# 4010
A hat tip to Crof at Crofsblog for picking up this very informative piece in the New York Times that explains, in great detail, some of the challenges facing Ukraine’s medical system and how that greatly exacerbated their recent pandemic flu outbreak.
The author describes a health care system so dysfunctional (and at times corrupt) that many Ukrainians simply preferred to rely on home remedies like lemon and garlic, rather than seek help at a local hospital.
By the time many influenza patients finally sought medical care, their condition had become critical.
The sudden appearance of so many pneumonia patients not only overwhelmed local hospitals, it also launched a maelstrom of Internet rumor and speculation.
By all means, read this article in its entirety. There’s a lot of good information there, and it appears to be the most `reasonable’ explanation of what happened in Ukraine that I’ve seen so far.
When you return, a few comments about Internet rumors and pandemic speculation.
Fragile Care Worsened Swine Flu in Ukraine
By ELLEN BARRY
Published: November 13, 2009
LVIV, Ukraine — When patients began arriving in Vyacheslav Bonder’s intensive care unit two weeks ago, their lungs so saturated with blood that they could barely gasp, the only thing he could compare it to was a field hospital in wartime. As soon as he hooked one patient up to a ventilator, a second and third would appear in the doorway.
By that time, hospitals were clearing wards to make room for a wave of pneumonia cases, and people were crowding into drugstores to buy whatever they could get their hands on. Rumors were circulating that the government had ordered the city aerially sprayed with chemicals, to cure Lviv (pronounced luh-VEEVE) of disease or, in a grimmer version, to exterminate its carriers.
The panic lifted almost as quickly as it had arrived, and the World Health Organization announced Friday that the swine flu illnesses and deaths so far in Ukraine — 265 fatalities nationwide, with 87 in the Lviv region — were statistically no worse than those in other countries. But what happened here has drawn rapt attention from experts bracing for the epidemic to hit Europe, and especially the fragile health care systems of countries of the former Soviet Union.
Early this month reports of Ukrainian patients with `bloody lungs’ arriving at hospitals quickly spread quickly across the Internet.
Within hours conspiracy blogs, twitter accounts, and even some newspaper reports eagerly began offering explanations that ranged from `Russian biological attacks’ and `possible mutated flu viruses’, to even outbreaks of `pneumonic plague’.
Most were patently ridiculous on their face, although the possibility of a mutation in the H1N1 virus that increased virulence was always a possibility.
`Hemorrhagic viral pneumonia’, however, isn’t all that rare, and has already been documented with the pandemic virus.
The July 10, 2009 / 58(Dispatch);1-4 MMWR (Morbidity & Mortality Weekly Report) of the CDC described several such cases observed in Michigan in: Intensive-Care Patients With Severe Novel Influenza A (H1N1) Virus Infection --- Michigan, June 2009
On November 3rd, in Three Updates From The Ukraine, I wrote:
While all of this is obviously a concern, none of these reports gives any credence to the wild (and unsubstantiated) reports of `pneumonic plague’ or a Russian `bio-attack’, or of `thousands of deaths’ that have recently surfaced in some newspapers, and are spreading on the net . . .
. . . For now, however, there is no evidence of anything more ominous here than a large outbreak of pandemic H1N1 influenza, possibly along with a mix of other respiratory viruses common this time of year.
Since then, I’ve received a number of emails and comments (some removed) that argued that the WHO was covering up the truth, and that by not printing these `allegations’, I was complicit in that cover up as well.
After penning more than 4,000 essays on pandemic influenza and other emerging infectious diseases, it was a novel experience to be labeled a `pandemic denier’.
The frequency and tenor of some of these comments regrettably forced me to, after nearly 4 years, go to completely moderated comments on this site.
The Internet loves a conspiracy, and if I wanted to quickly triple the number of daily visitors to this site, all I’d have to do is fabricate and print some of the conspiratorial cyber-crap that seems so prevalent these days.
It would be easy enough to slip some Google Ads into my sidebar, start selling homeopathic `anti-flu pills’ or e-books with `insider flu information’ and maybe make a buck or two.
You can rest easy, that’s not going to happen.
While it may not draw huge crowds to this site, I find the science and `reality’ of this pandemic far more interesting than any conspiracy theories or speculation. And I’m quite happy with the small, and largely erudite readership of this blog.
This is living history, and it deserves sober and sane coverage.
You’ll find others striving to do the same in my sidebar links, and in my essay Reliable Sources In Flublogia.
While it is certainly possible that one of these days one of the thousands of wild Internet rumors or stories will turn out to be true, I’d rather be a few days late reporting it, than to embrace the 99.99% that are false or misleading.
For those who might be disappointed with this policy, all I can do is suggest that a quick Google search will turn up scads of `alternative’ pandemic flu sites.
I’m sure that you’ll have no trouble finding a number of them more to your liking.
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UPDATED: 11/17/09 WHO : Ukraine Update # 2
This latest dispatch from the World Health Organization states that no significant mutations have been detected in the virus samples taken in Ukraine.
