For much of your correspondent?s generation, mysterious viruses?the types which spread fast, from human to human, with often deadly effect?have been the subject of medical thrillers and Hollywood blockbusters, not reality?at least until swine flu. Does anyone remember the 1995 blockbuster movie, Outbreak, the one with an all star cast (how many movies have Dustin Hoffman, Morgan Freeman, Kevin Spacey and Donald Sutherland on the same set), the one which tells the story about the fictional Motaba virus, which is set to annihilate a fictional Californian town and possibly the rest of America. That fictional virus, like the very real Ebola virus it closely resembles, was admittedly scary?Ebola has a fatality rate of between 50% and 90%. So one could plausibly rationalise all those masks and protective body suits that one saw in the film.
Now it is all too easy to forget in all our hysteria about swine flu/H1N1/influenza A?the 21st century virus that has seemingly turned gripping fiction into an unpleasant reality?that this is no Motaba or Ebola. There is no doubt that it does transmit rapidly between humans, but it is hardly the killer it is being made out to be. From all accounts, mortality rates are well below 1%, and not significantly higher than mortality rates from regular seasonal flu.
In India, of a total of 10,578 people that have been tested for H1N1 so far, only 2,026 have tested positive. That means only one in five of those reporting flu have the H1N1 strain, surely a comforting fact. In any case, most people have made a full recovery and only 28 deaths have been reported so far, mostly in people who have other medical complications.
So, it was an unpleasant revelation for your correspondent to be greeted by a small army of people wearing face masks (and operating thermal scanners) on arrival at Delhi?s Indira Gandhi International Airport on Wednesday morning, as if they were on a mission to prevent Ebola from entering the country. It was particularly jarring after having spent ten days in Europe (in affected countries), crossing more than one border, passing through more than one airport, spending times in places swarming with tourists from seriously affected countries (US, UK) with barely a mention of the H1N1 word. And no mask-wearing immigration officials, or thermal scanners either.
The rest of the world has seemingly come to terms with the reality of the virus: one can hardly stop it from coming into a country given the speed and frequency of travel; in any case, by now a significant number of cases in most countries are indigenous with no history of foreign travel. And only an insane general from a fictional movie (again Outbreak) would consider firebombing an entire city to prevent the spread of a deadly virus. Interestingly, the WHO has given up compiling statistics on H1N1 infections on a daily basis?there was simply no point.
So instead of wasting resources on trying to keep the virus out by deploying battalions of masked men and women at airports?a futile exercise and one that creates unnecessary panic and anxiety ?most countries are focusing on managing the disease?treatment for those affected (remember, not everyone needs to get admitted to a hospital) and research on vaccines.
Unfortunately, in India, our response is veering in just the opposite direction. And it?s not just restricted to the arrivals area of the international airport. The health and family welfare ministry, perhaps in an effort to stave off hysterical media coverage and criticism, requires all passengers from affected countries (as if India isn?t an affected country!) to fill in a rather smart-looking form (at least when compared with the cumbersome arrivals form) in which among other things like name, address, phone and email, one has to specify one?s seat number on the plane and come clean on any possible symptom of H1N1. Fair enough at a stretch, perhaps.
But what was most peculiar about the H1N1 form was the short (but in large and bold font) slogan on the form that said, ?Be a hero, save lives? by filling in this form. Again, this makes H1N1 sound like Ebola and creates a completely false public perception about the reality of H1N1. The authorities should be playing down panic, and certainly not increasing it with false notions of Bollywood-like heroism.
That kind of dramatic and exaggerated thinking is also behind the response of authorities to close schools and cinema, and ban public gatherings. How long can you do that for? Most experts believe that H1N1 is here to stay?the WHO even hazards to say that it may eventually affect 2 billion people. So, what does clamping down on public activity achieve other than to create panic? Everywhere else in the world, children are going to school, people are going to cinemas and tourists are going to be tourists. Those who do take ill get the right medication, very, very few die, and we move on.
By getting our thinking wrong at this stage we risk focusing on the wrong strategy to manage H1N1. It can?t be anyone?s case that the government should do nothing. But it must do the right things?reduce panic, spread awareness, and focus on appropriate, affordable and timely treatment. And if the government wants to go into overdrive, there are plenty of other public health issues to tackle, those which probably cost many more lives.
It?s just that we don?t count them every day.
