Honestly, I don’t have the exact answer. Only time will tell whether we, the citizens of Pune (and India) over-reacted, or should have done a lot more. All we have right now are statistics, data-points, examples from other regions of the world, and expert advisories to look at and learn from.
In this article, I am listing out the various relevant factoids, observations and information resources that I have stumbled upon over the past few days. I will let the readers draw their own conclusions.
What is painfully clear though is that we don’t have enough data, and we often don’t rely on credible sources of information. In absence of data and facts, the common population is always swayed by ‘headlines’ and ‘sound bites’ – Sadly, this is true even in the 21st century. Thanks to the latest technology, data can be accessed easily; yet this same technology can also help in spreading rumors a lot faster as well.
Here are some factoids and observations:
1. According to WHO and other estimates, there are nearly 1 Billion cases of normal flu (influenza) each year. Around 3-5 Million of these are severe and 300,000 – 500,000 of these result in deaths.
Statistically speaking (based on a simple extrapolation that India’s population is apprx 1/5 of World Population) that translates to 200 M cases, 600,000 – 1 M severe cases, and 60,000 – 100,000 deaths.
For a city of Pune, that translates to 500 deaths/year or 10 deaths/week.
All these are huge numbers. And yet, until a few weeks back, we hardly even thought about ‘influenza’ as something serious!
2. On a related topic – Pollution levels in Pune and in all major Indian cities are at very dangerous levels. Yet very few perceived the need to wear masks over all these years. Do we know the statistics of upper respiratory problems in major Indian cities?
3. According to WHO (World Health Organization), the recommended mask to protect against H1N1 infections is the one that meets the N95 standard. Yet, these constitute a miniscule amount of the ones being worn around in Pune. The others don’t really offer any significant help. For a complete list of Do’s and Don’ts regarding masks – please refer to the next section.
4. Commonsense tells us that it is better to wear masks in crowded places; but they are not very critical when walking or driving on uncrowded, open roads. Yet, what we are seeing around in Pune is quite the opposite. It is also amazing to see so many people wearing masks that are covering their mouths, but not their noses?!
5. Last year, over 200 riders lost their lives in 2-Wheeler Accidents in Pune – many of these deaths could have been prevented had the riders been wearing helmets. Yet I see so many people on Pune roads today wearing masks but not helmets!
6. According to what I have read thus far, the H1N1 strain is not significantly more virulent than the traditional influenza virus. The prescribed treatments are also very similar to normal flu.
7. Most individuals who get infected with H1N1 will get back to normal in a few days (similar to the normal flu). This is not a virus like HIV that an individual will carry with him / her for the rest of their lives!
8. Apparently, a vast percentage (by some accounts, up to 90%) of the Indian population tests +ve on the skin test for TB (Tuberculosis). Majority of these tests yield a –ve result on a follow-up (and more reliable) X-Ray test. Disease causing germs (viruses and bacteria) are present everywhere – in most of the cases, the immune system should be able to take care of them! It is only when the immune system becomes weak (in case of old age, young children, patients suffering from certain chronic ailments, etc.) do these germs present any significant danger.
Here are some useful information sources:
1. Flu related statistics (from Roche Laboratories – makers of Tamiflu) http://www.flufacts.com/impact/statistics.aspx
2. Comprehensive Flue Related Information from US Dept of Health & Human Services and CDC (Center for Disease Control) www.flu.gov http://www.cdc.gov/h1n1flu/
3. Comprehensive Flue Related Information from WHO (World Health Organization) http://www.who.int/csr/disease/swineflu/en/
4. A map based depiction of Flu cases across the globe http://www.healthmap.org/en
5. WHO – FAQ about H1N1 http://www.who.int/csr/disease/swineflu/frequently_asked_questions/what/en/index.html
6. WHO – Document regarding use of masks http://www.who.int/csr/resources/publications/swineflu/masks_community/en/index.html
7. WHO – Document regarding cleaning hands as a key preventive measure http://www.who.int/csr/resources/publications/swineflu/AH1N1_clean_hands/en/index.html