Wednesday, May 20, 2009

A Tale of Two Pandemics


# 3228




A popular sport in the media these days seems to be taking pot shots at the WHO and the CDC for raising the alarm over what has, so far anyway, not turned out to be a horrific pandemic threat.


While I believe the jury is still out on what this virus ends up doing, pundits who snort, and write about the H1N1 virus with derision and scorn, may actually have a point


At least if you are relatively well off financially, live in a developed country with good medical care, are in relatively good health, and are older than the `target age’ for this virus – which seems to be from about 5 years – to 24 years of age.


If you meet these requirements (and shouldn’t everybody?), then this virus understandably scores pretty low on your daily threat assessment.


At least as long as hospital beds in your community remain available, and antivirals continue to be effective against this virus.   Otherwise . . .


Of course, if you have a pre-existing condition, or live someplace where medical care isn’t quite so readily available, then this virus might be a wee bit more of a concern.


The WHO is the `WORLD’ Health Organization, not the `Middle-to-Upper Class American/European Health Organization’.   


Sorry, I know for some people, that has to come as a bit of a shock. 


Not only do the billions of  people who live in developing countries outnumber the rest of us, their health and wellbeing actually count.


At least to some people.


The WHO actually has to consider what the impact of a disease might be in Haiti, or Cameroon, or Vietnam.  Or how it might spread in mega population centers like Lagos, Mumbai, or Sao Paulo, or how it will affect the millions with Tuberculosis, or HIV around the world.


And the CDC, which also supports health agencies in countries worldwide, has to concern itself with the health of millions of Americans who live without health insurance, and the burden that even a mild pandemic would put on our already over-stressed health care system.


For these agencies, a `mild pandemic’ is still a big deal. 


Even if it doesn’t meet some people’s expectations that a pandemic must mean we’ll see push cart operators roaming our city streets crying `Bring out your dead’, or a collapse of civilization as we know it. 


Consider for a moment that we may very likely see two very different pandemics from this virus. 


A relatively `mild pandemic’ for developed countries where antivirals and antibiotics are available, and a moderate or even severe one in developing countries where they are not.


It’s true. 


We may find that this novel H1N1 virus will prove no more troublesome to Americans and Europeans than did the 1968 pandemic, which was so mild that many failed to realize we were having a pandemic.


I certainly hope so, although that outcome is far from assured.


But even if that happens, that doesn’t let the rest of the world – or the WHO and the CDC - off the hook.


Public Health agencies, and NGO’s like CARE and Save The Children, are engaged in a daily battle against disease and poverty around the world.  


The already have to contend with the death and suffering caused by poverty, cholera, malaria, TB, HIV, and scores of other diseases. 


Adding an influenza pandemic into this mix, even a `mild’ one, is not going to make matters any easier.


It will undoubtedly add to their workload, stretch their meager resources even thinner  - and despite their best efforts – claim hundreds of thousands of lives around the world.


To get an idea of what some of these agencies are dealing with, I would invite you to visit some of their websites.



Just because the worst may not happen in the better neighborhoods of Los Angeles, London, or Paris doesn’t make a pandemic any less real, or any less important to deal with.


While some pundits may find it hard to believe,  it can’t always just be about us.


          *          *         *        *        *        *   


Now is a good time to remind my readers that agencies like the Red Cross, Red Crescent, CARE, Save The Children, UNICEF, and others are working around the world every day to combat poverty and disease, and are going to be on the front lines during any pandemic.


They could use your support.


These NGO’s do a great deal with very little, and even small donations can help make a difference.


Chuck Simmins said...

There are over 70 countries where the median age is 21 or less. All Third World. If this is a disease of young people, it is going to be a big deal in Africa and Asia.

As a general rule, the Third World will be screwed no matter what the pandemic disease. Problems in transporting medicines and vaccine. Problems in distribution. And the local religion deciding that the treatment is a plot.

FLA_MEDIC said...

You are correct of course, this virus (and most pandemic viruses) has a predilection for the young.

The aging of American, and Europe decreases the impact here, but the demographics in the third world are quite different.

Nick van der Leek said...

Thanks for some great work here. Is H5N1 resurging? I notice last year, 2008, had fewer cases than 2007, around 44, but in 2009, in late August, we're already at 41. Do you think H5N1 might make a comeback, perhaps on the shoulders of H1N1?