Saturday, March 26, 2005

Quang Binh status still unclear

A story from Bloomberg News Service (reported by Jason Folkmanis in Ho Chi Minh City) provides the most detailed information to date on the situation in Quang Binh. The story broke Monday (March 21, although Bloomberg records it as March 23) when a local newspaper, Nguoi Lao Dong, reported 195 people in the province suffering flu-like symptoms. The story was picked up by Thanh Nien News and posted on the net (see our posts here and here). There had already been several cases of H5N1 in the province, so this report sounded alarm bells.

According to Bloomberg, the figure was based on a household survey asking for the number of people feeling ill, rather than on a medical assessment of each person. A follow-up investigation by "local health officials" brought the 195 number down to 24 with flu-like symptoms. The drop from 195 to 24 is substantial, but even if accurate, is rather a large number of simultaneous cases. The report now says the figure of 24 has been reduced to 7 people with temperatures above 38 degrees Celsius (100.4 degrees F.). This criterion neither rules in nor rules out influenza infection, but selects the more seriously ill for further investigation.

Characteristically, WHO is playing down the seriousness of the situation:
"The whole thing seems to be shrinking,'' said Hans Troedsson, WHO's chief representative in Vietnam, in a telephone interview yesterday. "But we still need to get this verified and confirmed officially. We are still waiting for the conclusions in the reports from the investigating teams.''


"We don't have enough information to make any certain statements about whether there's anything significant happening in Quang Binh or not,'' said Peter Horby, an epidemiologist with WHO in Hanoi. "Our information is that the numbers reported in the local press are very exaggerated, but we don't know the number of people with significant symptoms.''
So they have no idea, but they are relying on reports from local health officials that it's not likely anything significant to reassure us. Unfortunately accurate information, one way or another, seems difficult to obtain from "local officials":
Meanwhile, a local health official said that there are about 200 people in the commune suffering from flu, 120 of them in the village.

Nguyen Tang Ba, an official of the Centre for Hygiene and Epidemic Prevention, said it’s difficult to contact the communal health centre because they lack money for telephone service. The centre sent seven workers to the commune, but they lack resources to stem an outbreak.

Ba said no one here wants to be moved to the district or provincial hospital because they will lose their livelihoods. However, Local residents are already having difficulty selling their agricultural products because buyers worry about catching the bird flu. (Vietnam News Agency)
Agence France Presse (via Vietnam Tribune) reported on Thursday that all test samples submitted so far are "negative," although other tests were being done, exact number and nature unclear. All this tells us is that whatever tests have been done on whatever kind of samples and of whatever number have so far not come up with anything.

There are clearly significant obstacles to getting information and incentives and disincentives to report. It doesn't sound as if we should place much confidence, one way or another, on the basis of what we know from this. Why WHO feels the constant need to minimize public concern when it has insufficient basis to do so is beyond me. Apparently they don't understand they are wasting one of their most precious resources: credibility.

Something they're going to need it when it counts.