Alarming Flu Reports From Mexico

[dianahsieh]

By Paul Hsieh from NoodleFood,cross-posted by MetaBlog

BBC News has posted a number of "in the trenches" readers' reports on the swine flu epidemic in Mexico. Here are two disturbing excerpts from Mexican physicians:

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 work as a resident doctor in one of the biggest hospitals in Mexico City and sadly, the situation is far from "under control". As a doctor, I realise that the media does not report the truth. Authorities distributed vaccines among all the medical personnel with no results, because two of my partners who worked in this hospital (interns) were killed by this new virus in less than six days even though they were vaccinated as all of us were. The official number of deaths is 20, nevertheless, the true number of victims are more than 200. I understand that we must avoid to panic, but telling the truth it might be better now to prevent and avoid more deaths.

Yeny Gregorio Dávila, Mexico City

A few natural questions:

1) How will this affect border control policy?

Mexico has arguably been teetering on the edge of being a "failed state" for a few years now. If a flu pandemic causes the central government to lose effective control over the country, will we see a flood of desperate illegal immigrants seeking to cross into the US to escape the problems in Mexico? And given that some of those people may be infected, how will the US respond?

Although I support open immigration in the sense that Craig Biddle discusses in his article "Immigration and Individual Rights" from the Spring 2008 issue of The Objective Standard, I also completely agree with him that it is a legitimate function of government to prevent people with deadly communicable diseases from entering this country. In an emergency, this may require fairly drastic steps (such as deploying the US military along the border).

Hence, border security may become a big issue in the near future.

2) If the pandemic strikes the US, will this lead to a permanent increase in government control over our lives?

Again, in a mass casualty medical emergency, I think the government can legitimately impose controls that would not normally be justified. For instance, it might restrict normal commerce, assume temporary control of hospitals and health care facilities, impose quarantines/curfews on neighborhoods and cities, etc. One can argue over whether any specific proposed measures are justified for a given emergency, but the basic principle is valid.

But we also know that once government assumes "emergency" control over a sector of the economy, it rarely gives up that control after the emergency has passed.

Hence, a flu pandemic could lead to permanent new government controls over health care and/or other major sectors of the rest of the American economy, even after the immediate crisis has passed.

3) What would be the long-term economic effects of a flu pandemic on the US?

If there is significant loss of life, the individual tragedies will be bad enough.

But I expect this would be compounded by significant disruption of normal economic activity. In the present political climate, this could deepen our current recession, thus creating more pseudo-justification for further government controls over the economy, which would further worsen the recession, etc. How far could this downward economic spiral go?

We'll soon know the answers to these questions.

I also wish to emphasize that I am not taking an alarmist position. For instance, I think it's a huge positive that medical technology has advanced immensely since the flu pandemic of 1918.

If you want to read some good practical advice, take a look at this page from epidemiologist Dr. Tara Smith (not the Objectivist philosophy professor) written during the bird flu scare of two years ago. In short, she recommends:

Don't panic

Wash your hands

If you're sick, stay home

Don't touch your eyes/nose/mouth

Stock up on food, water, and other household necessities (i.e., standard prep for blizzard, earthquakes, or other natural disasters)

There is also recent research suggesting that Vitamin D may help strengthen your ability to fight off the flu. (The article doesn't specifically address swine flu, but my guess is that correcting any Vitamin D deficiency wouldn't hurt and would likely help against this new virus.)

[Note from DMH: As I've mentioned before -- here and here and here -- most Americans are deficient in vitamin D. For example, a recent study showed that 72% of men over 65 are deficient using 30 ng/ml as the cutoff. From what I've read, levels should be over 60 ng/ml. For some people, that can require thousands of IU supplementation per day.]

So don't panic, keep informed, and stay tuned for updates!

(BBC link via Instapundit.)

Cross-posted from Metablog

[D'kian]

Mexico has arguably been teetering on the edge of being a "failed state" for a few years now.

Arguably is the key word. As a Mexican citizen I can tell you it doesn't seem as though government is about to loose control of the country. If anything there's way too much government control. The drug cartels are bad, yes, but they ar emade up of mostly smart criminals. meaning they go after each other and after the government, they don't go after the general population.

If a flu pandemic causes the central government to lose effective control over the country, will we see a flood of desperate illegal immigrants seeking to cross into the US to escape the problems in Mexico? And given that some of those people may be infected, how will the US respond?

You'd first have to see something out of the Dark Ages, specifically the black death complete with people dropping dead in large numbers every day. Short of that, the flu epidemic won't amount to much as far as internal politics go. I'm willing to bet it won't even be a feature in the upcoming mide-term election (and will be forgotten by 2012).

