THERE has been much alarm over the rising number of cases and the fatality rate of the A(H1N1) virus, and rightly so, because the A(H1N1) is infectious.
Unfortunately, 67 have already died in Malaysia. But if you were to be objective, 67 deaths, out of a possible 70,000 to 80,000 cases, amounts to a death rate of 0.08%. This is still a bit higher than the usual seasonal flu death rate of 0.04%, but surely not anywhere near panic-inducing proportions.
But while alarm and widespread panic is unnecessary, there exists the pressing need to restrategise and implement mechanisms and Standard Operating Procedures (SOP) for the prevention of secondary bacterial pneumonia.
A closer look at the deaths reveal that 80% were A(H1N1)-associated, or were incidentally found to have contracted the virus, the virus by no means causing the death.
We can call this A(H1N1)-associated death or death with incidental A(H1N1) infection. So, if the certification of death is proper, it may be that only 15 deaths were actually due to A(H1N1), giving a fatality rate of 0.02%.
The flu itself is usually a mild disease in the majority of cases. From all available clinical epidemiological evidence, the bulk of patients dying in flu pandemics are from secondary bacterial pneumonias. This has been shown to be the case in all flu epidemics and pandemics.
This is why we need to consolidate measures that are already in place. This should include a national level SOP whereby all affected patients with secondary bacterial pneumonias would be immediately triaged for intensive tertiary level care.
Indeed, we should all be vigilant, because there is an infectious disease in our midst. Good personal hygiene is crucial, now and at all times, even after this crisis. If you are not well, as always, seek medical advice.
But there is certainly no need to panic and there is no national emergency here.
There is already too much misinformation and misperception of the situation out in the lay media without having to distract the public with the hype about a national emergency.
Dr Ng Swee Choon
Member, Medical Affairs Committee
Federation of Private Medical Practitioners’ Associations Malaysia
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