Recent events have fueled the belief that the situation is getting out of hand. Panic is certainly spreading among the general public as the number of fatalities rises. The information about H1N1 can sometimes be conflicting even to the medical fraternity. The goal posts are often shifted as the situation evolves.
Many experts believe that H1N1 is a less virulent strain as compared to the H5N1 or the bird flu. However, the former has the ability for human to human transmission which obviously have accelerated the spread globally. When more and more individuals contract the disease, the case fatality rate is bound to increase. Notably patients with co-morbidities, at extremes of ages and now obesity appears to be at risk for developing complications which may be fatal.
Seasonal human viral influenza infection has been making its rounds for a long time. Despite recent statements by our honorable health minister, it does not resolve in 2-3 days time. It must be differentiated from the common cold, which is also an air borne viral disease. It will usually also take about a week to completely recover. Thus doctors cannot tell if someone has H1N1 or not, especially so now that local transmission is increasing. Keeping track of contacts is no longer feasible.
So the perennial question now is, do we test for H1N1 for everyone who comes in with a flu like symptom or to anyone who requests for such a test?
The stresses on frontline healthcare workers must be immense. The situation is not abating with an increasingly agitated and worried public. With the high number of patients presenting to hospitals, deciphering the clues to alert the doctor of a potentially problematic case can be challenging. For someone who is well enough to barge into a press conference, the doctor probably saw it fit not to pursue testing with little evidence of contact. It is important at this juncture to preserve our limited resources.
The actions of the Health Minister in undermining the team that he represents only escalates the tension among the public and cements their belief that the situation is not under control. Having the flu for more than a week may indicate other coexisting pathologies. Her clinical condition may also not warrant testing. Unfortunately our DG and Health Minister has taken the bait dangled by a panic stricken patient.
Antiviral treatment is also not the answer to H1N1. Already resistance has been reported. Using it judiciously will delay the spread of resistant strains of the virus. Our only salvation now is for mass vaccination programmes once a vaccine becomes available.