Friday, 1 May 2009

Swine Flu - H1N1

Members of the Mexican Red Cross receive calls at the 065 emergency call center. These calls are forwarded to the ambulance service located in different strategic points of Mexico City. Jose Manuel Jiménez/IFRC

Today has been absolutely frantic drawing up a Business Continuity Plan for Swine Flu or H1N1, consulting with the UN and other partners, so we can support the Indonesian Red Cross carry on its essential services across the archipelago of Indonesia if this pandemic hits. Services such as blood transfusion, hospitals, clinics, ambulances, public awareness campaigns and emergency response teams are vital to keep running when the balloon goes up.

I was quite emotional when my two boys left for school this morning thinking that a cough or a sneeze from someone who is carrying the H1N1 virus, could leave them sick or dead in matter of days. I gave them another lesson on how to cover their mouths correctly when they cough (respiratorial etiquette) and other simple preventive measures. I instructed Naila my wife to buy four weeks food, buy water and gas.

Avian Flu has killed over 120 people in Indonesia so the country has quite a high level of preparedness, but with a human to human pandemic of Swine Flu, extra precautionary measures are required. This is where a Business Continuity Plan is important. The aim of this Business Continuity Plan is to outline the preparatory and response measures to be undertaken by the IFRC Indonesia delegation should an outbreak of Swine Flu affect, or threaten to affect, the office’s capacity to function, thereby enabling us to remain operational throughout the crisis, in support of the Indonesian Red Cross essential services.

My colleague Paul Conneally, who runs our media department in Geneva, describes his frantic week.

Whatever your view on Swine flu (which we now officially call H1N1) my reality is that it has taken up all my waking hours (and extended them) over the last week. I haven't had lunch since last Friday and there are journalists following this story with a dedication I have rarely witnessed. What is it that grips the collective imagination to such an extent? The Spanish flu of 1918 / 1919, which laid waste to an impressive 40 million people, is certainly a harrowing lesson of our time but really, how many people truly knew about it last week? (In fact, some accounts claim that as many as 100 million perished).

Swine Flu, Mexico, 30 April 2009. Members of the Mexican Red Cross prepare the distribution of 2 million panphlets and 200 thousand posters that starts today all over Mexico, to inform the population about the sympthoms of the swine flue and the ways to prevent its expansion. Jose Manuel Jiménez/IFRC

But how much has our world changed since 1919? How much has our world changed since 1999 for God's sake? Last night, at 22h00 Geneva time the World Health Organization (WHO) raised the global alert to level five. Again, people and journalists (often one and the same) who last week knew little about WHO, never mind phase four or five, are now providing sensational and, sorry to say, hysterical commentary.

What we really need, in my view at least, is a sense of perspective. At the same time I fully acknowledge we also need people to consider and plan for the worst case scenarios. And this is very much part of our daily modus operandi if truth be told. Disaster preparedness has to consider the gloomiest possibilities, else it will not work.

There is a human need to know the "what if" and the "worst case". If you doubt me just tune in to your nearest tv station and chances are it will be betting on millions of us falling about out of our minds on nature's latest toxic creation a.k.a. swine flu a.ka. H1N1.

Today at 14h Geneva time, we went to the international media to present our plans for scaling up and our sober analysis. Four Red Cross people talking to more than 50 journalists from Geneva's international press corps, including 6 different TV stations. Some even carried live on major news channels like Sky and repeated on a number of other major media afterwards. So, what did we have to say that is so different?

On one side we concur with WHO's analysis about taking the situation seriously - how could you not? On the other hand we feel calm and even confident. Never has the world been so well prepared for a global pandemic. We know that more than 70% of our national Red Cross and Red Crescent societies are already active, contributing to reducing the risk of pandemic in their countries. Next week this figure will most likely be closer to 100%.

And this is our niche. WHO provides the global guidance if you like, the Science. We, and many other governmental and civil society partners at the national and community level, carry out the much-needed efforts on the ground to drive the message home, coordinate efforts on the ground, deliver protective gear and advice and promote "respiratorial etiquette" (a wonderful phrase which I learned today - basically it means, don't cough in my face and I won't cough in yours).

It has been a real professional pleasure for me this week to be part of our crisis team, gearing itself up to support the global response of the international Red Cross. I have had the pleasure to work closely with some hugely experienced colleagues like Dr. Pierre Duplessis, our human influenza expert. Pierre is the former head of the Canadian Red Cross and has spearheaded our program to combat Avian flu over the last few years. A good guy to have in your corner, pandemic or not.

The situation has also provided an opportunity to reconnect with a former colleague, Marco Jimenez, in Mexico city, who has volunteered to report back for us and provide photographs so we can keep our worldwide network informed and provide some authentic images and stories to the world's media.

When I worked in Sudan, Marco was my handler in Geneva and plenty of sparks flew. That was 5 years ago or so and now our roles are somewhat switched - and this time we were hooked up through facebook.

