Wednesday July 1, 2009

Caution can save lives

I REFER to Dr Ong Hean Teik’s letter “Sickening measures to curb outbreak” (The Star, June 29).

Contrary to Dr Ong’s opinion, there is still fear that the A(H1N1) flu infection will continue to spread in the country, with most being imported cases but with a steadily growing person-to-person spread.

The plan is to try and contain and limit the contagion to as few people as possible and thus perhaps shield Malaysians from the worst aspects of this pandemic’s potential danger and socio-economic perils.

As of June 26, the latest WHO statistics show that of 59,814 reported cases, there have been 263 deaths — a mortality rate of 0.44%.

This is in contrast to two other high-profile global health threats of recent years. The Avian Flu (influenza A(H5N1) had 433 reported cases and 262 deaths while SARS had 8,096 reported cases and 774 deaths and thus, their mortality rates are much higher at 61% and 9.6% respectively.

Contrast this with our resurgent dengue fever: in the first half of this year, there were 23,057 dengue cases and 57 related deaths in Malaysia, i.e. one death in 404 cases or a case fatality of 0.25%. Therefore, the H1N1 flu has nearly twice the death rate of dengue fever, which must mean that we have to take it seriously, especially when it is also contagious.

Although some sceptics, including medical doctors, had brought up concerns that perhaps the response to this current pandemic is overblown and exaggerated, the Health Ministry and its director-general continue to point out that while this may be true in the longer term, we just can’t afford to sit by and let this pandemic go without careful monitoring.

The DG said that if and when this pandemic turns out to be truly benign, then all is well and good. But if this flu became more lethal and many Malaysians die, what then?

In neighbouring Thailand, two among the more than 1,000 infected have died. So this is not so benign after all. In the US, CDC spokesman Dr Ann Shuchart stated that perhaps as many as one million Americans may have been infected with the H1N1 virus. But this is just a guess.

Of the 27,717 laboratory-confirmed cases, about 3,000 Americans have been hospitalised. Their median age was just 19, and 127 have died. Therefore, if we consider just the lab-confirmed cases, the death rate is 0.45%, or one in 218 which is consistent with global figures thus far.

Still, Malaysians are known to be quick at pointing fingers and apportioning blame.

The Malaysian health authorities have very limited options. Rigorous vigilance, close monitoring and being overly cautious might be the more prudent approach.

Perhaps, this might cost us a bit of time, energy, resources and money in the beginning. In the long term, this would have been worth it — every life saved is and should always be a correct public health measure!

Dr DAVID K.L. QUEK,
President, Malaysian Medical Association,
Kuala Lumpur.

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