The Basics, Part 1: The Current Threat

The "current threat" at any given time is evolving, so I will be editing this blog post on an ongoing basis, even though the first version was composed on the afternoon of Monday, April 27, 2009.

The Situation as of the Mid-Afternoon, Wednesday, April 29, 2009

At this point (2:45 p.m., but see update below), there are many cases of the new swine flu, confirmed by laboratory analysis, in the United States. In the USA, 50 cases had been confirmed as of Monday, and 64 as of Tuesday. At present, there are 91 confirmed cases in the USA, including the states of New York (51 confirmed cases, by far mostly in NYC), Texas (16), California (14), Kansas (2), Massachusetts (2), Michigan (2), Arizona (1), Indiana (1), Nevada (1), and Ohio (1). There are also laboratory-confirmed cases in Mexico (49 cases ), Canada (13 cases), Spain (10), as well as in the United Kingdom, New Zealand, Germany, Israel, Costa Rica, South Korea, and Austria (fewer than 10 cases each).

It would be easy to be misled by these figures. There are only a very few laboratories in the world that can confirm a case of the new swine flu. Thus, there almost certainly are many, many more actual cases of the new swine flu around the world, and in the United States. Let us consider overall how many cases of flu there are currently around the world.

Overall, there are 2,547 cases of flu in Mexico, but it is unknown at present how many of these are of the new swine flu (beyond the 49 confirmed cases, mentioned above), because testing is not complete. In Mexico, over 160 people have died of flu; 7 of these have been shown to be fatalities from new swine flu, but it is currently unknown how many of the others may have resulted from the new swine flu as well. Mexico is largely shut down, with its schools and many businesses closed, and police patrolling with face masks (pictured).

There are reportedly hundreds of suspected flu cases just among schoolchildren in New York City; there are also unconfirmed cases of flu at Teachers College, Columbia University, and at the Ernst and Young accounting firm, at Times Square in Manhattan. Officially, in the US, there are over 277 cases of flu where the new swine flu is suspected but not yet confirmed. (As mentioned above, 91 confirmed cases of swine flu are known to exist in the USA.) So far, there has been just 1 fatality from the swine flu in the United States.

(4:45 p.m. update:) As reported by the Associated Press, the United Nations World Health Organization (WHO) has just upgraded its pandemic alert level to Phase 5. This means the following:

• Larger clusters of flu infections, involving 25-50 people in each cluster, have appeared, lasting from two to four weeks in duration.
• Person-to-person transmission is occurring.
• Although this person-to-person transmission is still somewhat confined to specific locations, the virus appears to be increasingly adapted to humans.
• "There is a substantial risk of a pandemic."
  

(The above is paraphrased and quoted from page 11 of the December 2005 edition of WHO Outbreak Communication: WHO Handbook for Journalists: Influenza Pandemic [WHO/CDS/2005.37].)

Phase 6 would indicate a full-fledged pandemic flu.

The United States federal government has been making preparations for a full-scale pandemic--although the government is not yet predicting a full-scale pandemic. Simply put, no one knows what direction this pattern of infections will take. However, as reported on Tuesday by the Associated Press, the feds are preparing for a worst-case scenario.

The big question now is, is this 'the big one,' or not? For many years, epidemiologists have warned that it was just a matter of time until a highly contagious and potentially fatal organism spread in a global pandemic. Is this the case with the new swine flu? That is unknown at present.

Sometimes infections like this peter out; at other times, they become pandemic. Given what we know right now, it could go either way.

It is important to point out that the authorities have noted troubling characteristics regarding this virus. These characteristics have implications concerning what you should do. For the characteristics of this virus, see "The Basics, Part 2: Why You Should Be Concerned." For what you should do, see "The Basics, Part 3: What You Can Do."


(The photo, "Mexican police officers with masks on [for] swine flu," by Sari Huella, April 25, 2009, was obtained from Wikimedia Commons under Creative Commons Attribution License 2.0.)