It's worth mentioning most people believe the government is lying. A few say there's no swine flu and it's all a ploy to distrct the public's attention (some said that about a volcanic exhalation, even as ash rained over the city). More believe the number of cases and deaths is much higher, bu the government pretends it's less in order to prevent panic; this after schools, restaurants, bars, movie theaters and many other places ahve been closed down. Most believe there are more cases and deaths, but not that many more (a general bleif that the government lies on principle), plsu that the response was slow.

Most people are being cautious. I caught a cold a few days before the epidemic was announced. Once the early panic set in, my co-workers, boss and family wanted to rush me to a hospital (I had none of the other symptoms like fever, headache, joint pain, lethargy or loss of appetite; a doctor confirmed it was merely the common cold). On the streets about 80% of all people wear surgical masks. I hope they're washing their hands often, too, as that is the best defense against infection. Mostly people are staying home, as can be judged by the lack of traffic.

This all means the outbreak will burn itself out in a few days. Right now I'd say the worse place to be is a hospital, especially one of the overcrowded government hospitals.

[K-Mac]

I noticed the last time I was in my allergist's office, they had signs by the sinks that said studies have shown that hand washing is not very effective, and most people do it wrong, so they had alcohol-based hand sanitizer at each sink (as well as soap.) The nurses and doctors were using that before and after each patient.

My husband stayed home from work today with something. Doesn't seem flu-like, seems more like bad spring allergies, so we're not freaking out or anything, but I did buy some hand sanitizer last night (which they were nearly out of) for us to keep at home and the office. It's cheap and I figure it can't hurt anything.

[D'kian]

I noticed the last time I was in my allergist's office, they had signs by the sinks that said studies have shown that hand washing is not very effective, and most people do it wrong,

Well, it's not rocket science Simply put: wash both sides of each hand, scrub vigourously, make sure you wash between the fingers, and keep it up for thirty seconds or so. Rinse thoroughly, dry completely (don't leave any damp, even if it means taking another paper towel).

so they had alcohol-based hand sanitizer at each sink (as well as soap.) The nurses and doctors were using that before and after each patient.

I've seen that at many hospitals. Since medical personnel wash their hands before and after dealing with each patient, the alcohol gel is more convenient than soap, water and paper towel. Since I am in charge of the petty cash at the office and must count money sometimes several times a day, I keep some gel at my desk at all times. it's more convenient than getting up to the bathroom several times a day.

My husband stayed home from work today with something. Doesn't seem flu-like, seems more like bad spring allergies, so we're not freaking out or anything, but I did buy some hand sanitizer last night (which they were nearly out of) for us to keep at home and the office. It's cheap and I figure it can't hurt anything.

It will dry your hands something fierce. So buy some hand lotion or hydrating cream. Water dissolves in alcohol, rather than the other way around. So it tends to suck up moisture from your hands each time you use it.

[K-Mac]

Well, it's not rocket science

Neither is driving, but a lot of people suck at that too!

It will dry your hands something fierce.

I found some sanitizer that has aloe in it and it doesn't seem to be as bad as some others I've used. Washing your hands thoroughly and properly several times per day will dry your hands out as well. Of course, I'm in Colorado, so you have to use lotion all the time anyway.

[D'kian]

I found some sanitizer that has aloe in it and it doesn't seem to be as bad as some others I've used.

I use one like that, too. It's better than most, but it still dries you up.

Washing your hands thoroughly and properly several times per day will dry your hands out as well.

Not as much. And moisturizers on soap do work.

Of course, I'm in Colorado, so you have to use lotion all the time anyway.

How high? I'm in Mexico City at 2,200 meters above sea level.

BTW the reason washing one's hands helps prevent contagion is this:

The virus for the flu (of all kinds) and common cold travels from the body in tiny droplets of fluid. You can inhale them and get sick, but it's not very likely to happen out in the open or even in a large room if only a few people are infected (it's more likley in enclosed spaces like the subway, elevators, etc). Anyway, these droplets eventually settle on some surface. The fluid evaporates but leaves the virus particles behind. So any surface you touch is potentially contaminated that way. Next when you rub your eye, or eat, or touch your mouth, you let the virus into your system and you're infected. Washing your hands kills the virus you may have picked up.

As to vitamin D defficiency, that's a consequence of another healthy habit: keeping sunlight away from the skin. Excessive exposure to sunlight can cause skin cancer and prematurely ages skin, but staying away from sunlight results in lower levels of vitamin D. This vitamin is produced through a photochemical reaction, therefore you need some sunlight every day (about 15 minutes if you expose all your body, more if you're covered. I habitually drive with my sleeves rolled up, or wear short sleeves, in order to get some more sunlight (I spend most of my time indoors anyway). Milk and dairy are good source of vitamin D, especially if they are fortified with it (lots of milk on the market is).

