The spectre of H1N1

The rapid spread of the H1N1 pandemic in Malaysia must be a cause for concern, as 56 afflicted patients have died three weeks after the first case was reported on July 22 in our country.

The report of 200 new cases a day also indicates that this highly infectious disease is on the brink of spinning out of control. The high fatality rate of 50 deaths out of 2,000 confirmed cases or 2% is alarming. Writing in the Sin Chew Daily, Lim Sue Goan offered following statistics.

She said: "If we compare to other countries, we can see the inadequacy of prevention and control in Malaysia. Vietnam reported 1,211 confirmed cases with one death and the mortality rate of 0.08%. While Hong Kong reported 5,991 confirmed cases with four deaths and the mortality rate of 0.067%.

"Australia reported 27,663 confirmed cases with 95 deaths and the mortality rate of 0.34%. Even Singapore that found death cases earlier than Malaysia, reported only nine deaths."

The urgent question is this: Is the Malaysian government and its people fully aware of the possibility of a massive flu disaster that could strike the nation in the not-too-distant future? Are we fully prepared to take all necessary actions to contain the spread of this H1N1 spectre?

The Ministry of Health (MOH) has predicted that the H1N1 outbreak will continue for a year or two at least, and 100,000 to 500,000 may need hospitalisation with 5,000 to 27,000 succumbing to the disease.

Whether the MOH prediction will turn out to be an under-estimate or not, only time would tell, but at what cost? The H1N1 influenza - called the Swine Flu at first - was first reported in Mexico and has since penetrated 167 countries.

According to the World Health Organisation, as many as 20% of the entire population on Earth could be infected. Already, there are people grumbling about the lack of urgency on the part of the government in the initial containment stage of the pandemic.

Greatest fear of the global community

Travelers have reported the absence of body-temperature checks at most entry points at our borders, especially at the airports. Malaysian travelers returning from China have recounted how stringent such checks were at their airports.

Our DPM Tan Sri Muhyiddin Yassin has also called the current situation "alarming", saying that we have left the initial control and containment stage into the "mitigation" stage. He has also announced that RM20 million has been allocated to the MOH to stock up on the anti-viral drug Tamiflu.

The situation is so alarming that the MOH secretary general Ismail Merican announced on Aug 14 that if you have all the flu symptoms, you can assume that it is H1N1, and there is no further need to seek testing.

The MOH has enough supply for anti-viral drugs like Tamiflu and Relenza, but advised medical professionals to exercise restraint when prescribing these drugs, for fear of the H1N1 developing resistence to them through mutation.

The spectre of the H1N1 virus mutating is the greatest fear of the global community.So far, it seems the pathogen has not yet mutated, and if and when it does, the fatality throughout the world would be unthinkable. It could explode into one of the worst disasters in the world in modern times.

So far, people who are in the high risk groups tend to succumb to the virus, like those with respiratory and heart disease, pregnant women, diabetics, and people with low immunity. But there have also been instances of patients who are well but deteriorate very fast after contacting the virus. Something is seriously amiss.

Though only over 2,000 cases have been confirmed, the actual number of people infected with the H1N1 virus could be much higher, because the testing facilities in our country are so limited and inadequate. It would appear that the Ministry of Health alone is not equipped to mitigate the rapid spread of this killer flu.

PKR vice-president and Gopeng MP Dr Lee Boon Chai has called for the immediate implementation of the preventive measures as outlined in the National Influenza Pandemic Preparedness Plan 2006, which includes the activation of the national Security Council at the national, state and district levels to coordinate government and non-government bodies to combat the influenza outrage.

Death toll could reach 1,000 in six months

His proposals are actually quite sobering, and they deserve our attention below:

• Start mandatory screening (of body temperature and symptom of Influenza A infection) at entrance to all public and private facilities where people congregate, including schools, hospitals, hotels, supermarkets, government offices, restaurants , factories, etc.

• Form a joint committee among BN and Pakatan Rakyat leaders so that both sides can co-operate hand-in-glove in confronting the greatest crisis ever in our healthcare system.

"Tough measures are essential for the next few months while awaiting the availability of the vaccines to protect high risk individuals," he said.

"The cabinet must re-examine the situation and review the existing measures to limit the extent of the epidemic, reduce mortality arising from the infection and minimise the social and economic impact," he added.

Dr Lee also predicted that the pandemic would peak in 3 to 6 months' time, with death toll at 1,000.

Already, shops in my neighbourhood are moaning that they are losing business to the H1N1 bug. The declaration of a national health emergency would indeed disrupt the economic life of the nation, and powerful vested interest groups would resist it all the way.

But we are talking about numerous human lives here. The protection of human lives is after all one of the most primal responsibilities of the government. Already, parents throughout the land are torn by anxiety when they send their young children to school every day, not knowing whether they will end up as just another addition to dead statistical numbers.

After all, we are facing a brand new viral phenomenon, and even the MOH in Malaysia and medical experts at WHO have admitted that they know very little about this latest strain of the flu virus. A vaccine would not be available until the end of this year, if ever.

If shutting down the whole country for a week or two would help contain this pernicious pestilential tenacious pandemic, then it must remain an option for our country.

With this fear of the pandemic smouldering in the silence of our citizens' hearts, perhaps the BN and the Pakatan Rakyat coalition should declare a moratorium in their over-heated politicking and discuss about a by-partisan effort to combat the H1N1 menace.

SIM KWANG YANG can be reached at kenyalang578@hotmail.com