Monday, May 18, 2009

The worst may not be over

BOB BROCKIE - World of Science - The Dominion Post
Last updated 13:05 18/05/2009

OPINION If flu aficionados had pressed the red button last month, we'd wonder what hit us.

During the 1918 Spanish flu pandemic, nearly every American city closed its schools, churches, theatres, dance halls, billiard parlours, saloons, soda fountains and sports games.

Many cities forbade funeral gatherings, public assemblies, door- to-door salesmen, children entering shops and theatres, and crowding in streetcars. Some cities enforced mask-wearing and staggered business hours to reduce congestion.

In 1918, the New Zealand government closed schools and shops (except food shops, which were disinfected daily). All shipping between ports came to a halt.

A local citizen wrote that he "stood in the middle of Wellington City at 2pm on a weekday afternoon and there was not a soul to be seen - no trams running, no shops open - it was like a City of the Dead".

That's what we could expect too.

Did these precautions do any good?

Yes, says a team of British, Dutch and American epidemiologists who recently analysed the restrictions imposed in 43 US cities during the 1918 flu epidemic.

Some cities were quick to impose precautions, enforced the measures rigorously and maintained the restrictions for months. Others acted slowly, off- handedly and for only a fortnight.

San Francisco imposed its precautions within two days but Philadelphia waited two weeks to act. As a result the flu killed eight times more people in Philadelphia than in San Francisco.

Had San Francisco maintained its restrictions for longer, the experts calculate that up to 95 per cent of its deaths might have been averted.

Restrictions came late in New Zealand, so we lost 8000 victims to the flu, 1400 in Wellington.

The trick is to impose immediate, thorough and prolonged "social distancing". This means shutting ourselves up at home for three months with no friends round for a beer or a coffee.

Although the present epidemic appears to be contained, we are not out of the woods yet.

Experts remember that the Spanish flu began with a wave of mild disease in early 1918, only to return with a vengeance at the end of the year. Several northern hemisphere epidemiologists are concerned that the same might happen when the weather turns cold next autumn.

Pig farmers resent the current epidemic going under the name of "swine flu" because today's strain has never been isolated from pigs. The Mexican Government too objects to the name "Mexican flu" because it puts the country in a bad light.

In years past, new strains of flu were named after the places where they first showed up. So we had Spanish flu, Russian, Asian, Qinghai and Hong Kong strains of flu.

But in 2007, Chinese officials were upset about the new Fujian flu. They argued that the province of Fujian was tainted by association with a novel flu virus, so they leaned on the World Health Organisation to invent a new politically neutral naming system. These days Fujian flu is called the "2.3.4" strain. The current swine flu is officially called "A/H1N1".

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