Has the media lost perspective?

Is the media responsible for the current swine flu panic in India or is the government's response to blame? This question is being asked and will continue to be asked. While the government could be faulted on many counts, we have to consider the media's responsibilities when there are health emergencies.

So has the media lost perspective? If you look at just the numbers affected and the fatalities, you would conclude that it has. More people die each day from malaria, infection, diarrhoea and other gastro-intestinal infections, and tuberculosis than have died of swine flu since the first incidents were reported.

Therefore why the overdrive by the media? What started as an epidemic of swine flu in Mexico in March 2009 has now spread to 100 countries. The World Health Organization (WHO) has been alerting countries for the past eight years to get prepared for a major influenza outbreak. It seems to have finally arrived. H1N1 virus moved from pigs and went on to infect humans, facilitated by crowded living conditions. From Mexico it spread to the United States, then to Europe and Asia.

In the US, swine flu has so far killed 436 people and infected about 100,000 people. The situation will get worse as winter approaches parts of the world. India has seen 21 deaths so far and this is causing panic among the populace. The good news is that the vast majority of the people who contract swine flu influenza are going to recover completely after going through a period of body aches, sore throat and fever. If the Mexican experience is any guide, the H1N1 swine flu is sometimes lethal in children and young adults. This seems to be the pattern in India also. People born before 1957 appear to have some protection from the current pandemic.

In the 1918 pandemic, it is estimated that close to 50 million people perished in different parts of the world. In 2009, healthcare is very advanced compared to 1918. Tamiflu tablets if taken early may minimise the severity of the disease. But if Tamiflu is used indiscriminately, the virus will adapt and become resistant to the drug. Governments have stock piled millions of tablets to be used in a major outbreak. The influenza virus sometimes settles down in the lungs and can cause severe respiratory distress requiring mechanical ventilatory support. Of the 2,155 cases of viral pneumonia reported from Mexico, 821 required hospitalization and 100 died of respiratory failure in spite of mechanical ventilation. Not all viral pneumonia cases need ventilatory support.

Pharmaceutical companies are racing to bring a vaccine that could be effective against the swine flu virus. Pilot clinical studies are going on in America. The vaccine is expected to be available to the public in October of this year. One also needs protection against the regular flu virus which shows up every winter. It is unlikely there will be enough vaccine to vaccinate the entire world population. Pregnant women, children, young adults, healthcare professionals engaged in patient care, military personnel all should get priority. Public need to remember that every year seasonal influenza causes 30,000 deaths in America especially the elderly with chronic lung disease, heart disease and kidney disease.

Death generally happens only when there is severe involvement of both lungs by what is called acute lung injury or acute respiratory distress syndrome. With modern medical amenities, 42 percent of such cases can be saved. Two classes of drugs are available to minimize the effects of flu on the body. They are Tamiflu (Oseltamivir) and Relenza (Zanamivir). Recently, Japanese scientists have successfully tested CS-8959 in a clinical trial. This drug may be released for public use in Japan next year. This is found to be safer and more efficacious than Tamiflu.

According to a British Medical Journal report, children under the age of 12 should not be given Tamiflu or Relenza. These drugs reduced the length of the flu infection by only one day. More importantly these drugs reduced the transmission of the virus only by eight percent. The Mexican experience has also revealed the effectiveness of personal protective equipment, to prevent the infection of health care workers. Doctors and nurses taking care of critically ill patients should be given N 95 masks for their safety.

So many people are dying everyday from dengue fever, malaria, tuberculosis and various bacterial and viral infections. Yet, the media by heightening awareness about the disease has unwittingly engendered undue public anxiety. One obvious reason is that when a disease hits the metros or the middle classes, it becomes a subject worth pursuing but when it affects people in remote areas, no news organization is willing to invest in sending people to cover it. Every year, hundreds of people die of kala azar, malaria and other infectious diseases in non-metro areas in India. Yet the coverage is only perfunctory. Only if the spread of infection threatens our cities does the media wake up and take note.

Typically, television news focused almost exclusively on the swine flu for days on end. On August 11, the Centre asked TV channels to show restraint in their coverage.

Although NDTV was one channel that did run a programme reminding viewers about other diseases and deaths caused by them that are a daily occurrence in a country like India, the main news bulletins on all channels were filled with non-stop visuals of people in face masks, crowds lining up in front of hospitals and grief stricken families who have lost a loved one.

The problem with this type of coverage is that it tends to make the problem larger than it is. The tempering words of a few individuals cannot possible negate this overall picture that comes through the visuals. And when one issue is covered to the exclusion of all else, then the general public is forced to believe that the problem is acute and out of control when it actually is not.

The tempering words of a few individuals cannot possible negate this overall picture that comes through the visuals. And when one issue is covered to the exclusion of all else, then the general public is forced to believe that the problem is acute and out of control when it actually is not.

On the other hand, Television news contributed to the panic reaction that led hundreds of people to rush to hospitals to get tested even if they had the mildest symptoms. Even the best-equipped public health system cannot survive such a battering and India certainly does not have the best of such systems.

If the swine flu can teach the media something, it should be this: that there are areas like health that require constant and sustained attention and not just when a "pandemic" is declared.

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