Thursday, January 28, 2010

H1N1 Pandemic - Well-Fought or Over-Reacted?

Vaccine galore?

As time progresses things are becoming clearer as to the nature, evolution and impact of the novel influenza A virus. From the beginning when it first appeared in Mexico in April 2009, experts were not sure as to the potential capability of the virus. All they knew was this virus, the combination of viral materials from swine,avian and human was new and human had not encountered with it before. As the epidemic unfolded, younger people were noted to be affected somewhat sparing the elderly  unlike the normal seasonal influenza.

The outbreak was severe in Mexico where about 100 deaths were attributed to it and whole city was virtually shut down for almost a week . By the time the virus had traveled around the world and a pandemic declared by the World Health Organisation (WHO) in June 2009, it was noted that the infection was mild and those who succumbed to it had pre-existing medical conditions such as diabetes, heart disease,respiratory disease, immunosuppression, obesity and pregnancy. In northern hemisphere, seasonal influenza, besides targeting the elderly, seemed to have the same effects vis a vis mortality.

The global reaction had been one for the worst case scenario. In UK the pandemic was estimated to kill about 65,000 ( to date however, the official mortality due to influenza A/H1N1 is 360). The race for vaccine was on right from day one so to speak. Pharmaceutical companies were right in the centre of the fight, increasing production of anti-virals and new vaccines. Canada (reeling from the bad experience of SARS in 2004), America,Germany and The UK ordered millions of doses of the vaccine in July- August 2009. By October 2009, following a short trial, the vaccine was ready to be distributed. Long queues for vaccination were seen in the US, Canada and other European countries  in November-December 2009.

Experts and health officials warned of the "second wave" just like in the event of deadly Spanish flu in 1918 where millions were said to have died. But in 1918 the world did not have antivirals like we do now. Could these antivirals had somehow modified the virus's "behaviour and severity"? By the way, Canada has stood down on the second wave alert. Malaysia is waiting for WHO's directive and thus is still screening for fever in all its health facilities.

Due to the "mild" impact of the virus H1N1 and the observation that the seasonal flu killed  a lot more people annually and also the heavy human toll of the recent Haiti's earthquake where more than 150,000 people had been killed, people start to wonder whether the global response to H1N1 has been exaggerated. A member of EU parliament has even accused the possible collusion of  health "experts" and the pharmaceutical industry to profit from the pandemic. A committee is proposed to investigate this allegation.

There is concern whether the public, in future, would believe the warning regarding future pandemic and would governments be easily persuaded to allocate scarce resources for similar, albeit, new anti-viral vaccine?  Some experts have come to the defense of the response by saying that it is better to err on the side of caution. Indeed,  in this situation, damned if we do and damned if we don't ( remember Y2K Millennium bug?). And it is always easy to be wise after the event.

In the meantime, millions of doses of vaccines are unused and now Canada is going to donate their left-over to WHO. And UK is renegotiating the supply of ordered vaccines with the respective pharmaceutical companies as the infection trend is declining and what in the world are they going to do with those vaccines? And you cannot force people to be vaccinated  and would people want to be vaccinated when they notice that the infection is actually generally mild?..... in Malaysia we have just got our  vaccine supply and also waiting for that "second wave". ... and  to think that Malaysia is in summers all year round.


Unless, of course, if  the influenza A/H1N1 2009 suddenly mutates and causes havoc in the Northern Hemisphere( as winter is not over yet) and becomes H1N1 2010 and travels by air to us here... .. maybe I should get vaccinated after all but I am allergic to egg!

2 comments:

AC said...

Wow! So lenghty! Anyway thanks for the detailed update about H1N1and I still watch out for it. :)

Marcella said...

Hi AC,
Thanks for visiting my blog. You know I am so passionate about the novel H1N1 virus thus the lengthy "thesis"... It is actually written for myself based on my extensive readings on the subject.

I have refrained from listing the journal and news references, otherwise longer still!

Sorry if you find it boringly long, will try to discipline myself next time :D