What We Learned From H1N1’s First Year

By RICHARD P. WENZEL
NYT

Richmond, Va.

ONE year ago today, a government worker in Oaxaca, Mexico, became the first person to die of swine flu. At the bedsides of other men and women struggling to stay alive in Mexican critical care units, we clinicians noticed early on that this novel H1N1 flu virus diverged from influenza’s usual pattern of activity in striking ways. It began in the Northern Hemisphere, not in Asia, and in mid-spring, not late fall or winter. It also had a worrying predilection for children and young adults, not the elderly and newborns.

In the months after those first deaths, the virus ignited a global pandemic. While the epidemic never became as deadly as we initially feared, it was not as mild as some experts now believe. What’s more, it exposed some serious shortcomings in the world’s public health response.

Those who now describe the pandemic as mild base their conclusion primarily on what, at first, seems like a mortality rate in the United States similar to those seen after seasonal influenza. But my colleagues in developing countries would strongly object.

Though we lack reliable death rates from country to country, certainly no one who helped care for the large number of critically ill patients in Mexico could conclude that the flu in the United States was as severe as in developing countries that lacked our resources.

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