This is my third posting on H1N1. Earlier I wrote that if H1N1 cannot be controlled because of local transmission, then we can foresee that the number of cases would climb up rapidly. Hence, we are told that we now have more than 2000 confirmed cases. What is surprising is that death toll have reached 38. As of yesterday, the WHO has recorded about 208,155 confirmed cases in 174 countries with 1,688 deaths, which brings the average mortality rate in H1N1 to about 0.5 - 0.8 percent. With 2000 cases, we are talking about 10 to 16 deaths. Here in Malaysia, we are talking about mortality rate that is nearly 4 times more than the accepted norm of 0.5percent. This is a cause of concern to the authorities and the rakyat.
In any infectious disease outbreak, controlling the source of infection is of paramount importance. Hence, the individual plays an important role in order to contain the disease. Public apathy in Malaysia is frightening. The level of cleanliness in public places leaves much to be desired. In a lot of shopping centres and offices, don’t hope to find soap in the public toilet. It is indeed sad that Hong Kong had done a better job in maintaining cleanliness of public amenities from public lift to toilet. Even public toilets in hotels in Malaysia, KLIA and LCCT have no soap. I have also read in the papers today that in Subang Airport, there was no soap found in the public toilet. The MOH has been advising the public to wash their hands regularly with soap to prevent viruses, but without soaps in public toilets, how are we going to contain the disease? Not only that, the public lifts are also not cleaned regularly, let alone sanitized. An infected person would have infected a lot of places in the course of his travelling and daily contact. Hence, one of the first rules in containment of infectious disease is cleanliness of premises which are frequently used by the public.
There is also a lack of public education or the education itself is not reaching the target group. The awareness should start from the schools. The MOH should not just close down schools whenever someone is infected with the H1N1 and send the children home. The children will just regard the closing down of the schools as school holidays for them. It is better for MOH to teach school children on self-cleanliness and to avoid close contact with other children by wearing masks.
The high mortality rate in Malaysia has also raised panic among the public who are now rushing to get the anti virals to protect themselves. However, the anti-virals must be taken with caution. It has its harmful side effects, especially on some children where it will cause nausea and vomiting, leading to dehydration and other sickness. Therefore, parents must be extra careful when it comes to the anti-virals because it will promote resistance, of which will weaken the body’s immune system and cause it vulnerable to fight any flu virus. Besides that, many are concerned about the late diagnosis of the doctor for H1N1. Many believed that the deaths from H1N1 were caused by late diagnosis from the doctors. This perception has to change. Doctors have to equip themselves with updated information from the WHO in order to make the right diagnosis. There is no excuse since there is enough publicity to alert doctors on the H1N1.
We must all keep in mind that it takes two to tango. Without the cooperation from the public, the government itself is unable to contain the disease. Hopefully both the government and the public will continue to stay alert to prevent further spread of the disease.