Scott McPherson's Web Presence

Over the past three days, it has been my pleasure to bring you the journal of the South American swine flu ordeal suffered by FSU law student Christin Foster.  She documented concisely her negative experiences in Argentina, along with her successful diagnosis and treatment in Chile.  She concluded the series with a comparison of her experience with her friend Malady, who had to suffer both the virus and the Argentine government's incompetence and mishandling of the entire incident.  My words, not hers.  But can any rational person conclude otherwise?

So what are the lessons learned from this South American onslought?  Plenty. 

First, treat people as thinking individuals who can withstand news, as bad as it might get.  I am so sick and tired of hearing "We have to be careful not to induce panic or incite panic."  It is the absence of reliable information that incites panic, not the presence of it!  Those who would withhold information for the sake of reducing panic are the same people who think people cannot think for themselves.  That line of thought is encroaching into the national health care debate, with predictable results. 

Tell people the truth.  If it's bad, tell them it's bad.

Second, prepare for inconsistencies before they happen.  Try to anticipate these things.  Look at the mishandling of the Tamiflu situation in Argentina.  That government's inept decision-making borders on the criminal.  Imagine withholding Tamiflu until the flu is typed, a process that took more than two weeks!  I guaran-damn-tee you people died because of the Argentine government's outright stupidity.

Third, the buck stops at the top.  Harry Truman said it, and leaders will not find easy nor willing scapegoats if this pandemic is worse than the one they planned for and told the people to expect.  Presidents and prime ministers need to take note of this.  Sacking some lackey will do little to fix the situation, especially if people are dying.

And we know that people will die in this pandemic in far greater numbers than we have seen so far.  I will address this in a future blog; suffice it to say that the easier this virus gets to catch, the more people will die, and that law applies even if the virus does not return more lethal.  It's simply the law of large numbers.  This virus is already more destructive than seasonal flu simply because the elderly are not dying from it; the young are.  There is a huge psychosocial difference between 40,000 old people dying of seasonal flu and 40,000 people ages 1-40 dying, especially if 6% of those are pregnant women.

A recent study has already theorized this virus is up to 100 times more virulent than seasonal flu, which I will address in that future blog. 

Telling people not to worry, or (worse) not telling them the honest truth in some vain attempt to forestall "panic," just won't cut it.  I have spent the better part of my life in public service and dealing with the press at a very intimate level.  My experience has told me to trust people and respect people enough to give them the truth.

Fourth, do not automatically believe the health care establishment knows what they are doing.  Let me relay a personal anecdote:  My wife is currently undergoing chemotherapy, her second time around on this carousel.  Her last treatment was last Friday.  Another person in the "chemo room" asked a nurse about the H1N1 vaccine.  The nurse could not tell her anything about the vaccine, nor the virus itself, and actually began confusing it with the seasonal flu vaccine!  She knew nothing about the CDC target groups; otherwise, she would have responded authoritatively that she needed to get her H1 vaccine as soon as it was available.

I found this so distressing as to bring it up to the head nurse as we left the facility.  Chemo patients will be at the top of the vaccine priority list, along with pregnant women, I emphasized to her (she herself is pregnant).  But that vaccine is not the seasonal shot; it probably won't get here until late October; and people will either need a doctor's note or will need to go to a special facility to receive the two shots in the first place.

I asked the on-call oncologist (the regular oncologist was at the hospital) about interactions with Tamiflu.  He said Yes, my wife could take Tamiflu.  But he counseled not to begin taking the drug until flu was confirmed.  Doctor, I said, they are not encouraging testing anymore!  But it only takes five minutes, he told me.  Yes, doctor, but five minutes in a crowded waiting room, or ER, and the test kits might be all gone!  Not to mention further exposure to the virus.  But it only takes five minutes, he again replied.

So is it any wonder, then, that a recent Hong Kong study said that 50% of the health care establishment there will refuse -- refuse -- to accept the H1 vaccine into their arms?!?!

The Argentine government's dangerous and inept bureaucracy regarding the dispensing of Tamiflu created shortages and facilitated deaths.  Contrast that with Chile's comparatively calm approach to diagnosis, treatment with antivirals and reasonable measures to isolate or quarantine suspected patients.  Other than looks of apprehension from hotel staff and others (reread the passage in Part Two about the Chilean hotel proprietor who doused Ms. Foster with Lysol!), the treatment of Ms. Foster was worlds ahead of the Neanderthal treatment experienced by her friend Malady back in Buenos Aires. 

Note the "apprehension" was not limited to Chilean or Argentine persons, in case you were about to utter some statement about backward South Americans.  Note that Ms. Foster's own husband was on the receiving end of the same looks and distancing from his American co-workers.  This, weeks after anyone would have reasonably been declared virus-free.

Clearly, we have a lot of work to do. 

I hope you enjoyed the series.