Traditionally vitamin C is recommended to fight off flu and the common cold. I eat citrus fruit or drink citrus juice almost daily, so I'm certain I don't suffer from any vitamin C defficiency. I've no idea if it helps at all to get better sooner or to ward off colds.

[dianahsieh]

As to vitamin D defficiency, that's a consequence of another healthy habit: keeping sunlight away from the skin. Excessive exposure to sunlight can cause skin cancer and prematurely ages skin, but staying away from sunlight results in lower levels of vitamin D. This vitamin is produced through a photochemical reaction, therefore you need some sunlight every day (about 15 minutes if you expose all your body, more if you're covered. I habitually drive with my sleeves rolled up, or wear short sleeves, in order to get some more sunlight (I spend most of my time indoors anyway). Milk and dairy are good source of vitamin D, especially if they are fortified with it (lots of milk on the market is).

Unfortunately, that's mostly wrong.

(1) People over 40 often lose the ability to synthesize vitamin D from sunlight. People in northern climates often can't get enough sunlight.

(2) The amount of D in milk is negligible. The most reliable source of vitamin D is oil capsules.

More generally, you must get your blood levels tested to determine whether you are deficient in vitamin D or not. (Most people are deficient.) And if you're deficient, you'll need to take well more than the government's recommended daily allowance.

For more details, see this post by cardiologist Dr. Davis: Dangerous mis-information on vitamin D. He's treated thousands of patients with vitamin D, often with amazing results. He knows his stuff.

[gags]

I found some sanitizer that has aloe in it and it doesn't seem to be as bad as some others I've used. Washing your hands thoroughly and properly several times per day will dry your hands out as well.

Make sure you don't buy the cheap hand sanitizer found in dollar stores. They say that it needs to contain at least 60 percent alcohol to be effective.

http://www.nytimes.com/2006/03/21/health/21cons.html

[D'kian]

Unfortunately, that's mostly wrong.

(1) People over 40 often lose the ability to synthesize vitamin D from sunlight.

I didn't know that.

People in northern climates often can't get enough sunlight.

That's mostly seasonal. In winter there's less hours of sunlight available and is often cloudy. In summer in central Mexico it's the rainy season and, while there are more hours of sunlight, it's cloudy almost daily all day long. So in most places you'll face a sunlight deficit part of the year.

(2) The amount of D in milk is negligible. The most reliable source of vitamin D is oil capsules.

I'm looking that up. Thanks.

[K-Mac]

I'm around 5500 feet. The humidity is extremely low here most of the time, so I've probably used more lotion since moving to CO nearly three years ago than I've used my entire life.

[D'kian]

I'm around 5500 feet. The humidity is extremely low here most of the time, so I've probably used more lotion since moving to CO nearly three years ago than I've used my entire life.

That's about 400 meters lower than Mexico, say about a quarter mile.

[Steve D'Ippolito]

Hmmm, I thought you were higher than that, K. By my quick back of the envelope calc, Mexico City is at about 7330 feet, which means it blows me out of the water too (6880). And here I thought I was the O-ist above the rest.

[D'kian]

Hmmm, I thought you were higher than that, K. By my quick back of the envelope calc, Mexico City is at about 7330 feet, which means it blows me out of the water too (6880). And here I thought I was the O-ist above the rest.

We've officially drifted way off the thread topic.

Yes, the Rockies aren't as high as people think. Funny thing is you hear a lot more about altitude problems in the Rockies than in higher places like Mexico, Toluca or parts of Colombia and South America (there are cities above 3,000 meters there).

So, could the altitude help or hinder the spread of swine flu virus? I've no idea. Thus far all I know is Mex City would have a lot less pleasant weather if it weren't so high. As it is the elevation limits high temperatures and makes for colder winters than would otherwise be the case (still no snow, though). But temps ahve been rather high this Spring, so the swine flu doesn't appear to need a colder climate like the common cold virus.

The number of new cases appears to have reached a plateau, but not a peak. Restaurants are closed, but street side stands are not (not most of them). People are upset, and with good reason: ots of people eat lunch out during the weekday. Now it's harder to find food. Take out places are still open, and even restaurants can provide food to go (some are doing that).

Schools are closed, too, along with movie theaters, bars, night clubs, gymnasiums, swiming pools, etc etc. Just about any place people gather is closed. The idea is to prevent a lot of close contact and thus limit infection. On the other hand, government hospitals (and that's an administrative mess of competing jurisdictions, and fodder for a thread of its own) are still crowded. Now, I don't suggest hospitals close down, but I hope they're taking measures to prevent infections. After all the places where most sick people will gather are hospitals, along with a lot of uninfected people.

