Threat recedes but preparedness must remain high

A world still reeling from the economic and financial shocks of the past 12 months needed a global flu pandemic like it needed news of another major banking collapse. For most of the past week, the international media has been breathlessly informing a startled world of the seemingly unstoppable march of Mexican swine flu across the globe. In the past 48 hours, there have been tentative signs of hope that the highly contagious virus may have peaked and its spread is being arrested. Medical experts around the world have denied that there was an over-reaction by the World Health Organisation (WHO) and health authorities in many countries to this latest health threat which has emerged in the wake of SARS and bird flu. These strains of virus are extremely unpredictable and it is impossible to know how they will behave when they emerge, so it was better to put the world on maximum alert to the danger posed by swine flu. In hindsight, the WHO chief"s remark at a news conference last week that 'all of humanity' was at risk might seem like something of an over-reaction when viewed this week, but it is always best to hope for the best but prepare for the worst. However, just a dozen or so days into the outbreak, medical experts are now saying that the swine flu virus appears to have peaked, that the symptoms appear to be mild outside of Mexico, no deaths have occurred outside that country (with the exception of a Mexican toddler in the US) and that infected patients were responding well to treatment. The Mexican health ministry has said it believes the virus is in its declining phase. While all this is undoubtedly good news, it does not mean we should in any way be complacent. The lesson learned from the Spanish flu of 1918-1919 which killed 50 million is that it first appeared in the spring, went away for the summer but returned with a vengeance in the autumn. On that basis, no-one can afford to let down their guard. This type of virus is very unpredictable, according to the experts, and could possibly mutate if it comes into contact with another strain, such as bird flu for instance, creating a potentially even deadlier and antiviral-resistant virus. While the threat appears to be receding, health authorities in this country - in common with authorities around the world - must use the six months between now and the start of the peak winter flu season to ensure proper and detailed planning is in place in the event of a more severe outbreak later this year. The HSE says it is continuing to stockpile medicines and other medical supplies. The Government says it is also ensuring that citizens have as much information as possible about how to best avoid catching the virus and spreading it should they contract it by way of a major public information campaign. Ever since the bird flu scare of a couple of years ago, the HSE has been stocking up on drugs and now says it has enough antivirals to cover half the population of Ireland. That is certainly a good start but people need to feel confident that if there was to be a mass outbreak of swine flu in Ireland, the HSE would have sufficient doses for the majority of the population. The speed with which this virus can spread from person to person is unnerving and poses real challenges to health professionals and reassurance is needed that the authorities in Ireland will continue to stockpile the type of drugs needed to fight this threat should it return in a more virulent form in the future. Reassurance is also needed that the infrastructure and health staffing at local level in Meath will be able to cope with a major influenza pandemic, following concerns expressed last week that already understaffed and overstretched hospitals like those in Navan and Drogheda would be unable to cope. The HSE believes it can manage the anticipated huge surge in demand for services in a pandemic by redirecting staff and resources to meet that demand and by using health centres as temporary hospitals, for instance. The hope must be that such a contingency will not need to be put to the test.