Swine Flu Outbreak

April 27,2009

So far there are 1,663 suspected infections and 103 reported deaths. Nearly all of the infections and all of the deaths are in Mexico (98 percent of both have been in Mexico City itself). The high population density of Mexico City has allowed the new strain to spread very quickly and provided ample opportunities for it to be carried abroad. There are now suspected cases in Canada, New Zealand, Spain, France, Israel, Brazil and the United States.

It appears that we’re not dealing with a 1918 style pandemic. While there obviously have been deaths, the numbers don't indicate this is a particularly deadly disease. Something like the 1918 "Spanish Flu" virus would already be killing people in significant numbers in places as scattered as Singapore, Buenos Aires, and Moscow. It appears that this H1N1 strain is simply a new strain of the common flu that is somewhat more virulent. All evidence thus far indicates that a simple paper mask is effective at limiting transmission, and that common anti-viral medications such as Tamiflu and Relenza work well against the new strain.

But the biggest question is why have there been deaths in Mexico City and not anywhere else? The fact that the Mexican health system is subpar does not answer the question. Since most people do not seek medical treatment for flu symptoms, medical quality does not yet seriously enter into the picture. The explanation could be nothing more complicated than the fact that the strain first broke out in Mexico City and has not yet advanced far enough elsewhere to produce deaths. If that is the case then we should be seeing some terminal cases in the United States in the next few days.

So far the CDC does not have an opinion on this topic, but we need to discover if there is something fundamentally different about the situation — or the virus — in Mexico vis-a-vis the rest of the world.

Swine Flu Symptoms from the CDC

The following advice on the Swine Flu is from the Center for Disease Control (CDC)

If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact your health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.

If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children emergency warning signs that need urgent medical attention include:

• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
• Fever with a rash

In adults, emergency warning signs that need urgent medical attention include:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting

Pirates you say? Part 2

As I mentioned before, there have been only two methods for successfully dealing with pirates and they have been employed in varying degrees for thousands of years - pay em off (tribute) or eradicate them (military action). Neither is cheap and both always have unintended consequences. Tribute runs the risk of creating more pirates elsewhere and/or creating a beast that can cause more trouble - the Principality of Monaco is an example of the latter. In the case of the Somali pirates the issue with tribute is both the danger of encouraging copycats elsewhere (like the Caribbean where cruise ship could be targeted) and the threat of some of the funds winding up in the hands of Islamic terrorists. We have seen Afghan drug money fuel the Taliban and al Qaeda for years now and no one is quite sure if Somali pirate money is not making its way into such coffers. Terrorists, it seems, have no qualms taking money from criminals and vice versa. So that leaves eradication in Part 3.

NATO seizes captured ship but frees the pirates

Yesterday Dutch commandos freed 20 fishermen whose vessel was hijacked by Somali pirates and used to launch an attack against a tanker in the Gulf of Aden. They seized weapons but let the pirates go. According to a NATO spokesman, the pirates were set free because NATO does not have a maritime detainment policy, meaning Dutch national law would apply in this case. "The Dutch force can only arrest them if the pirates are from the Netherlands, the victims are from the Netherlands, or if they are in Netherlands waters." US Secretary of State Hillary Clinton recently unveiled a plan to tackle piracy in the Gulf of Aden and the Indian Ocean off Somalia. Too bad she didn't include NATO in the process. This just goes to show that despite an official NATO mission there is yet to be any type of integrated planning. Until this happens the whole multi-national flotilla will be about as effective in deterring pirates as the US Border Patrol is in stemming illegal immigration - no disrespect to the Border Patrol. The international law is in place, forces are in place, but the planning and coordination is missing. It raises questions if the will is really there. As a military planner and former commander, I can assure you the quickest way to fail in any operation is to short change planning. I feel for the troops sent on this fools errand without the authorization to act decisively and responsibly.

Pirates you say?

Pirates have been around as long as we have been traveling on rivers and seas. Like slavery, piracy is an economic driven enterprise that thrives in areas that have little to no state presence or has a state sponsor who see their activities as both profitable and politically expedient. The naval flotillas plying the waters off the Horn of Africa will have no significant effect on curbing piracy. There are too many ships to escort, too wide an area to patrol and too few armed assets to do the job. Arming cargo ships will run into legal, liability, and safety issues. It also will be minimally effective considering the income made at pirating. Arming cargo ships will likely result in only a stalemate and an arms race between the pirates and commercial ships. Think about the drug trade and the international success to suppress it in areas where there is little stability or law enforcement. To end piracy in the Red and Arabian seas will require draining the swamps in the geographic territory known as Somalia. That will entail more than just going ashore and burning out a few pirate dens. There is big money in it for the locals and unless you establish security followed by a viable economy they will spring back about as fast as you can get out of port. Good news is that the skills and talent for nation building, and that is what we are talking about, are well known and available. Bad news is that it will take at least a decade and tens of billions to do it and no one wants to foot the bill or contribute the forces. The ship owners are content to limit the liability by insuring their ships and cargo's. The insurance company are willing, at least at the moment, to endure the losses. When the pirating goes beyond the tolerance level of either the ship owners or insurance companies then some action will take place. There are only two tried and true methods for dealing with piracy and it is not arming merchant ships. Both methods have been used with varying degrees of success by nations around the world, including the US, for millennia. More to follow.

World Affairs and International Diplomacy

In today's complex international environment, just knowing what happened is not enough. You need to know why, by whom, who is affected and who is not, who is interested, and what is likely to happen next. With this in-depth information, the event can be put into perspective and it will start to make sense. Then the information goes from being interesting to becoming useful.