Wednesday, August 12, 2009

Swine Virus and the Government Response

Me And The Swine Virus

No, I am not infected – yet. This is a brief insight on swine virus pandemic on Brazil and the government response.

I am in Brazil for 2 weeks now. It´s my vacation, time to see my family, specially in my little girl – Luisa (10 years old). It happened that part of my family (my mother) lives in one of the most swine flu affected cities in Brazil (Passo Fundo – state of Rio Grande do Sul). I had to decide if I´ll go there or not. This winter has been specially cold and it was below zero at Passo Fundo, but I decided to go. Bringing my daughter with me.

People there – my family included – was specially concerned about the flu. Passo Fundo had 5 deaths by swine flu in the first week of August. Even local newspapers stopped to notice flu death cases.

I took some precautions there: I rented a car to go (avoiding go by bus) and, once there, I stayed at home as much as possible. Thanks God, everything went fine.

Two questions arose:

Why my state, Rio Grande do Sul, was so affected by the flu, with averages much ahead of Brazil´s and even ahead of many other countries´ averages?

Brazil´s measures against the virus are adequate?

Trying to elucidate the first question, let me put out some information.

Rio Grande do Sul State, by Monday, 10 th August, had 44 death cases (now, Wednesday, there are 50 deaths). It is 0,4 death cases by 100k people. It´s is higher than Mexico, with 0,13. A local newspaper made a report on the subject ( read here).

Rio Grande do Sul is the southern state of Brazil, has borders with Uruguay and Argentina, which is on the way to be t he country most affected by the swine flu worldwide. The other fact is that we are in the middle of the winter and RS (Rio Grande do Sul abbreviation) has the most severe winter in Brazil. It is common to have below zero temperatures and even snows here.

Winter time is the perfect environment to the swine flu to spread. Specialist say that below 10 Celsius the virus can survive for more that 10 hours in the open. It may explain why Rio Grande do Sul state and Argentina are being affected: the weather.

RS and Argentina have much in common with European and US winter, so they must be prepared for swine flu. The situation could be worse by then.

But only the weather does not explain it. In Brazil at least, the long arm of government made it possible Why?

The medicine tamiflu was seized from all drugstores by the government by the excuse that the misuse could make the virus stronger. Tamiflu is only sold with a doctor´s recipe so this was not an excuse, at all.

Other government – by the health ministry – measures was to only give tamiflu for the people which was really with the virus or if they are in a risk group (pregnant, children). The problem is that the medicine is only effective on the first 48 hours of the symptoms The lab tests asserting who was really infected are delivered only 15 days after the sample was collected. So these measures were useless.

Thank god, doctors at Passo Fundo hospital (São Vicente) started to ignore Health Ministry recommendations and gave tamiflu to all suspected to have swine flu. It made many people survive. But initially many officials consider to apply disciplinary action against SaoVicente Hospital board because they are not following the instructions. Many other hospitals around the country followed São Vicente and could save many lives too.

I believe that none central government can replace the doctor authority on what is the best for his patients.

On this issue, you can read an opinion by a Brazilian doctor here: