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2008年12月 3日 (水)


2008/12/3 --The Asahi Shimbun, Dec. 2(IHT/Asahi: December 3,2008)

EDITORIAL: New-strain influenza


The government's basic stance on combating an outbreak of potentially disastrous influenza caused by a new strain of virus is about to undergo a major overhaul.


A panel representing the various ministries concerned completed drafting revisions to the government's existing action plan last week. The revised plan, which will be finalized early next year after input from the public, acknowledges that an overseas outbreak of a new-strain flu pandemic would inevitably reach Japan. Thus, the focus of the revisions is to prevent an outbreak from developing into a pandemic.


The current action plan is centered on trying to keep flu out of the nation and isolating infected people quickly. Facilities for such purposes have been set up, but the plan is still lacking in proactive measures to deal with a pandemic.


Many advanced nations already have measures in place to deal with a pandemic, having concluded that containing one would be impossible in densely populated urban areas. We must say our government's proposed change in policy was long overdue.


The panel also drafted guidelines on infection prevention and improvement of medical services, among other things. However, some of these guidelines are still based on past policies and lack coherence. The panel should review them thoroughly and put together effective measures without delay.


Any new-strain flu can quickly spread out of control because people have no immunity.


According to estimates by the Ministry of Health, Labor and Welfare, one in four residents would be infected; 2 million people would be hospitalized; and, in a worst-case scenario, 640,000 people would die. Hospitals and clinics are simply incapable of dealing with so many patients. The same would hold true even if this nation had a fully functional health care system.


The panel guidelines offer two different sets of flu-containment measures by drawing a distinction between the early stages of a pandemic when infections are at their lowest and the more advanced stages of widespread infection.


In the early stages, all patients would be hospitalized, and those who have been in contact with these flu-carriers would be urged to take Tamiflu or other anti-virus drugs for prevention. In the advanced stages, all but the gravely ill would be urged to recuperate at home, and Tamiflu would be dispensed only for treatment, not for prevention.


But who decides when the early stages have evolved into something more ominous? The public must be informed in advance. It is necessary to establish systems, such as the one for delivery of flu drugs, to support people who are recuperating at home. Otherwise, hordes of people will rush to hospitals and clinics. We can't overstate the confusion that would follow.


The panel has proposed setting up a dedicated "outpatient section for those running a fever" at each hospital to prevent infection to other patients. But even experts are divided on whether such a measure would prevent the spread of infection.


The panel also calls for across-the-prefecture closure of all schools when even just one student has come down with flu. If this happens, it would likely result in increased numbers of parents and guardians taking days off from work, which in turn could lead to staff shortages at medical and other facilities where anti-flu services are provided.


Local governments are now faced with the major challenge of planning and implementing specific measures of their own. Each community must ascertain what to do if a crisis arises. It is the responsibility of the central government to support these local efforts.


And now, each one of us should also start thinking about what to do if a pandemic occurs.



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