Juan Antonio Sarmiento’s Blog

Suddenly, so many countries are reporting Influenza AH1N1 cases, and each case aparently has it’s origins in a recent travel to Mexico. I have my doubts.

The illness becomes symptomatic in the first 24 to 48 hours of exposure and, without any treatment, it can be serious at day 7, deadly by day 9. Usually, the ill person, receiving Tamiflu, is fine at day 9 – (source WHO). Now, 20 days after the outbreak alarm, Mexico is almost completely empty of tourists, visitors or international travelers. So:

1. How all those new cases – 20 days after the outbreak – did catch the virus in Mexico, sometimes three or four weeks after their departure? 
2. How is it possible for a person to catch the virus in Mexico, and start to be symptomatic two weeks later, for instance in Argentina or Cuba?

The answer – I think – is fear.
It seems like some countries in the world were hiding their cases, driven by the fear that they could get in trouble and economic stress, just like Mexico did.

As soon as Mexico confirmed this illness was due to a new strain of virus, many voices started to blame on Mexico, as if Mexico produced it, or as if there were no cases going on already, all over the world.

And some politicians took this opportunity to raise popularity inside, taking useless measures like cancelling flights, or even worse, taking only Mexican travelers into quarantine, as if this virus were only meant to infect Mexicans. (If that were the case, what is the point in taking only Mexicans into quarantine, being for instance, Chinese?).

But there are some dangerous implications:

1. Mexico has been honest about this illness, or at least, was the first country to send the alarm. If you travel to one of those countries that have adopted “anti-Mexican” measures, you would not be so sure. Their overreaction on Influenza A sounds more like a “don’t look at me” attitude, than like a real protection measure. All that paraphernalia around quarantines, were just intended to hide the obvious: They had it already and didn’t say a word. They are hiding it. So, as a traveler, I would prefer to go to Mexico, USA or Canada now, than to all those countries, in which I am in great risk, because their lack of transparency.

For instance, Cuba announced yesterday they had their first Influenza AH1N1 case, (and very conveniently, it was a Mexican student). But according to their own reports, the student returned to the Island the last days of April (at last, by April 26th), with an Influenza-Like Ilness.

The Oficial Report was released yesterday (May, 11th – you can read it at Granma Online – the Cuban Government Owned Newspaper). I mean, they released the report 15 days after Cuba suspended all flights to or from Mexico, so, either the student is already healed, or he is death. Or even worse, he doesn’t exist, and the Cuban Health System is trying to “make wood out of the fallen tree”, faking this case, just to preserve the Cuban bizarre tourism industry, or to use this bad situation that affects everybody, to politically damage Felipe Calderon in favor of the left, in this Congressional elections year in Mexico.

2. Some day in the future, for sure, H1N1 virus will mutate into a more deadly form – recombining with the Avian Flu. It will start somewhere, in some country. Do you think the country in question will “push the button” and send an alarm to the world? Based on the Mexican experience, and some international reactions, I think not.

So, every country is at great risk.

3. This epidemic has shown to the world the real agenda behind some countries and politicians. Cuba, China, Argentina, Ecuador, and some other countries are obviously looking forward to close all frontiers and stop international commerce, except their own.

4. All other countries have to review their international detection and response system, regarding health. How in the world, WHO staff has to know first the statistics, leaving the national governments last in line to address the situation?

I think both entities should be simultaneously informed. During the peak of the alert in Mexico City, WHO released information before Mexican Heealth Authorities, at least twice) causing scepticism among citizens, regarding how well their authorities were addressing the situation. 

More over, Periodico Reforma (a Mexican Newspaper) published an article, quoting declarations from Dr. Michel Ryan (WHO top authority regarding epidemic control). Dr. Ryan declared Mexican Authorities didn’t pay attention to previous reports. 

We are talking about a pandemic risk. It is not enough to publish reports online, waiting for someone to read it, and hoping the reader is a Health Authority in other country. There should be a more close communication system, with conferences, emails, twittering, IM and a whole real-time network. How often a laboratorist from Canada sends and get’s confirmation from Mexican Authorities?

5. We are now aware that there is a lack of communication skills among global scientific community and health authorities including Mexican Ministry of Health, and as this crisis has shown the world, it is a top skill needed. Health authorities have to realize that common citizens have no knowledge whatsoever on medical terms; therefore, keeping things simple is crucial. The activation of an alert system is, deep down, a mere act of communication.

More and more implications out of this crisis are there. Just think about it.