbreak of swine flu in 1975, which resulted in 100s of cases of Guillian Barre syndrome, rest easy. More than 30 years of technological advancement means that the vaccines of today are far purer than their 1975 counterparts. A pandemic vaccine will certainly do more good than harm, by a very wide margin.
And for those of you who like a human face to all the drama, here is a first hand report from a survivor of the swine flu. Mind you, she says that the most prominent feature was she couldn’t get out of bed which sound pretty much like normal in the MacDoctor household.
Youngest MacDoctor daughter asked what the symptoms of Swine flu were. As a dutiful father should, I informed her that it turned people into rabid, brain-sucking zombies. Youngest MacDoctor daughter then wondered how she would be able to tell if her father was infected. Macdoctor told her not to worry about it as she was only a brief snack and not worth bothering with… :-)
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- Photomaniacal » Blog Archive » Swine flu: alert raised — [...] A New Zealand doctor blogs that the WHO should have raised the threat level days ago when the first ...
Apr 28 09 2:04 pm
A couple of points you raised have me wondering for instance, we are into the flu season, is the increased likelihood of panic balanced out by having more people go to the doctor to get their shots? And how will our health services cope? Containment won’t work so what is the purpose of advisorys etc?
Why are they giving people tamiflu, a vaccine developed for a previous flu, and if as you say, they have to keep ahead of the wave, but cannot- then what’s the point? Will the stockpiles created now be used for the next flu to come along? If we haven’t seen this strain before then how do you know that there will be minimal side-effects or adverse consequences of taking any vaccine for it?
I know I’m not a doctor but they are legitimate questions that i have.
Apr 28 09 2:26 pm
Marty: Tamiflu is not a vaccine, but a treatment. It reduces the ability of virus to multiply giving the body a chance to fight the infection. It works with some forms of influenza and appears to be effective against swine flu, at the moment.
The current flu vaccine may provide a small amount of protection against swine flu, even though the viruses in the flu vaccine are a very different strain. This is akin to increasing your fitness by exercising a single group of muscles.
Advisories help to reduce the spread of the disease making it easier for the health services to keep it together. I suspect, however, that our health services will quickly be overwhelmed by a pandemic.
Apr 28 09 2:41 pm
Thanks for the info, and yes i agree that if there is a pandemic or if people think there is, then our health services will not cope.
Apr 28 09 2:56 pm
8,000+ now confirmed dead in Mexico.
ZenTiger’s last blog post..Mexican death toll now over 8,000
Heh. You are a sick puppy, ZT.
Apr 28 09 5:13 pm
I’m sorry, but, what? Why can’t we recall the disasterous MenzB vaccination campaign of 2005, that literally shattered the reputation of the NZ MOH in the eyes of a great number of NZ mothers and fathers? How many docos do we have to see on tv regarding the horrible impact of that mass experiment on both our population and on those in Norway?
I think the great elephant in the room with all this discussion of how to deal with the pandemic is the fact that after this farcical vaccination program and for numerous other reasons, trust in the MOH and the medical profession is at an all-time low. It’s unfortunate but true- people have not forgotten.
The MOH is faced with the task of enforcing compulsory treatments on a population that has one of the lowest vaccination rates in the OECD. This pandemic will be a real test of the NZ health system, but unfortunately it will also expose the lack of trust that has grown between doctors and patients as patients go to extreme lengths to avoid medical treatment.
How about talking about the reality of mass pandemic treatments will be preceived by your average mum and dad that has become jaded by the MOH constant fearmongering over every disease that comes along, and wants to be fully informed. I would appreciate it if you could go further than just talking about the basic logistics of how we are going to be dealing with this pandemic. Sorry for the rant. This blog always has something interesting to sink the teeth into.
Apr 28 09 7:05 pm
Johnnieboy: Feel free to sink teeth.
If you have read my older post you will have realised that I was less than impressed with the entire meningococcal vaccine debacle. However, unlike MeNZB, this is an emergent virus whose spread could be controlled if a vaccine was available soon enough. A vaccination scheme is about the only thing we can do against this virus now.
Apr 28 09 7:59 pm
Well I know of 1975 swine flue debacle.
The so called ‘prevention’ killed more than the disease ever did. Only one soldier at Fort Dix died, which is the event that initiated the panic. In fact the epidemic had burned itself out before the mass vaccination program even got underway but this killed at least thirty.
The thing is if this epidemic comes to nothing the Public Health people and WHO will be lining up to claim the credit, regardless. They have to justify their existence even though with Flu they little to offer beyond snake oil.
Apr 28 09 10:02 pm
Andrei: I agree with you that a vaccine program is likely to be available too late to be of any good. And, so far, the public health authorities have nothing to crow about. Their performance so far has been less than impressive. The WHO have now announced that containment of the outbreak is unlikely. Their casual announcement of the possible death of several million people makes Osama Bin Laden look like Mary Poppins.