Monday, 27 April 2009

World Unnerved by Spread of Swine Flu

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Man with maskThe world watched warily on April 27, as cases of swine flu that first emerged in Mexico in recent weeks in near-epidemic proportions started surfacing in other nations. Mexican officials said the flu strain may have sickened 1,614 people since April 13. Officials were awaiting the results of laboratory tests to confirm how many of 149 suspected flu-related deaths were in fact caused by the illness. So far, at least 22 deaths in the nation of 111 million people have been attributed to swine flu.

U.S. officials upped the number of reported cases to 40, double the number counted just one day earlier. The increase was solely attributed to further testing of ill students at a Queens, New York, school, raising the count in that single location from eight to 28. Students from the high school had spent spring break in Cancun, Mexico.

In addition to the New York cases, the CDC confirmed seven in California, two in Texas, two in Kansas, and one in Ohio. An additional six cases have been confirmed in Canada. Outside North America, suspected swine flu cases have been reported in Colombia, the United Kingdom, France, Spain, and Israel, and at least 10 high-school students returning from a school language trip to Mexico on April 25 were thought "highly likely" to have the illness, according to the country's health minister.

The U.S. Centers for Disease Control and Prevention (CDC) has identified the flu strain as type H1N1, which contains genetic material originating in pigs, birds, and humans.

Dr. Richard Besser, acting director of the Centers of Disease Control and Prevention, reported that the cases of the disease reported in the United States appear to have been less severe than the outbreak in Mexico. There have been no deaths reported as a result of the disease in the Untied States and only one patient required hospitalization.

"I wouldn't be overly reassured by that," Besser told reporters at CDC's headquarters in Atlanta. "We are taking it seriously and acting aggressively. Until the outbreak has progressed, you really don't know what it's going to do." quoted Dr. Anne Schuchat of the CDC, who cautioned during a telephonic briefing April 26 that the situation may change quickly. "We may be fortunate," she said, "but I think we really need to prepare for the idea that we will have additional cases, additional affected states, and I do fear that we will have deaths here."

Homeland Security Secretary Janet Napolitano said Sunday the United States had declared a "public health emergency," but downplayed the seriousness suggested by the term, describing it as essentially a state of emergency preparedness, similar to steps taken during recent floods in Minnesota and North Dakota, or during the presidential inauguration last January.
One-quarter of a national stockpile of 50 million doses of Tamiflu would be made available for use by states, she said in a briefing at the White House.
Though the United States had declared a "public health emergency," the State Department did not issue travel advisories for Mexico. Napolitano said that the screening of arrivals from Mexico would be "passive," explaining that people would be asked whether they were now or had previously been ill. Those answering affirmatively would be referred for further examination. "Right now we don't think the facts warrant a more active testing or screening of passengers coming in from Mexico," said Napolitano, adding that the situation could change in upcoming days. (The situation apparently did change, as the CDC posted a travel warning on its website by April 27 recommending that people avoid non-essential travel to Mexico.)

On April 27, Napolitano told reporters that the World Health Organization is operating at level three, with level six a full pandemic. She said officials at the WHO were meeting that day to consider whether to raise the level.

Many nations around the world have taken precautionary measures. In Asia, Singapore, Hong Kong, Japan, Taiwan, and China all made plans to screen and/or examine passengers arriving from Mexico.

The European Union health commissioner advised Europeans to avoid nonessential travel to Mexico and the United States, but Dr. Richard Besser of the CDC said that including the United States in the advisory seemed unwarranted at this time.

One of the most outspoken members of Congress about this crisis is Rep. Eric Massa (D-N.Y.), a member of the House Homeland Security Committee who on April 25 called for "an immediate and complete closure of the Mexican border until the H1N1 Swine Virus is contained and controlled." Massa was the first member of Congress to make such a recommendation. In a follow-up statement posted on his website on April 27, Rep. Massa said:

The H1N1 virus is a cause for concern and I again call on the public to pay attention to the new reports being issued by the Center for Disease Control and World Health Organization.... The epicenter of this outbreak is still in Mexico and while we now have several confirmed cases in the United States, we must consider all options to help reduce the number of new cases entering our nation. I'm glad that the White House has issued a travel advisory and is conducting passive screening at the border, but I think we should consider stronger measures at the border. I am in favor of using all tools available to reduce the spread of Swine Flu.

Controlling our borders and preventing anyone or anything that might be potentially harmful from entering the United States is, of course, one of the few legitimate functions citizens should expect of their federal government. However, citizens must be vigilant that overly ambitious government officials do not use the threat of a health crisis to increase the size and scope of government beyond limits set by our Constitution. A look back in time confirms that such an outcome is likely. Consider this excerpt from an article, "Uncle Sam and the Bogeyman," by the late Robert W. Lee, published in The New American magazine for May 7, 1990:

In early February 1976, an Army recruit died at Fort Dix, New Jersey, of what some medical authorities thought was a strain of flu similar to what caused the terrible influenza outbreak of 1918-1919. The trainee's condition had been incorrectly diagnosed by his doctor a few days earlier as a common respiratory disease. Although urged to stay in his barracks, the young man went on bivouac, during which he collapsed. Despite the unusual circumstances, his case was used to stir up a national Swine Flu frenzy. Congress appropriated tens of millions of dollars for a program to develop a vaccine and set up a liability program to reimburse vaccine makers in case the vaccine itself caused problems.
Many competent authorities questioned the very existence of Swine Flu, and some reports at the time indicated that up to 25 percent of those inoculated would suffer ill effects of one sort or another. Prior to voting against the Swine Flu legislation, Congressman Larry McDonald (D-Ga.), a medical doctor, stated during debate on the House floor that the panic was completely unjustified. Nevertheless, President Gerald Ford signed the program into law.
The civilian population was cajoled to participate in the vaccination program. Military personnel were threatened with court martial for refusing to be immunized. By mid-1977, legal claims filed against the government for deaths and injury resulting from the vaccine  — not the flu — totaled more than $300 million. By January 1978, more than 1,000 claims totaling $1.5 billion had been filed. An entire new legal speciality developed around Swine Flu lawsuits, and litigation continues to this day.

Meanwhile, only six cases of the actual flu were recorded by federal health authorities. The power (and inclination) of our central government to manufacture a crisis, spend millions of dollars "solving" it as counterproductively as possible, and protect powerful special interests at taxpayer expense had again been demonstrated.

This is not to minimize the potential health danger of the flu that currently has struck many individuals in Mexico. However, a combination of common sense, consultation with competent private medical professionals, and — where appropriate — the imposition of local quarantines by city and state health officials, is most certainly a preferable option than federally mandated inoculation programs. Federal involvement almost always increases costs while decreasing the quality of healthcare.

Photo: AP Images