Government claims victory over swine flu
Daily
life in Mexico started to return to normal on 6 May after the authorities
relaxed the emergency measures to control the outbreak of swine flu (AH1N1).
The government first introduced the emergency measures and closed schools in
Mexico City on 23 April, and subsequently across the country. Schools and
universities began to reopen on 7 May and all were open by 11 May. Government
offices reopened on 5 May after being closed from 1 May. Opinion polls show that
a majority of Mexicans were impressed by the government's response to the
crisis.
President Felipe Calderón
Hinojosa was cautious about claiming that the government had controlled the
outbreak. On 6 May he said that it was too early for the government to “claim
victory". Even on 12 May, the health minister, José Angel Córdova Villalobos,
was still only saying that life could gradually get back to normal, not that
the virus had been beaten.
The outbreak of the virus
has, perversely, been a political boon to the government. There are clear signs
that the opposition parties sense that the government's management of the swine
flu crisis has given the ruling Partido Acción Nacional (PAN) an advantage in
the forthcoming congressional elections on 5 July.
The key to the government's
success has been Córdova's steady performance. He has been on TV every night since the crisis erupted on 23
April, calmly answering questions and providing statistics. As the PAN does not
appear to have a viable presidential candidate for 2012, Córdova may become a
possible runner to succeed Calderón.
In response, the leftwing Frente
Amplio Progresista (FAP) has argued, initially quietly but now more
vociferously, that the government overreacted to the AH1N1 outbreak. This policy
position may be a mistake. The FAP could easily have argued that the
constructive support offered by opposition politicians, such as Marcelo Ebrard,
the mayor of Mexico City, and Enrique Peña Nieto, the governor of the Estado de
México, were vital in ensuring that the outbreak was controlled. Ebrard is a
prominent supporter of Andrés Manuel López Obrador, the founder of the FAP,
while Peña Nieto is a likely contender for the presidential nomination for the main
opposition Partido Revolucionario Institucional (PRI) in 2012.
The FAP is determined to
emphasise that the government misjudged the AH1N1 outbreak. One prominent
Fapista, Porfirio Muñoz Ledo, claimed that President Calderón's assertion that
the measures he had introduced not only protected Mexicans but also “all
humanity" was “ridiculous."
Muñoz Ledo also criticised
the government's poor handling of the crisis for the stigmatisation of Mexicans
around the world. In China, Mexicans had to be flown home after they had been
quarantined because of Chinese fears about the virus. Singapore also introduced
measures singling out Mexicans for special treatment.
Within Latin America,
Argentina, Cuba and Peru suspended flights to and from Mexico, triggering
disgust from Calderón. It is worth noting that on 12 May President Luiz Inácio
Lula da Silva went out of his way to praise Mexico's response to the outbreak.
This contrasted with Brazil's government health watchdog, which had been
outspokenly critical of the Mexican response.
Domestically, the federal
government's big move was to order a nationwide shutdown from 1 to 4 May. May
Day parades were cancelled and the government called on people to stay at home
for that period. The shutdown appeared to work. The government then announced
that schools and universities would start to reopen on 7 May. Schools and
universities had been shut in Mexico City since 23 April and throughout the
country from 27 April. On 12 May the government announced that the school year
would be extended to 14 July to make up for the lost classes. Originally term
was due to end on 3 July.
On 12 May, Córdova said
that the current toll was 58 confirmed deaths from the AH1N1 virus in Mexico
and 2,282 confirmed cases. Both the death toll and the number of confirmed
cases are continuing to rise, but Córdova stressed on 6 May that there had been
no new deaths in Mexico since 7 April. He said that the outbreak appeared to
have peaked on 26 April. The
reason the numbers are continuing to rise is that the authorities are working
through a backlog of suspected cases and suspicious deaths. The last confirmed
case in Mexico was registered on 8 May, Córdova said on 12 May.
Córdova said that the death
rate was 2.5% of confirmed cases. The virus appears to be more dangerous to
women than men. Of the deaths, 59% were women,
though only 49.7% of the confirmed cases were women. Unusually, 79.3% of those
killed by the virus were between 20 and 54 years old. Usually, the flu virus
kills mostly the very old and the very young.
Córdova
argued that the government measures had been successful, since 93% of the
confirmed cases showed symptoms before 23 April, when the government started to
take action against what it said, and the World Health Organization confirmed
(WHO), was a new virus. The most typical symptom was a fever (91%) and then a
cough. Most people with virus also complained of breathing difficulties,
coughing and general aches.
Mexico
City accounted for 72% of the deaths from the virus. The next worst affected
places were: San Luis Potosí, Tlaxcala, Estado de México and Hidalgo. Córdova
added that almost 28% of those who died from the virus were either obese or
suffered from a diabetic condition.