The subways and public transit are still open, naturally. If they closed the city would grind to a halt. But traffic is still light. Lots of people are staying home.

[sanjavalen]

http://www.smh.com.au/world/only-7-swine-f...90429-aml1.html

A member of the World Health Organisation (WHO) has dismissed claims that more than 150 people have died from swine flu, saying it has officially recorded only seven deaths around the world.

Vivienne Allan, from WHO's patient safety program, said the body had confirmed that worldwide there had been just seven deaths - all in Mexico - and 79 confirmed cases of the disease.

Just FYI. Take it for what its worth.

[DavidOdden]

That's mostly seasonal.

In a population-density sense, yes, but as you move far enough north UV intensity can't become high enough. This affects a low percentage of the world population, but affects those individuals significantly.

[D'kian]

http://www.smh.com.au/world/only-7-swine-f...90429-aml1.html

They've been mentioning that report on the radio, too. Comentators are already saying the government doesn't know anything about anything anyway, or words to that effect. There are some conspiracy theories making the rounds already, all the spectrum from "they're hiding the truth," to "they made the whole thing up," to "they did it on purpose." Of course the next great conspiracy theory that has any basis in fact will be the first.

David, as I understand UV light is more or less the same wherever the sun shines. I don't know this is so, mind, but I do recall getting sunburned up in Ontario during the summer. So do you mean the Arctic Circle, Scandinavia, Alaska or what? Skin color also has something to do with it, as darker skin blocks off sunlight both visible and UV.

[SD26]

They've been mentioning that report on the radio, too. Comentators are already saying the government doesn't know anything about anything anyway, or words to that effect. There are some conspiracy theories making the rounds already, all the spectrum from "they're hiding the truth," to "they made the whole thing up," to "they did it on purpose." Of course the next great conspiracy theory that has any basis in fact will be the first.

Thank you so much for the local perspective.

[Grames]

David, as I understand UV light is more or less the same wherever the sun shines. I don't know this is so, mind, but I do recall getting sunburned up in Ontario during the summer. So do you mean the Arctic Circle, Scandinavia, Alaska or what? Skin color also has something to do with it, as darker skin blocks off sunlight both visible and UV.

The reason the sky is blue is that the air preferentially scatters the blue and UV end of the spectrum over the red. This is the same reason sunrises and sunsets are reddish, the red light is transmitted relatively unobstructed compared to the blue light, which by scattering paths illuminates the rest of the sky. The low angle at sunrise and sunset causes sunlight to travel through a greater thickness of air, enhancing the effect compared to the noonday sunlight. Being at a high latitude (above the artic circle) which creates the same geometry of a noonday sun low in the sky has the same effect that attenuates UV.

[DavidOdden]

David, as I understand UV light is more or less the same wherever the sun shines.

One way to test this is to stand out in the noon sun for 2 hours in the Arctic and on the Equator on a cloudless summer day -- I've done both. I have never managed to get a hint of a tan in Tromsø, but I managed to peel skin in Tanzania. This is actually why Scandinavians are so fair-skinned -- otherwise they would have died out from vitamin D deficiency.

[K-Mac]

We have no problems with strong UV rays or enough sunshine here. The Front Range area of Colorado gets more than 300 days of sunshine per year and you better have on some sunscreen or you're toast!

[Capitalism Forever]

Mass. Senate approves pandemic flu prep bill

The new Senate version would allow the public health commissioner — in a public health emergency — to close or evacuate buildings, enter private property for investigations, and quarantine individuals.

(Emphasis mine)

Kind of makes you wonder how they define a public health emergency...

[gags]

If you're behind on paying your taxes, that's a public health emergency.

[K-Mac]

I suppose that would be true with socialized medicine.

[RussK]

Maybe I'm just being naive, but I'm not the least concerned about this Flu. D'kain, how many people in Mexico die annually from 'human flu'? One of the reasons for my lack of concern is the CDC's data, which they released a couple of days ago, showing that some 36,000 died last year in the U.S. from the flu; however, there have been very few infections (100?) and no deaths yet from swine flu.

[K-Mac]

I'm not particularly worried or freaking out; however, the advice being given to prevent infection is every-day type preventative measures, so it's not a big deal to take precautions.

Personally, I find strains like this more scary because they kill healthy people in their 20s and 30s. The flu that normally kills thousands each winter, is killing those with weakened immune systems, the young, the elderly, the already sick, etc. Since I'm 30-something and have not had the flu, I'm not as concerned with the normal bug that goes around every winter. I am more concerned about a rare strain that kills people like me.