As Swine Flu Eases Mexicans Ask: Was Government Lucky or Good?

The worst fears about swine flu seem to de dissipating in the Mexican capital as quickly as they arrived. And with plenty of time on their hands — President Felipe Calderon ordered all but the most necessary businesses shuttered and advised families to stay in their homes during the long Cinco de Mayo holiday weekend — many Mexicans are wondering: has the crisis abated because their government was diligent, or because it was lucky?


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Once Calderon's administration learned on April 23 that it was dealing with a new flu virus type — A/H1N1, a unique mix of swine, avian and human strains — it moved swiftly to control its spread. As of Saturday night, the official number of confirmed swine flu cases in Mexico stood at 473, less than a third of early estimates, and the death toll was only 19. (Health officials have stopped publicly tallying suspected cases; there are still so many garden-variety flu cases they felt that to keep reporting "suspected" cases of swine flu would unnecessarily add to the alarm.) (See pictures of the swine flu in Mexico.)

But at the same time, Mexican media outlets have begun to question whether health officials moved quickly enough at the end of March and beginning of April, when strange flu cases began emerging, to get the strain identified. (See the 5 things you need to know about swine flu.)

In an interview with TIME, Dr. Miguel Angel Lezana, director of Mexico's National Epidemiological Center, rejected the criticism. "When you're dealing with a completely new germ, it tasks any health system's early-response capacity," said Lezana. "But it's difficult for me to imagine how a country could have acted more rapidly than Mexico did in this case."

Still, Sunday's Mexico City daily Reforma quoted a report from the World Health Organization, based in Geneva, Switzerland, suggesting Mexican officials should have sent samples from flu patients — including the first Mexican believed to have contracted A/H1N1, 5-year-old Edgar Hernandez of Veracruz state, and the first to die from it, Adela Maria Gutierrez, 39, of Oaxaca — to labs in Canada and the U.S. sooner than April 22. Reforma notes that the first analyses of Gutierrez's blood and tissue samples done by Lezana's agency diagnosed severe pneumonia instead of flu. (Swine flu victims usually die of pneumonia-like symptoms.) TIME has obtained a copy of Lezana's agency's medical report on Gutierrez, which concluded, in some respects mistakenly, that she was negative for a number of flu types.

Oaxaca state Health Minister Martin Vasquez tells TIME he pressed for further analysis and sent more samples — which then tested positive for flu. A week later, Lezana received word in a teleconference with Canadian officials that Gutierrez's cause of death, and the strange cause of illness for hundreds of other patients showing up in Mexican clinics and hospitals, was A/H1N1. Lezana concedes that Mexican labs did not then have the rare and expensive form of PCR and RT-PCR analysis — a means of identifying a virus' genetic makeup — to pinpoint such an unusual strain. (They have such analysis now.)

The WHO has generally praised Mexico's response to the pandemic. For his part, Lezana insists the media "misinterpreted" his quote in an Associated Press article last week suggesting the WHO itself should have acted in a "more immediate" manner after Mexico informed it on April 16 that the flu strain that had killed Gutierrez seemed abnormal. "I wasn't claiming any delay on the WHO's part," Lezana tells TIME. What he was noting, he says, was that because the flu strain seemed atypical, there was a generalized fear among health officials "that we might not be able to learn its transmission characteristics fast enough. When you're dealing with an unknown virus, part of the hypothesis is that it will move faster because the population is more vulnerable. Thankfully, its capacity for transmission, its virulence, turned out to be relatively low compared to what we'd originally estimated."

Lezana says Mexican and international virus sleuths are "much closer than we were a week ago" to determining the geographical, animal and human origins of the swine flu outbreak — which may not even be in Mexico. (Until late last week, most media reports speculated that Hernandez's village in Veracruz, La Gloria de Perote, where large pig farms are located, was ground zero; but many Mexican and international health officials now say it could be California or even Asia.) But it could take weeks if not months for a final answer.

For many Mexicans, meanwhile, concern has moved from health to the economy. The global financial crisis has already battered Mexico; now tourism, one of the nation's top three sources of income along with oil and migrant-worker remittances, stands to take a severe hit because of the epidemic scare. (See the top 5 swine flu don'ts.)

Mexican Health Minister Jose Angel Cordova warned his countrymen Saturday evening that it's "premature to say we've passed the [outbreak's] most worrisome moment." But the positive flu-containment news coming from the government may well put public pressure on Calderon to let businesses like restaurants open sooner than the end of the long Cinco de Mayo weekend on Tuesday. With few people on the streets on what is usually a bustling Mexico holiday, businessmen like taxi driver Francisco Diaz are chafing. "I've been driving all day and all I've got to show for it is 60 pesos [$4.60]," says Diaz. "It's like we've protected ourselves health-wise but now we won't survive economically." link...