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Monday, April 27, 2009

Swine flu: we must remember 1918, yet not repeat the fiasco of 1976

As you probably well know by now, the White House has declared a state of emergency as 140 plus people have died of the swine flu in Mexico, the disease has been reported now in four countries, and in several states within the United States.

So far, of the 50 plus Americans to get the swine flu in the U.S., all cases have been generally mild and are not expected to be life threatening. Which begs one to wonder if the deaths in Mexico are due to lack of good medical care, or a more virulent strain in Mexico. This lack of knowing is certainly troubling to scientists and politicians, hence the seriousness of the matter.

Officials are wise to add that there needs NOT be a state of panic because of this outbreak, just a state of vigilance because officials are not quite positive how rapidly this virus spreads. The basic reason for the state of emergency is to "allow the federal and state governments easier access to flu tests and medications," according to HealthCentral.com.

I think it was Obama who wrote a memo regarding the seriousness of preparing for a possible flu outbreak when he was a young Senator, and George Bush set aside in his budget monies to prepare for such an outbreak, and to work on finding a cure if such a "mutated" virus were to cause havoc. Currently, drug makers are in a mad dash to create a vaccine.

So I think the Obama administration is making all the right moves at the present time to create awareness, and yet not cause a panic. Which, by the way, reminds me of what happened during the 1976 swine flu scare. One soldier at Fort Dix caught the flu and died, and an estimated 500 other soldiers had the flu while having only mild symptoms.

Yet, with a flu virus spreading so fast, the population -- including those in Washington -- were worried because any virus that spreads that fast could, possibly, cause a pandemic. So, does the government take the wait and see approach, or work to create a vaccine and make everyone take it?

There was a lot of political pressure on Gerald R. Ford. Plus there was the memory of the Great Flu. According to capitalcentury.com, (an article by Paul Mickle) "The Great Plague... rivaled the horrid Black Death of medieval times in its ability to strike suddenly and take lives swiftly. In addition to the half million in America, it killed 20 million people around the world."

The irony of that last quote was the Great Flu more than rivaled the Great plague. The Great flu spread across a nation and killed 20 million people within a short time, and the black plague killed that many people in over a decade of work. The Great Flu, by all means, was an even greater threat as the plague.

And considering the Great flu spread so fast at a time when few people traveled great distances by plane, bus or train, or from one continent to another within a few short hours, it would seem the fear of a disease spreading in 1976 -- or today -- would spread faster and be twice as deadly.

The swine flu comes from poultry and swine, and people who have intense exposure are at most risk of getting it, as the strain can also effect humans. Unfortunately, the strain has the ability to genetically change (mutate), and thus become more resilient and difficult to inoculate against. As what happened in 1976, the current strain of swine flu seems to have mutated.

So Ford, in 1976, amid a highly politicized season where Reagan had just recently beaten Ford in the North Carolina primary, did not want to be seen as doing nothing, especially if a pandemic did spread. And so, he and Washington hastily made a flu vaccine available for mass inoculations, and a $135 million flu inoculation program was swiftly available. It was announced to the public on March 24, a day after the North Carolina primary.

My point is simple: politics had a hand in what happened next, and Obama does not want to make the same mistake. So, while there were the "naysayers" who warned Ford that the swine flu epidemic was limited to one military base, and only one person had died, the plan for inoculating the public was rushed through Congress. The goal was to get all 220 million Americans inoculated.

By October 1 the vaccine was ready and sent to many doctors, health departments and schools across the nation. Jim Florio, a top democratic Senator who supported Jimmy Carter, was the first to take the vaccine. He did this instead of taking a swipe at Ford for his hasty actions. He too was scared of the swine flu.

Soon thereafter two people who had been given the vaccine died of heart attacks. By Dec. 16 40 million poeple (20% of the population) had received the shot, many of whom later reported symptoms of a rare disease called Guillen Barre. Because of the "Epidemic that never was" people were now becoming paralyzed. In total, over 500 people became paralyzed because of the "Epidemic that never was."

Mickle states it best when he writes: "The swine flu case of 1976 forever reduced confidence in public health pronouncements from the government and helped foster cynicism about federal policy makers that continues to this day.Citing the swine flu fiasco, for instance, one scholar recently authored a report suggesting the threat of AIDS has been similarly overblown."

Said another way, because of the "Epidemic that never was" people lost confidence in the government (big surprise there). I can think of several other times where the government has failed the people, and these failures are spread across many presidencys, both republican and democrat.

The fear that "something has to be done" often superseded rational thought. On the other hand, fear that something will be done and it will be the wrong thing -- as was the case with Katrina -- makes governments fear they must do something -- however hastily.

Fear of the inoculations lead people to not want to get the vaccination, and the program was halted by Dec. 16. In total, over 500 people became paralyzed as a result of the vaccine, and 25 of them died. It is also true that only one person died of the actual flu.

So, fear -- especially fear in politics -- is a double edged sword. If you rush to create a vaccine and it works, you are a hero. If you rush and it doesn't work, you are a failure. If you don't do anything and nothing happens, you are fine. But if you do nothing and a pandemic hits, you are again a failure. So, it could turn out that no matter what Obama does, he may merely be a passenger on a roulette table.

So, with all due respect, our politicians must not rush to make judgements, yet they must -- as Obama has done -- educate and prepare, yet not scare, the public. How to do this in the most effective means has yet to be determined, and may prove impossible.

One other thing must be understood about the flu. The current outbreak is said to have effected (at this point) a few thousand individuals, 100 of whom have died in Mexico. One expert, however, was quick to point out that the total number of flu victims is widely inaccurate.

He said that when a flu virus mutates, the death total is usually 1-2% of the total number of cases of the flu. He said, if his calculations are correct, the actual number of people right now with the swine flu is more likely to be in the range of 10,000 to 100,000.

Yet, as government officials have said, we must not panic, yet we must also be prepared.

For the latest updates on swine flu and flu symptoms, click here.

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