Swine flu bites Southern Hemisphere

BUENOS AIRES — It's vacation time in the Northern Hemisphere as families pile into cars for a day at the beach. But in South America, it's winter, and this year that means swine flu.

Argentina's health minister claims his country is currently the most affected on earth. Visiting infectious disease specialist Alejandro Macias, who helped coordinate the response to the H1N1 epidemic in Mexico, calls it “the epicenter of the world.”

This is where most of the swine flu deaths are now happening, according to World Health Organization numbers. With 137 official H1N1 deaths, the outbreak in Argentina has been the second deadliest of the pandemic, second only to the United States.

All of those deaths were registered in the past month, almost a third of them just this past weekend. With the flu up north slowed by the summer but just moving into full swing down here, Argentina may very soon have lost more people to the disease than any country on earth.

"The countries of the Northern Hemisphere are looking at Argentina as a mirror," Macias said in an interview with the second largest Argentine newspaper last week. "The same scenario will be reflected next winter in the north, and we've come here to learn."

Canada, Australia and neighbor Chile have all reported several times as many cases of the infection. But the death toll and the mortality rate have been drastically worse in Argentina than in any almost any other country, raising questions about this government's handling of the outbreak.

About half of Argentina's H1N1 deaths have been in and around the capital, Buenos Aires.

“Paranoia” is the word resident Natalia Mueller used to describe the atmosphere in the epicenter of the epicenter, as she accompanied a feeble, mask-wearing friend to a clinic. Mueller was herself sick for a week, and she says that most of her co-workers at a popular Buenos Aires shopping mall fell ill too. A few of them died.

Although life has largely gone on as normal, the fear has been palpable at certain times and places. The financial district was eerily empty when the government declared a bank holiday last week, lengthening the Independence Day weekend. It has also shut down all schools nationwide, doubling the the usual two-week winter vacation. The mayor of Buenos Aires asked children to stay home, but didn't pass any prohibitions on large gatherings.

Many of the usual gathering places have closed by their own choice. In the face of an 80 percent drop in ticket sales, the Argentine Association of Theatrical Businesses closed all the theaters in the country for 10 days. A range of other social events have been individually cancelled, from tango balls to professional conferences to religious pilgrimages.

Economists warn of significant contraction this year due to the drop in business activity — except, of course, in the pharmaceutical sector, which has been selling out supplies of face masks and antiseptic hand gel.

But for the most part Argentine life has continued undaunted. Buenos Aires is not the white-faced ghost town that some would imagine.

With the new holidays, many vacationing employees and schoolchildren took the opportunity to go shopping. Some of the most popular retail districts of the city bustled as busily as ever, with nary a medical mask in sight. The subway and the streets at rush hour are as packed as ever; and the cafes are still busy with denizens tarrying over a coffee and the newspaper, which blares headlines of the mounting death toll.

And hospital visits don't give a picture of pestilence either, although there have been scattered reports of overcrowding. That seems only to be a problem at public hospitals, many of which have postponed non-urgent procedures to prioritize flu victims. To bolster the availability of medical care, the government has installed mobile medical booths, at least 30 in the capital area.

Still, many accuse the government of President Cristina Fernandez de Kirchner of failing to adequately confront the epidemic. Critics say that the government has obfuscated statistics and downplayed the gravity of the situation in order to save face — a common complaint against this administration, and an especially pointed one during the recent election.

Many voters lined up for the polls on June 28 wearing face masks and standing the suggested meter apart; some even defied the obligatory vote, preferring to stay home and healthy. Graciela Ocana, who has now been replaced as health minister, quickly revealed that the president had ignored her advice to postpone the elections due to contagion concerns. Criminal cases have now been brought into federal courts accusing the ruling party of “propagating the illness and causing us to infect each other.”

This is an ironic turn for a government that, when the pandemic first surfaced, had taken action that was too strong even for the WHO: cancelling all flights from Mexico. Now it's getting a taste of its own medicine, with Brazilian airlines cancelling flights and Brazil's government issuing travel warnings, and neighbor Bolivia threatening to close the border.

Closed borders would pose a problem for Argentines crossing over into Chile and Uruguay to buy Tamiflu. Distribution has been tightly controlled in Argentina, with the drug available only by prescription through the government. Last week the government said it would start administering the drug to anyone showing H1N1 symptoms. That should be made more feasible by large shipments imported this past weekend. Argentina will also get a quarter of the nearly half a million doses donated worldwide by the United States.

Officials hope that those stocks will be enough to curb the mortality rate, provided the epidemic stays controlled. Signs suggest it may have peaked with national health minister Juan Manzur claiming that doctor visits and hospitalizations are down in recent days. But his provincial counterpart Claudio Zin warns that there could be a resurgence in Buenos Aires in the coming weeks without vigilance.

And even if the situation in Buenos Aires doesn't get worse, it remains to be seen what will happen in other provinces, which often catch the second wave of outbreaks that start in the capital.

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