It’s about four months when the first major outbreak of ‘Swine flu’ took place in Mexico, it was only a piece of news for the people in India; when (i.e. 11th June) the World Health Organization (WHO) announced it as a ‘pandemic’, we did pay some attention to it through the screening and scanning of the inward air-travelers at our international airports; and now, we are slowly and substantially slipping into its snare and scourge. With the flu-death-toll increasing day by day, tested-positive cases crossing thousands and lakhs of people carrying A(H1N1)symptoms across the country – now, at least psychologically, we are drawn to a situation where, we do not have an escape from the fear and anxiety that accompany the dreaded disease. In the face of this human-to-human transmission disease, India being highly populous is highly vulnerable and thus a “risk society”. It is feared that if it is not adequately checked, its spreading tentacles might reach every nook and cranny of our country.
Let’s see the gravity of the disease-menace. The WHO has a measure to categorize the epidemics and this is done in taking into consideration the possible effects of any disease on the population of the world as a whole. Accordingly, there is a six scale categorization of such diseases. To designate any disease as ‘pandemic’ has been the last and final one in the scale. And lo! The WHO has declared ‘Swine flu’ as ‘pandemic’ taking note of its potential threat to the humanity across the globe. Endorsing the WHO’s stand Dr. Norbert Bischofberger, an American who has invented Tamiflu, the only medication on the market to treat the swine flu virus has said, “I think the threat by new bacterial or viral agents is higher than the potential of a nuclear war.”
This kind of influenza pandemic is the first in this millennium and the fourth one since last century. It last appeared in 1968 as the Hong Kong influenza which killed approximately one million people. The last one was, however, the mildest than the other two i.e. the Spanish influenza (1918) and Asian influenza (1957) where the death toll was 40-50 million and 2 millions respectively. In case of the present one, though until now, the virus has remained mild, but still, it is spreading like wild fire leaving none – the developed nor the developing world. A developed country like Australia, as per the latest report, has 121 cases of death and more than 32,224 confirmed cases of infection; where as, a least developed country (LDC) like Nepal, the death toll has reached 22. It was reported that towards the end of June, the U.S. had over 27,000 confirmed cases and more than 130 fatalities. As per the WHO report it has killed almost 1,800 people worldwide within a week (August 8-15) and it is estimated that as many as 2 billion people (nearly one-third of the world's population) could become infected over the next two years. Another report of the WHO says, until August 13 there were about 182,166 laboratory confirmed cases of H1N1 and the death toll was about 1,799 deaths worldwide. The victims are the maximum from Mexico and the US. What adds to the woe is that the vaccine to contain it is either not developed or wherever it is invented it has not yet being tested in the human beings. Further, the bad news about the flu is that it would stay for a minimum of two years as apprehended by the experts. Another thing about the Swine flu is that normally, flu viruses disappear with warm weather, but are found to be resilient afterwards.
In India, within a very short period of its appearance, it has claimed an alarming number of 48 lives and has infected 2,539 persons. It opened its account of infection more than three months back and its first death victim was from Pune on 3rd August. Now one can imagine with what speed it has proceeded during these twenty days. In just 20 days 47 persons have been fallen its prey. The states where such deaths have occurred are Maharashtra, Karnataka, Gujarat, Tamil Nadu and Kerala. Two persons are also its victims from Delhi. Maharashtra has been the worst hit State by the A(H1N1)virus where 27 people have been died. The State has experienced a record number of six deaths in the last 24 hours. Next to it is Karnataka where it has claimed eleven lives. According to the health ministry of India, about 13,364 people have been tested so far out of which 2,539 tested positive for Influenza A(H1N1). Among the 141 new cases recorded recently 62 are from Pune, 19 from Bangalore, 12 from Delhi, 10 from Chennai, 7 from Ernakulam, 6 from Mumbai, 3 each from Nasik , Kolkata and Bhubaneswar, two each from Nanded, Nagpur and Srinagar and one each from Ahmednagar, Akola, Jalna, Kolhapur, Bijapur, Silchar, Kota, Jammu, Agra and Raipur. The above account shows that gradually it is spreading from metros to small towns and villages.
At present, in India, most of the cases seem to be mild. About 0.4 per cent of all the suspected cases are being tested positive and the casualties of the pandemic remain very less vis-à-vis the confirmed cases. However, it is the just the beginning of a devastating calamity.
The Central Government has been acting on war footing to contain this menace. It has issued preventive guidelines to all states. We have got sufficient Tamiflu (Oseltamivir Phosphate) capsules and some domestic pharma manufacturers such as Cipla, Ranbaxy, Hetero Drugs, Natco Pharma and Strides Arcolab have come forward to replenish the government supplies. Our government too has roped in the private health facilities to fight the deadly disease. At the instance of the Central Government, some Indian companies are also working on to develop the flu vaccine; however, the preparation of the vaccine would take over a period of minimum six months.
