FINDING A proper balance between medical preparedness, timely action and public fear is a difficult task when health authorities face a rapidly emerging and potentially fatal disease. So far the World Health Organisation and most national authorities, including Ireland, have handled the Mexican swine influenza emergency in a responsible fashion.
Planning is well advanced, setting out clear stages of required response. News of the first probable Irish case of the disease confirms medical advice that this was a case of when not whether, given the number of Irish people who have recently visited Mexico and other infected countries.
Those criticising the swift scaling up of warnings by the WHO underestimate the possible risks and the need to mobilise all the actors concerned. Media frenzy is a separate though related issue. The WHO decision to move the warning to the second highest alert about an imminent pandemic was taken in response to just such an assessment of risk and according to established criteria that the disease is active in two or more jurisdictions. It needs to ensure every member state activates an emergency response plan, that pharmaceutical companies redouble their efforts to create an anti-viral drug and that precautionary measures are taken about air travel, quarantining victims, activating medical procedures and stockpiling medicines. Much of this action is precautionary, but in a setting of exceedingly rapid change. It is driven – and validly so – by a belief that it is better to be prepared than to be found wanting after a possible major outbreak.
If that does happen previous experience suggests large numbers of people could be affected. Much about this virus is as yet unknown, even though it is related to previous strains. What we do know leads experts to explain that it is containable by timely action, but that certain groups are much more vulnerable than others. The origins of the disease in a genetic crossover between birds, pigs and humans near a highly intensive pig factory in Veracruz, Mexico, is yet another warning that such industrialised systems of food production in the midst of gross poverty are dangerous in the extreme. Avian influenza had a similar origin in Thailand and southeast Asia some years ago.
In Ireland preparation has been stepped up greatly since the avian flu emergency. There are ample stockpiles of relevant medicines and a well-rehearsed catalogue of necessary actions. It is one thing to have a plan, of course, quite another to execute it. If few military plans survive contact with the enemy, a serious outbreak of this disease would force hard choices on medical authorities and stretch existing resources to the limit.
In a media saturated age medical planning must factor in likely panic by publicity. The best antidote to that is a policy of maximum openness about threats and cautionary measures. It makes better sense in such circumstances to publicise rather than disguise the extent and numbers of suspected cases. Media have a clear responsibility to respect a balance between threat and action.