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Girding up for a pandemic

Tragically, a 14-year-old Pune schoolgirl has become the first person in India to succumb to the swine-origin H1N1 flu virus that is responsible for the current pandemic. But this is no cause for panic because the death does not mean the pandemic flu has, in any way, become more deadly. The experience of other countries has been that a small proportion of those infected by the virus develop severe forms of disease and some die as a result. More than 1,100 deaths have been reported to the World Health Organisation by countries around the globe. But what needs to be borne in mind is that most people who sicken with the virus get well again without suffering more than the usual flu-like symptoms. Indeed, data from the United States, Canada, and Chile suggest that only up to 10 per cent of confirmed cases need hospitalisation. A recently published estimate suggests that just 0.06 per cent to 0.0004 per cent of those infected by the pandemic virus die. As parents of school-going children know only too well, infectious diseases spread easily in an environment where a large number of young boys and girls come together. Several countries have reported outbreaks of pandemic flu in schools, with the data indicating that the majority of swine flu cases are occurring in the school-going ages. But it is adults above the age of 20 years who are at higher risk of developing fatal forms of disease. Even among adults, it has been pregnant women and those with underlying conditions such as asthma and other lung disorders, cardiovascular problems, diabetes, suppressed immunity, neurological trouble, and obesity who are most at risk of severe disease.

The death of the Pune schoolgirl must, however, be a clarion call to the central government. It has invested far too much effort in airport surveillance, a strategy of doubtful effectiveness in a situation where many countries are reporting flu transmission at the community level. The government has taken solace in the limited number of officially confirmed cases in the country, without recognising that such cases are likely to be the tip of the iceberg. This is a virus that cannot be contained, and more people must be expected to become infected of the disease it causes. In order to forestall the panic that could ensue, the government needs to educate the public about how easily the virus spreads as well as how best people can protect themselves and their families. The central and State governments must also ensure that the health care services provided by the public and private sectors do not become overwhelmed by the demands likely to be placed on them. It is time for the governments to act purposefully.

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