Córdova
tried to emphasise on 12 May that tourists should not have any worries about
coming to Mexico. He said that there had been no confirmed cases of AH1N1 cases
at the resorts of Puerto Vallarta, Los Cabos, Cozumel, Mazatlán and Zihuatanejo de Azueta.
Fidel takes a swipe at Calderón: On 11 May Fidel Castro, the former president of
Cuba (1959-2008), accused Mexico of covering up the swine flu outbreak. Castro's
gibe was a reaction to the decision by President Calderón to postpone his
long-awaited trip to Cuba. Calderón said that he could not go because Cuba had
been so unfriendly towards Mexico over the outbreak. Cuba unilaterally
suspended flights between the two countries on 29 April to try to escape
infection, even though the WHO's guidance was that such moves would not work.
Indeed, Cuba now has its first confirmed case of AH1N1, ironically a Mexican
medical student.
Castro
accused Mexico of covering up the outbreak in order not to interrupt the visit
by US President Barack Obama to Mexico City on 16-17 April. Castro pooh-poohed
Calderón's postponement of his visit, but Calderón's decision is actually a
serious diplomatic setback for Cuba. Under Calderón, Mexico had made a
considerable effort to improve relations with Cuba. Calderón, however, has also
shown himself to be a leader who does not forget slights and insults.
International
dimension: The big worry for health policymakers is that previous pandemics have
occurred in waves. It is worth noting that the WHO has never before issued a
Level Five influenza pandemic alert. It issued such a warning about the AH1N1 outbreak
on 29 April. Such alerts do not have any bearing on the lethal nature of the
virus. A Level Five state of alert means that the virus is now present among
people who have not themselves been to Mexico, which is assumed to be the
source of the current outbreak. The fact that the virus appears to have spread
globally has made Mexico the butt of local and international criticism. This
seems unfair. Julio Frenk, a former health minister under President Vicente Fox,
and before that a senior official at the WHO, was quoted by the New York Times
as saying that the current Mexican government's response to the crisis had been
“competent". Frenk is now Dean of Harvard's School of Public Health. Frenk
elaborated to the NYT: “Not perfect, but quite competent."
Why pigs? A deputy health
minister responsible for prevention and disease control, Alejandro Escobar
Mesa, admitted on 28 April that between December and March 2008 there had been
500 cases of respiratory illnesses in La Gloria, close to Perote, Veracruz. La
Gloria is the site of the pig pens that are supposed
to be the origin of the swine-flu outbreak. Escobar said that two people in La
Gloria had died of “pneumonia". One of these corpses tested positive for swine
flu, according to the health ministry.
The governor of Veracruz
state, Fidel Herrera Beltrán, denied that the pig farms had anything to do with
the outbreak of swine flu. He suggested that the virus had come from Asia and
pointed out that none of the workers, nor any of the 500,000 pigs at the
Granjas Carroll plant, the site suspected of being the source of the outbreak,
had shown any flu symptoms. Herrera, like Granjas Carroll, maintains that the
virus has only been spread from human to human.
The
Obama visit: In a highly unusual move, the White House published a statement on 27
April, originally issued by the US embassy in Mexico, concerning the death on
23 April, of Felipe Solís, the director of the Anthropological Museum in Mexico
City. The centrepiece of Obama's visit to Mexico was a dinner, hosted by Calderón
at the Anthropological Museum. Solís greeted Obama and shook him by the hand. The
US embassy said that Solís died of a pre-existing condition and not of AH1N1.
The local press reported that Solís died of pneumonia.
One comfort for Mexican
policymakers was that the US showed confidence in and solidarity with the
Mexican government's management of the crisis. On 29 April, President Obama refused to countenance the idea of closing the border. He said that this would be pointless.
The
role of the WHO: Michael Ryan, director of global alert and response at the World Health
Organization, said his team had contacted Mexico on 10 April and 17 April regarding
separate incidents, and were assured that they had been investigated and found
to be isolated cases. The WHO then informed Mexico on April 19 of the US cases,
and began talks that triggered an alert on April 22 of severe pneumonia
associated with influenza. Ryan stressed that he had no criticism of the
Mexican authorities: “They have been dealing with a complex situation and a
difficult epidemic, and have been exceptionally responsive to requests for
information," Ryan said.
Mexico's
analysis: Initially, Mexico had to send samples for analysis to Canada's
government labs in Winnipeg and the US Centers for Disease Control (CDC) in
Atlanta because its own labs had only just been equipped with the proper
machines. Mexico's National Institute of Diagnostics and Epidemiology had just
bought one genetic decoder, called real-time polymerase chain reaction machines.
Jonas Winchell, chief of the response and surveillance
laboratory at the CDC went to Mexico City on 26 April to help build the
procedures to test for the virus.
· Winchell's help meant
that the Mexican lab could, within a week, test 500 samples a day. The next
stage, according to Miguel Ángel Lezana, the government's top epidemiologist, is
to set up a network of regional labs, so that any suspicious samples can be
tested almost immediately.