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We don’t know yet how bad this outbreak of swine flu is going to get. At worst, it could turn into a full-fledged pandemic. At best, the outbreak could burn out in the USA with a domestic tally not much larger than the 200 mostly mild cases suspected or confirmed as of Monday.
Much of this is up to the nature of the virus itself. But for insight on how the situation should be handled, the nation’s last encounter with swine flu is instructive. It was a fiasco.
(In San Francisco: Belia Salgado exits customs after flying back from Mexico City on Monday./ Ben Margot, AP)
In 1976, a single death from swine flu in New Jersey and fears that the disease might have spread sent the government into overdrive. Almost overnight, it created a program to vaccinate all Americans. But the feared epidemic never materialized. The vaccine, it appears, turned out to be deadlier than the disease.
As for the current outbreak, the facts so far present a puzzling contrast between Mexico (where as of Monday 1,995 suspected cases had resulted in hospitalization since mid-September and 149 had died, many of them young adults) and the U.S. (where no one had died and only one case had required hospitalization).
To put those numbers in context, about 36,000 Americans die each year from complications of flu, and more than 200,000 get sick enough to be hospitalized.
The 1976 experience demonstrates why it’s necessary to avoid hysteria. The outbreak began with a handful of cases at a New Jersey army base, where one new recruit had respiratory symptoms, collapsed and died of pneumonia. Tests showed that he and others at Fort Dix were infected with a flu strain health officials believed had not been seen for 50 years. It appeared to resemble the virus that had caused the infamous 1918 flu pandemic, which killed millions worldwide.
The government moved with too much speed and too little thought. President Ford pledged that the government would vaccinate “every man, woman and child” in the USA. In October, the program began, and nearly 45 million Americans were vaccinated. Within weeks, though, the program was suspended. Those vaccinated were getting sick, but not from influenza.
All told, more than 500 of those vaccinated got a rare neurological illness, Guillain-Barre; dozens died. It was a medical and political debacle, one that spawned fears of flu vaccinations lingering to today.
The strain of the current virus might be entirely different, so the lesson of history should not tie the hands of officials today, but it should set the tone for a calm, measured reaction that involves preparations for the worst but avoids stirring panic. On Monday at least, that appeared to be the case.
President Obama said there was reason for a “heightened state of alert,” but not a cause for alarm. The government released 25% of its anti-flu drugs to the states. Public health officials urged simple precautions: Wash your hands frequently. Stay home if you’re sick. Close schools if there’s a flu outbreak.
Such actions are effective, particularly at a time when there are still many unanswered questions. For instance, can states and communities quickly distribute the drugs the federal government is releasing to them? Most urgently, why have so many young adults — who usually fare well in flu outbreaks compared with infants and the elderly — died in Mexico? Troublingly, the same thing happened in 1918.
Until the answers are known, the best medicine has already been prescribed: smart preparation and a big dose of caution.
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