Since the World Health Organization declared a worldwide pandemic in early June for the first time in 41 years, news about swine flu has slowly lost momentum. Now, with students going back to school in the northern hemisphere, and with fall on the way, experts are preparing for the worst as scientists try to predict exactly how bad it will be.
The response so far is that no one can answer the most important questions regarding swine flu, such as the number of people likely to be infected and the number that will die because of it. Also, while vaccines are being created -- Australia is set to be the first to start wide scale vaccinations next month -- it isn't clear who should be vaccinated and how many vaccinations are required for each person.
All of these unknowns make it difficult to determine the best course of action for governments. Hindsight will either have us looking at money spent on the disease that wasn't or at many more deaths than a normal flu strain. No matter the outcome, the facts of swine flu mean that Canada needs to carefully consider its response to the outbreak as it unfolds. Ultimately, the worldwide problem demands a solution that goes beyond our borders.
There can be little doubt that factory farms are culpable for the swine flu outbreak. The elephant in the room turned out to be 20,000 pigs placed in a small pen and, despite the best efforts of many to brand swine flu as H1N1 to avoid the obvious, the former name has stuck.
Nothing particular about Mexico made the outbreak inevitable, and countries that didn't place trade bans on Mexico were in the right. The bigger point is that meat production in this manner has long been known as an epidemiological nightmare: swine flu just so happens to harm humans more severely than mad cow disease and others.
Another obvious fact about disease prevention is that diseases tend not to restrict themselves to political borders. The rate of transmission of swine flu, which follows a speed similar to the SARS outbreak, means it is not sufficient for developed countries to restrict their efforts to within their own borders. There is little good in developing a costly vaccine if it will soon become ineffective due to mutations occurring elsewhere.
It is an ethical and pragmatic imperative, then, to help supply developing nations that can't afford vaccines with the money to buy them. The pharmaceutical companies SanofiAventis and GlaxoSmithKline Inc. have both agreed to donate at least 150 million doses of the vaccine to developing countries. Canada, the United States and the European Union should also commit to donating vaccines if demand requires it; if anything like the worst case scenarios predicted do occur, the financial costs will be much less than what the health systems will incur, to say nothing of the loss of lives.
The New York Times reports that swine flu infections are 20 times more common in people 5-to-24-years-old than those 65 years of age. This means that there are real risks to those who attend primary, secondary or post-secondary schools -- many of whom typically shrug off flu symptoms and avoid vaccines. Inevitably, the balance will be between giving the first vaccines to those most at risk before flu season hits without causing alarm that will burden the healthcare system even more. Canada's supply isn't set to arrive until mid-November, so this balance will be paramount to limiting problems. By keeping the focus on those with the most need, the ethically untenable position of letting those with more money survive can be avoided.