The Year of H1N1

Now that there are almost 90,000 laboratory-confirmed human cases of A/H1N1 influenza, it is becoming more difficult to form a clear global picture of the virus' spread. Newspapers no longer report worldwide figures, but focus exclusively on the country, and sometimes, once in a while, on the region. It's quite a recent phenomenon. Less than a month ago news agencies continued to provide fairly detailed breakdowns and accounts of cases worldwide, like this Xinhua report.
And it wasn't just how the breadth of information that has shrunk as the caseload increases exponentially, but also the depth of detail. A June 9 Straits Times report on 3 new cases in Singapore still described in detail how each of the patients contracted the flu; the latest update, in contrast, doesn't say anything about the 91 new cases confirmed. Bulletin boards and forums such as this now provide more complete, but less organised, information.
The increase was really quite fast. Three weeks ago France and the Netherlands combined had 20-something cases, whereas Singapore only had a handful; now despite rapid spread in both these places, and everywhere else, Singapore has almost twice as many cases as the two European countries combined. It's probably the huge number of people returning from the States, Australia, and everywhere else for the summer, plus the fact that Singapore is a major air hub, plus the absolute density of this place which makes it only a matter of time before a few imported cases start to trigger community transmission. Europe, despite its lack of borders, may simply be less dynamic a place in terms of human traffic than the Pacific rim; its lower density also, certainly, cannot hurt.
That curve looks a bit scary ... until you realise that the usual seasonal flu probably spreads just as rapidly, or even more rapidly. It's only that nobody usually tracks the worldwide or even countrywide numbers. Which makes one wonder: is A/H1N1 really so much worse than the normal seasonal flu? Is all the fuss warranted, or is it just a mere fuss?
We shall have to wait and see, probably. The WHO and health establishments worldwide had reasons to be cautious: the novelty of the strain, having mixed swine, avian and human origins; and similarities in provenance and situation to H5N1, which is considered fairly virulent and has a high reported mortality rate---about 60%, although that is not controlled for factors such as poor healthcare, failure to diagnose and seek treatment in time, etc.---; warning signs such as a high proportion of human cases being young people, as had been the case with Spanish flu, and a long incubation period which means the virus can spread before we realise, relative high morality in the initial outbreak epicentre of Mexico; and so on.
But so far the virus has been mild. With about 450 deaths amidst almost 90,000 cases, the mortality rate works out to be about 0.5%, not at all very scary. The general consensus is that it hasn't been spreading much faster than seasonal flu---only it's still spreading after flu season. On balance, the world seems to have over-reacted so far; it was simply not necessary to expend so much resources, effort and attention on something barely worse than the seasonal flu. On the other hand, at least more drastic measures such as border closures or the cancellation of major events such as the haj have not been taken. It is a good thing that there is debate about such measures, and that advisories are issued and precautions taken; but seeing as how H1N1 is not yet especially severe, disruptive restrictions are, in my opinion at least, not warranted.
Then again, how were we to know things wouldn't have turned out for the worse instead? And there are still reasons for caution: having already started to acquire drug resistance, the virus may further mutate or recombine to become more virulent, more severe, or, the WHO forbid, both. So we should keep our guard up, but perish any thought remotely linked to paranoia or panic. Unless it does get much, much worse, A/H1N1 should remain a headline topic, but not the headline topic, as it is, more or less, now.
The press and government here are admirably cool-headed in disseminating information about subjects other than themselves; but judging from Warrant Officer Roslan's theatrics the other day maybe they use too many big words, and need to work more on putting the gist of the message across to people who will not spend so much time reading fine print. What most people hear from the whole long spiel about "community transmission" and "mitigation" and "social responsibility" is "H1N1 is a threat, we are dealing with it; do not panic and follow these instructions." A rather clearer picture would have been "H1N1 is a new strain of flu. We have been treating it as though it were much worse than the usual flu so far, because it could have been. Don't worry too much about it though, because as it turns out it isn't. But don't get too complacent, and do adopt some of these precautions, because it could still get worse." Actually, it isn't too hard to see the big picture after a bit of reading and background research ... and the government and The Straits Times do provide sufficient background information to fill in parts of it. Guess simple laziness is the only reason why people can still go around wide-eyed asking "so what is H1N1?" and "are we going to die?"