Mexico & Nafta - May 2009 (ISSN 1741-444X)

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.