The White House held a briefing this afternoon with the Secretary of Homeland Security, Acting Director of CDC and Nat’l Security adviser to the President in attendance. If you have been following this you wouldn’t have learned much, but the overall tone was one of serious concern but steady confidence. It was good security theater, and I say that in a good way. Information was divulged (judging from some of the press questions there was no danger over estimating the knowledge of the audience) and a sensible plan described.
There are now officially 20 confirmed cases in the US in five states (California, Texas, Ohio, New York, Kansas). The Department of Homeland Security will be the lead agency (the incident command) for this, but the health end will be taken by the Department of Health and Human Services (DHHS). Whether it would have made a difference if DHHS had a confirmed cabinet secretary isn’t clear. Obama’s nominee is being held up by Republican abortion ideologues, so there it is a headless Department at just the wrong time. The US version of the disease continues to be relatively mild, although most people expect severe and fatal cases to turn up as case finding intensifies.
DHHS has declared a “public health emergency,” a legal designation that permits certain public health resources like a portion of the 50 million courses of antivirals in the Strategic National Stockpile (SNS) to be prepositioned in the states should the need arise. A number of topics were discussed but not much new information. Daily briefings were promised.
I may be making this sound less valuable than it was. For those following it closely not much new came out, but it was a pretty credible performance overall.
If you want to know what happens when the government lacks credibility and compounds it by not keeping people informed, just take a look at the responses from Mexicans, including physicians, who were invited to comment by the BBC. I’m guessing a lot of the things said here will turn out to be false, exaggerated or distorted in some way. That’s what happens in outbreaks. But which things?
Here are 4 of 17 comments, more or less random (hat tip commenter habebe):
I’m a specialist doctor in respiratory diseases and intensive care at the Mexican National Institute of Health. There is a severe emergency over the swine flu here. More and more patients are being admitted to the intensive care unit. Despite the heroic efforts of all staff (doctors, nurses, specialists, etc) patients continue to inevitably die. The truth is that anti-viral treatments and vaccines are not expected to have any effect, even at high doses. It is a great fear among the staff. The infection risk is very high among the doctors and health staff.
There is a sense of chaos in the other hospitals and we do not know what to do. Staff are starting to leave and many are opting to retire or apply for holidays. The truth is that mortality is even higher than what is being reported by the authorities, at least in the hospital where I work it. It is killing three to four patients daily, and it has been going on for more than three weeks. It is a shame and there is great fear here. Increasingly younger patients aged 20 to 30 years are dying before our helpless eyes and there is great sadness among health professionals here.
Antonio Chavez, Mexico City
I think there is a real lack of information and sadly, preventative action. In the capital of my state, Oaxaca, there is a hospital closed because of a death related to the porcine influenza. In the papers they recognise only two people dead for that cause. Many friends working in hospitals or related fields say that the situation is really bad, they are talking about 19 people dead in Oaxaca, including a doctor and a nurse. They say they got shots but they were told not to talk about the real situation. Our authorities say nothing. Life goes on as usual here.
Young people are going to schools and universities. Buses and planes go and come from Mexico City as frequently as before. Even with two people dead locally, last night the local baseball stadium was full, mainly with young people. What’s really happening? I know vaccines are good for nothing, and if you take care, maybe you won’t die, so, why not acknowledge the real situation? I know that the economic situation is not the best, and it will worsen with panic. But panic comes from a lack of information. Many people travel for pleasure or without any real need. Stopping those unjustified trips can help a lot to ease the situation. We must do something!
Alvaro Ricardez, Oaxaca City, Oaxaca, Mexico
The truth is that it is very strange, what we are living through here. The streets are empty, we are all staying in our houses. People are only going out to the hospitals, drugstores and to buy food. The great majority have their mouths covered. Concerts, festivals, masses have all been cancelled, the football matches have all been played behind closed doors. On the television and radio, every commercial break contains information on the symptoms, saying that if you have them to go to the doctor at once. Although we have been told to go to work as normal on Monday, I am worried because I am employed at a company where there are many people and believe that it could be highly contagious. They say on the news that the cases that are most critical involve people aged 20 to 50.
Nallely T, State of Mexico
I have a sister-in-law from San Luis Potosi state in Mexico and we were told that in San Luis Potosi there have been at least 78 deaths, just in that city alone, not 68 in all of Mexico, as is being reported. Schools have been closed until 6 May in this state and in other areas in Mexico. Also, many public venues are being closed, so this makes it more deadly and dangerous than has been stated.
Migdalia Cruz, Phoenix, Arizona, USA
The Mexican authorities have provided a textbook case on how not to do it.