martes, 2 de junio de 2009

Lecciones de la Crisis por Influenza

Mi amigo Tapen Sinha del ITAM me ha enviado una interesante nota publicada en la Revista Nature del 21 de mayo con el título Pandemics: avoiding the mistakes of 1918, firmada por John M. Barry, profesor del Centro de iNvestigación de la Biodiversidad Barry de Tulane and Xavier Universities, New Orleans, Louisiana

Lo interesante es que llega a una conclusión similar a la que el mismo Tapen y su coautor señalaron en un documento reciente que comenté en este post. Y en particular respaldanb la estrategia seguida por el país en este evento. Una parte de la nota, pero esta en inglés.
Until we develop a vaccine that is effective against all influenza viruses and available globally, the world will be vulnerable to influenza pandemics. H1N1 is the most immediate danger, including the possibility that a more deadly wave will strike later this year, but H5N1 and other viruses remain pandemic threats.First and foremost, authorities must tell each other the truth. This provides crucial lead time for vaccine production. Models even suggest that in a few circumstances, surveillance and transparency may allow a new virus to be contained and extirpated.The world has performed well in the past few weeks in this regard, but this is a lesson that has not been entirely taken on board. In 2003, China initially covered up SARS, putting the world at risk and contributing to near-panic in Beijing, where people felt they could trust nothing coming from the government. In 2004, Thailand and Indonesia withheld information during the first outbreaks of H5N1 bird flu. There continue to be both political and bureaucratic problems in ensuring that H5N1 isolates are shared — especially by Indonesia — thereby increasing the risk to the world.Telling the public the truth is also paramount. Before a vaccine becomes available during a severe pandemic, at some point the government will ask citizens to adhere to a series of public-health guidelines for non-pharmaceutical interventions, such as staying at home if they become ill. Large-scale, sustained compliance will be essential if those measures are to succeed. Compliance requires trust, and that depends on truth-telling.In the United States, former health and human services secretaries Tommy Thompson and Michael Leavitt deserve credit for institutionalizing real transparency in the current US pandemic plan. And the administration of President Barack Obama has performed admirably so far. Obama himself has addressed the issue several times, making perhaps only one mistake, when he said the threat was "cause for concern, but not alarm". Had things deteriorated quickly, he ran the risk of suddenly having to reverse his position.In Mexico, the problem was not reticence but candour, releasing inaccurate information that overstated the problem. Mexico should be congratulated for this, not condemned.Although a false alarm can be damaging, it is not nearly as damaging as silence — the type of silence that makes people believe the truth is being withheld. That is how trust disintegrates and how rumours — passed in the streets in 1918, today passed over Internet blogs — take hold and grow.I don't much care for the term 'risk communication'. It implies that the truth is being managed. The truth should not be managed, it should be told. Only by knowing the truth can imaginary horrors be transformed into concrete realities. And only then can people start to deal with those realities, and do so without panic.

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