Pandemics and Politics

At the time of writing, almost a week after we all learned that a lethal new strain of influenza had appeared in Mexico, every single death attributed to swine flu has been Mexican, and all but one of those deaths happened in Mexico itself. (The one exception was a Mexican toddler visiting Texas with his family.) The media work themselves into a frenzy about how this may be a pandemic that kills tens or hundreds of millions of people around the world. Even with a prescription, you can no longer buy Tamiflu or Relenza, the leading antivirals that could lessen the impact of swine flu: in most countries, governments requisitioned the entire available supply last weekend. And yet air travel between Mexico and the rest of the world continues unhindered. Our elders and betters assure us that a travel ban would not help. The World Health Organisation’s assistant director-general, Keiji Fukuda, tells us that trying to contain the virus by enforcing travel restrictions “is not a feasible option.” Besides, he says, “the virus has already spread to several other countries.” Texas governor Rick Perry says that closing the US border with Mexico, crossed by tens of thousands each day, would be “a little premature.” Am I alone in experiencing a desire to strangle these people? To begin with, Rick, you either close the US border now, or you don’t bother. Closing it a week from now would be completely pointless. If human-to-human transmission of the virus has not already taken root in the United States, it will certainly have done so once another few hundred thousand people have crossed the border. Obviously, people from other countries who are currently holidaying in Mexico (overwhelmingly Americans and Canadians) must be allowed to come home, but would it be unreasonable to monitor their health for a week or so in case they are carrying the virus? Indeed, shouldn’t we stop further holiday-makers from travelling to Mexico and ask Mexicans to stay home for a while? It would cause inconvenience, yes, but large numbers of lives are at stake here. It may be too late to stop the spread of the virus by banning non-emergency travel to and from Mexico, but nobody knows that for sure. The virus has already appeared in a dozen other countries, but at this point almost all the victims are still people who were recently in Mexico. If the flow of further people from Mexico dwindled rapidly as the remaining tourists and business travellers came home, there would still be a chance of containing the virus. If this “swine flu” really is like the “Spanish influenza” virus that killed tens of millions of healthy young adults in 1918-19, then we should be doing everything possible to hold it at bay. And even if the virus is bound to get out of Mexico in the end, it’s worth winning some time before it does. It is spring across the northern hemisphere, where most of the world’s people live, and flu typically goes into retreat in the spring and summer. Even if it comes back in the northern autumn -- and pandemic flu often comes in several waves some months apart, becoming more virulent in the later waves -- by then we might have a vaccine ready. The process of designing and mass-producing the vaccine takes four to six months, which is exactly what immediate and severe restrictions on travel to Mexico now might win us. So why do government bureaucrats everywhere, together with the international civil servants of the World Health Organisation, assure us in massed chorus that travel bans are futile? Because they work for governments whose economies could be severely damaged by those bans. Governments do accept a certain responsibility for protecting the lives of their citizens, but even in the developed world, where resources are not scarce, they interpret that responsibility quite differently. Britain and France have stock-piled antiviral medicines like Tamiflu for 50 percent of their citizens (and Britain is now going to over 80 percent). Japan, Australia and New Zealand are all over 40 percent, but the United States only has 25 percent cover and Canada a mere 17 percent. The biggest difference, however, is between the vague, general responsibility that governments feel for the lives of their citizens and the acute, real-time responsibility they feel for the health of their economies. They are inundated daily by demands from commercial and industrial organisations to keep the borders open and commerce flowing. They are NOT inundated by demands by powerful citizen organisations to impose travel bans and save lives. So they yield to the greater pressure, as governments generally do. At the extreme, they conspire to hide the disease altogether, as China did with SARS (and Mexico may have done for some time with swine flu). And they lie routinely about the usefulness of stopping travel from infected countries, because to do so would gum up international commerce and damage economies. The less reflective ones may not even realise any more that they are lying, because within WHO and the various national governments it has become an article of faith that you can’t contain pandemics once they move beyond the first few villages. But that is quite obviously bullshit. Bullshit that could kill your kids. Ends