Thursday, April 30, 2009

Mexico to take 5 day break at home to stop spread of swine flu -- but ever optimistic Americans are going about business as usual

The NY Times reported this morning:

As the swine flu virus appeared in new locations as far apart as Peru and Switzerland on Thursday, Mexicans braced for a national shutdown of offices, restaurants, schools and even the stands of soccer stadiums in an attempt to slow the spread of the disease. In nationally televised speech on Wednesday night, the Mexican president, Felipe Calderón, said that many public services would be closed Friday through Tuesday, encompassing a long holiday weekend. Most government offices and many private businesses will be ordered closed, restaurants, schools and museums will remain shuttered, and spectators will be barred from all professional soccer matches. Churches are expected to be nearly empty on Sunday.

...in Mexico, the epicenter of the disease, Mr. Calderón urged much broader precautions [than those being taken in Britain]. People should stay inside their homes during the holiday hiatus, he said, and the shutdown and restrictions could possibly be extended further into next week.  The Mexican minister of health, Jose Cordova, said all nonessential federal services will shut down, and Mexico City extended the federal ban to include health clubs, gyms, museums and movie theaters.Police stations, airports, bus stations and the capital’s subway system were to remain open under the federal plan, along with banks, food stores, pharmacies and gasoline stations.

Some 2,500 Mexicans have been sickened since the swine flu outbreak began last week in the town of La Gloria, 110 miles east of Mexico City. Mexico has reported just 99 confirmed cases of swine flu to the W.H.O., along with eight deaths, although as many as 168 people are suspected to have died from the disease there.

Contrast this reaction with that of NYC:

The number of swine flu cases in New York City continues to grow, with hundreds of confirmed or suspected cases mostly among students. Four schools - two in Brooklyn and two in Queens - will be closed for the rest of the week to prevent any further spread of this new variant of influenza. But with only one reported death and few reports of severe illness in the U.S. attributed to swine flu, New Yorkers are mostly brushing off worries about the illness. 

Anna Garcia and daughter
Anna Garcia and daughter
The number of swine flu cases has been growing, but New York seems more like a city under the spell of spring weather rather than worried about a possible pandemic. Parents, students and workers say they're watchful, but not alarmed. Letia Frandino is from the borough of Queens, where the New York outbreak was first detected, says this is the reason why she paid closer attention to the alert: "... because it was in Queens. I have heard that we shouldn't be panicking because there are still mild cases so far in the United States, so that's what we are going on," she said.  Anna Garcia, picking up her daughter after school, said she's also not worried. "I'm a public school teacher in Brooklyn, in a community that's mostly from Mexico, and they don't seem to be panicking. And as long as you keep your hands clean," she says, "you tell the children to keep, you know, like you would any cold or flu, you're just telling them to protect themselves."  Students doing homework at a park in Manhattan said they've been warned at school about what could happen if swine flu emerges there. One student, Alison, says, "They were saying how all the kids would miss school for two days while they cleaned the whole school, and the kids would have to go to doctors." Student Jonathan adds, "No one really wears masks, like they're not afraid, it's just the flu. But they don't know how bad it is, maybe?"

Michael Bloomberg
Michael Bloomberg
On Tuesday, New York Mayor Michael Bloomberg said swine flu is expected to spread around the city - as some form of influenza does each year - but that, for now, it does not look as if it will cause more deaths than other flus.  "From what we know now, swine flu seems to spread similarly to seasonal garden-variety flu, that we regularly see in our city and we have no reason at the moment from what we have seen here to believe its symptoms are any more severe," he said.  The mayor said that people with flu should stay home, but that no one in New York has yet become seriously ill. 



"Almost every case has been very mild," Bloomberg said. "And the process of going from catching it to noticeably getting better, has been in a few days, very quick."  That may be why New Yorkers don't appear worried, and subway cars are as jammed as ever, with few people wearing masks.  "What can you do?" one man said. "You have to get around. Wash your hands, just be careful what you do."

The difference in New York City and Mexico City is not a difference in the virus.  It is a difference in the length of time that the virus has been active and a difference in the level of government response.  Time will tell which response is more appropriate -- but I'd prefer that the government follow the precautionary principle and err on the side of caution.  The federal government seems to be doing that, but most of the decisions about community mitigation measures are in the hands of the state and local governments, not the federal government.  With uneven response, the likelihood that everyone in the United States will get an opportunity to be exposed to this flu is high.


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