Flu questions

One's entry back in the homeland is greeted with a line of doctors with masks seated behind the immigration desks. You are directed to go up and present a form you filled up in the plane, about the countries you visited and whether you have certain symptoms.

Its a 5 second meeting, and you go off to collect your baggage, in a chaotic area populated by some in masks, many without, a maze of carts and bags, and a few helpful staff , asking if you wanted help, with swinging your bags of the circulating belt and loading the cart, all , for a price.

With the amount of news trickling in about the closure of markets, schools, colleges , here and there, and rumors about masks disappearing from shops (to enhance illegal profit), thanks to a government making them available only on prescription, I expected some kind of heat sensing probes that someone would track the passengers with, as they came in. I half expected stuff to beep and maybe weed out the "hotter" ones for further investigations.

None observed.

Amidst the massive lethargic flow of traffic , stranded next to a rush hour bus for several minutes, one wonders at the level of protection available to a few masked types, all standees in the bus aisle, about 50 people crushed in an area meant for 22. Like a jigsaw puzzle where the pieces have curves, and they fit in tight against each other. Most without masks. Just worried about their own square foot of floor and the possibility of reaching the exit door in time. The kind of crowd that would have made even the H1N1 virus stare.

Come the monsoon, every year, folks in Mumbai go through a viral scare. Chest experts give interviews and advice in newspapers, statistics are flashed around, water contamination is highlighted, students miss more school than usual. There is talk of water borne diseases and mosquito diseases. Typhoid cholera, leptospirosis, malaria, faliciparum malaria, and various gastroenteric upsets do the rounds. Incidences of these recede with the monsoon, the city cools a bit , and the world carries on.

Just a few questions.

Given our population, our crowds, our levels of city sanitation thanks to homelessness of the worst type, and the little pleasures afforded by vices like tobacco, Tuberculosis (TB) in India currently kills 2 people every 3 minutes. It is spread through the air by a person suffering from TB. A single patient can infect 10 or more people in a year. Every year, 1.8 million persons develop the disease, of which about 800,000 are infectious; and, until recently, 370,000 died of it annually —1,000 every day.

Given that this disease, to mention just one, is so rampant, one never hears of a similar hype regarding it. The The Revised National Tuberculosis Control Programme (RNTCP) based on WHO recommendations, continues to administer, treat, followup and research all aspects of the disease.

No one, including foreign visitors to the worst slum areas in Mumbai wears masks and stuff on an ongoing basis. Our trains carrying several times the number of people they are supposed to, are used everyday by thousands of people of all ages, during epidemics, monsoons, and other crowded occasions. You can actually get lost in a major vegetable market near railway stations at rush hour.

Why is no fuss made about this ? Why are Swine flu fear scenarios being enacted by keeping schools, colleges, and markets closed , in a city like Pune ? Does it behove the Health minister to micromanage and advise schools to stop their morning assemblies and sports (but keep the school classes going), and forget that the same students will sit together in classrooms, which are not exactly sterile ? While we hear of path labs being overburdened by the onslaught of cases that land up more because of fear than actual symptoms, is any thought being given to more staff being sanctioned for the already overburdened government path labs who are testing patients for the disease ?

While Tamiflu has now attained star status, thanks to unscrupulous types hiking the unofficial price consequent to demand outstripping supply, is a strict vigil being maintained on the quality assurance aspect of the medicine , which often appears in rural markets in its counterfeit avatar , to the detriment of a patient?

There is talk of a Swine Flu vaccine . There is also a recent report from Britain about the likelihood of of people using this vaccine developing the Guillaine Barre Syndrome , a paralysing disease . We read about the National Institute of Virology getting this vaccine ready by October 2009 etc . Has the Guillaine Barre aspect of it been verified ?

How come, in a so called pandemic of major proportions, we hear a Health Minister making populist general statements, but there is no authoritative scholarly medical official statement made, by those who are experts, at, say, the All India Institute of Medical Sciences, (hitherto known for disagreements between its erstwhile Head and the former Health Minister) ?

Rumors abound about certain worldly powerful folks on the Boards of pharmaceuticals making a killing in this pandemic ; like they did during the Bird flu/Avian flu earlier . Are there any connections here?

What do we believe ? What do we discard ?

In the meanwhile, it seems that the most sensible thing to do is to avoid contact with a "T" area on the face (across the eyes, and down the nose), with anybody, and wash your hands and feet , thoroughly when you come in from outside.

Colder temperatures supposedly make these virii thrive. We are experiencing a hot non-existent monsoon this year , with drought conditions, with cities having to declare water cuts for the populations. Sanitary conditions in say Mumbai , remain unchanged. Contrast this with the drastic changes effected in Surat, Gujarat, after Plague was supposed to have made an appearance a few years ago. The entire face of Surat changed.

In the meanwhile, Mumbai's always-optimistic entrepreneurs continue to make profits in innovative ways.

A friend who travels daily to work, by suburban train to South Mumbai, mentioned seeing hawkers selling cloth masks in trains.

And you could even bargain .....