There is no doubt that we are in a serious situation but we need to address it calmly, reassured in the knowledge that we have never been so well prepared. We have never had such early warning and early action. As far as I know all cases (more or less) have originated in Mexico and no more than a few dozen confirmed elsewhere. If we fail to prepare we prepare to fail - this is a truism and this is our thinking right now. And its Roy Keane's motto - and your a braver person than me if you take issue with his philosophy.

WHO is right when it advises that we are beyond containment. But we are absolutely not beyond mitigation and organizations such as the Red Cross will certainly make a massive difference in reducing the impact. Let's go about our business cooly and calmy, confident in our capacities to make a difference. Confident in knowing that we have learned some positive lessons from recent pandemic scares. Confident in our own common sense. Perspective is a good ally in such sensationalistic times.


JT said...

Hi Bob, good to see the IFRC taking a sensible, measured approach. The media reaction here in New Zealand has been nothing short of hysterical. Instantly television, newspapers and radio ramped up their predictions to the apocalyptic maximum. All it needed was a group of New Zealand students returning from Mexico exhibiting symptoms to be one of the first suspected cases outside of North America, and the fuse of the media bomb was lit.

The Fourth Estate morphed into Chicken Little, quick to suggest the sky was falling on our heads and the end was nigh. The media hungrily sought any suggestion or comment on worst case scenario rather than focus on the reality on the ground.

I have to credit the Ministry of Health here for appearing to be prepared, organised and responsive, but that didn’t stop media with little or no knowledge of pandemic disease management from firing shots making accusations of delays and disorganisation.

The following headlines are just a taste of the frenzied ‘drama queen’ approach in New Zealand papers.

*Pandemic would cripple NZ: study
*A boy, a game and fears spread
*'Fingers crossed' for tourist industry as flu fears take hold
*Swine flu revives memories of 1918 pandemic
*Demand for medicine and masks set to soar

The irony is the frenzy hasn’t been maintained while the issues relating to H1N1 remain as serious as they were a week ago. There have been no deaths in New Zealand (one can almost sense the disappointment amongst some media), the dire nightmare scenarios don’t appear to be advancing towards eventuating and in short, the public interest in waning. We have gone from screaming headlines in bold red type, special television bulletins and breathless hourly updates on our airwaves, to stories being pushed back in the paper, down the television news bulletin etc. The problem is, if you go to immediate full panic mode in your reporting, where can you take the story after that?

The media pitched it at the wrong level from the start, chasing the biggest number regardless of scientific merit, the worst scenario, the gloomiest economic forecast. As you can tell, I’m a little exasperated at the inability of editors to guide their newsrooms with a little restraint and adherence to the facts. Still, at least the Crusaders won in Johannesburg last night so that’s cheered me up!

Ruahines said...

Kia ora Bob,
I have to agree with JT's fine assessment of the media reaction here, and also the rugby though I like the Hurricanes result a bit more. I will admit I too have laid in for a few extra supplies, but having written that it is simply topping up what I have already set aside in case of natural disaster.
Enjoyed following your trip to New York and Garrison Keillor post as well. I have been up in the Naki for the week and will be there 3-4 days a week for the next few months. Quietly have secreted my tramping gear in the boot, though had no view of the lovely mountain this week due to the non stop rain! Have a great weekend Bob.

Bob McKerrow - Wayfarer said...

Dear JT

A measured approach is essential in the early stages of H1N1 outbreak as we stikll don't know the nature of the beast. the Indonesian Govt and PMI are quietly, and responsibly ramping up levels of preparedness put in for H2P and Avian flu. I noticed the NZ media were having a field day with parliament thought to be infected. I remember Muldoon believing in his day that parliament was infected with Reds under every desk. Perhaps he was the Father of Swine Fever as I recall his nickname was piggy.

Great to read the Crusaders and Hurricanes had wins. Both teams are looking good and The Chiefs should have a win too.

Take care.


Bob McKerrow - Wayfarer said...

Dear Robb

I hope you are enjoying naki. If you are in New Plymouth, give my younger Barry a call. His number is in the phone book. His wife Bark is the CEO of the Province.

Thanks for your feedback. NY was a wonderful experience. Pleased you read a little of Garrison Keillor for he is such a refreshing writer with a wicked sense of humour.

Must do some more reading about the windmills. Do we blame marja and all her clogged friends for bringing windmills and windfarms to NZ ?

You enjoy your weekend too >

Anonymous said...

Hi Bob,

I came accross your blogs while reading a little bit about the explorer, James Mckerrow.

Its great to see you are continuing to lead such an interesting and fulfilling life.

Your Nephew,
Gary James McKerrow
Rio De Janeiro, Brasi

Bob McKerrow - Wayfarer said...

Dear Gary

I was delighted to hear from my long lost nephew after so many years. I will write you an email to catch up on the 30 years since I last saw you.

Take care


Gary Mckerrow said...

Yes it has been 30 years I am ashamed to say. Time sure does get away from oneself..........

Not being familar with I couldn't find a way to send you an email. Hence I will leave you mine.


Bob McKerrow - Wayfarer said...

Hi Gary

Just sent an email a few minutes ago. Take care. Bob

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