Today, what concerns our government the most is that there has been very less difference between the ordinary flu and Swine flu in the early stages. The symptoms of the A(H1N1)infection include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus have also reported diarrhea and vomiting. Sometimes the seasonal flu too bears the similar symptoms. This may causes panic among the people who would then rush to all the health facilities and there lies every possibility that the infection would spread to more people from the few real infected ones. Since our normal flu season (winter) begins after two to three months from now, it will be an uphill task to cater to the needs of a large number of apprehensive people who would rush for testing and diagnosis. Given the poor health care infrastructure in India this would pose a great challenge to the government in the days and months to come. It’s a fact that our underequipped and underfunded health system has been strained to contain the accelerated spread of swine flu.
Options are very limited. To resort to allopathic treatment has been the only solace. Some practitioners of Ayurveda, argue that remedy for disease lies in the traditional 'science of life' i.e. Ayurveda. They have advised that the intake of 20-25 middle sized fresh basil leaves (commonly known as Tulsi) twice a day on an empty stomach would serve as a deterrent to the disease. They see the anti-flu property of Tulsi which can do wonders. A dedicated homoeopath Dr. D.G. Nayak has suggested a clue to distinguish the seasonal flu from that of the pandemic. He argues that since there exists similar symptoms in both the flues therefore, initially a patient could be administered few doses (i.e. six globules twice in empty stomach for a week) of Influezium-200 or Ledum pal-200 according to the preliminary symptoms. If the patient does not show signs of improvement then the patient is advised to go for a swab test etc. However, for renowned yoga guru Baba Ramdev, ‘yoga’ is the only remedy for the disease. He has advised people to practice yoga( especially Kapalvatti) as a preventive measure against swine flu. According to him “People with strong immune system cannot be affected with swine flu.” To him, through yoga and pranayma, one can keep his/her immune system particularly the respiratory system strong.
Some countries like the UK, Australia and Russia are going to administer preventive vaccination to the highly risk group such as the pregnant women, the chronically ill and health workers. We have in India, a potentially vulnerable community in the rural areas who are poor and malnourished. They need special attention. However, for India preventive vaccination is a very very difficult option and proposition.
Some say that declaring a health emergency is another solution which could curb travel to and from affected countries. That may put an adverse impact on our external investment scenario. In any case, our governments must act quickly to educate the public, prepare their health systems to care for severe cases and protect those deemed more vulnerable to prevent unnecessary deaths. Being a thickly-populated country, especially the remote villages where the awareness regarding the flu and personal hygiene is very less, swine flu is likely to spread fast if no such concrete action is taken. The Union minister has rightly asked people having flu symptoms to take precautions and stay away from public places till their status of infection was clear. We must learn from the directives of the American health system that “those who get sick with the virus stay home unless they have signs of severe illness or fall in a high-risk group.” It is extremely relevant to India. If this is brought to the attention of all, the panic rush to hospitals will reduce, allowing doctors to treat those with severe affliction. Helplines and prompt response teams should be put in place immediately. Only awareness, preparedness and coordination can fight the enemy effectively. The public should be enlightened on the hospitals that treat swine flu and the laboratories that test the samples.
A concerted effort should be made by the health authorities and the government to check the spread of the epidemic by all means. Containment of the disease should be the key objective. It is necessary to establish testing and treatment facilities at strategic locations. It should set up free check-up centres and help-desks at bus stands, railway stations and markets. Awareness campaigns on the symptoms and preventive measures should be taken. Even the door-to-door campaigns like pulse polio immunization would be handy in dealing with the rural folk. The isolation wards needs to be established or created in each health centre to put the infected person into quarantine. Even private health facilities should be provided with Tamiflu capsules. Last but not the least, the doctors and paramedical staff should be given orientation training to handle the pandemic effectively.
Media too has a significant role to play in this ensuing human tragedy. It must be creative and constructive in disseminating information on the pandemic so that people will not be panic stricken. It must give more stress on how to prevent it, instead of giving coverage to the death-tolls. It must be more informative with regard to educating the people in facing the crisis bravely and patiently.
The period of a calamity is often regarded by some as an opportune moment for swindling. When the patients are scared one can infuse more anxiety and fear in them in order to extract some benefits by exploiting their panicky state of mind. That person may be a doctor, a vendor of medicines or a pathologist etc. It is a matter of concern that the private hospitals in Bangalore are reported to have seen goldmine in A (H1N1) screening. It has been reported that in Berhampur (a town in Orissa) some herbal preventive packs have been sold on a record margin on the pretext that it would work as a preventive. For many, it is reported, it seems to be the time to cash in. What is needed in these moments of such a crisis like a pandemic is nobility and honesty of character in the citizenry.
We, the commoners, too have some responsibilities in fighting swine flu. We need to observe hygiene and sanitation and should not throng the place out of curiosity where somebody is kept being affected by swine flu. We need to report to the designated centres regarding the infection of a person. We should not blow our noses or spit in public places. Unless people cooperate, no hospital and no government will be able to prevent epidemics. To conclude, we should never give up the hope that we can overcome this lethal influenza as we have succeeded in doing so in case of the diseases like Chicken Gunia, malaria and Surat plague in the past.
Dr. Anil Kumar Mohapatra is Head , Department of Political Science, Government Women’s College, Jeypore, Dist- Koraput (Orissa)-764001