When swine flu first hit, Egypt killed its pigs. All of them. Now this senseless decision has left Cairo with a major public health problem on its hands.

The pigs used to eat tons of organic waste. Now the pigs are gone and the rotting food piles up on the streets of middle-class neighborhoods like Heliopolis and in the poor streets of communities like Imbaba.

Ramadan Hediya, 35, who makes deliveries for a supermarket, lives in Madinat el Salam, a low-income community on the outskirts of Cairo.

“The whole area is trash,” Mr. Hediya said. “All the pathways are full of trash. When you open up your window to breathe, you find garbage heaps on the ground.”

The pigs belonged to the city’s traditional waste collectors, Christians who lost their animals and their livelihoods. “They killed the pigs, let them clean the city,” says one. “Everything used to go to the pigs, now there are no pigs, so it goes to the administration.”

Update: It doesn’t make me feel any better about this story to see that the pigs seem to have been buried alive.

I’m also reminded of the 4 million or so cows the UK ended up slaughtering and burning during the BSE crisis, because we couldn’t be bothered to maintain basic standards of animal husbandry.

For governments, managing risk is a pretty thankless task. Today, the House of Lords Science and Technology committee published its report on pandemic flu. Here’s the finding you won’t see widely reported:

We know from the evidence we received prior to the outbreak of swine flu that there has been a significant amount of work undertaken to ensure UK pandemic preparedness. According to Ms Merron, the WHO recognised the UK “as one of the best-prepared countries in the world”. Professor Lindsey Davies, National Director of Pandemic Influenza Preparedness at the DoH, told us that “No other country in the world has done more than we have to ensure that we protect the population and that we minimise the pandemic’s impact”-other countries are now coming to the United Kingdom for advice.

Instead, the spotlight will be firmly on where the government has got it wrong:

Guardian: “Committee concerned over delays, failures and preparedness for expected ’second wave’ of virus in autumn.”

Telegraph: “Committee says Government has failed to offer reassurance that NHS services can deal with a “second wave” of swine flu.”

Sun: “NHS can’t cope with swine flu.”

Independent: “The spy who blew the whistle on his former colleagues is now living in a squat, dressing as a woman, and railing against the ‘Zionist empire’.” [Sorry - seem to have got my wires crossed here.]

Of course, none of these stories is a surprise. The Committee made sure the bad news got out over the weekend, leaking the bad bits to the BBC. Ministers have been on the defensive ever since.

Three reasons why this matters. First, it feeds cynicism about the public sector, helping convince ordinary punters that civil servants are such morons that they haven’t done anything useful to prepare for the pandemic.

Second, it creates a cartoonish view of the nature, and limitations, of any response to a serious pandemic. With an attack rate of 30%, our social, economic and health systems are certain to degrade to a degree (though hopefully, in a controlled way). Resilience relies on individuals, families, communities and networks of all kinds to pull together.  Expecting the government to ride around dolling out magic bullets is both a self-indulgent and ultimately self-defeating strategy.

The final point, though, is perhaps the most serious one. The Lords’ criticisms are aimed mostly at patchy implementation of a good strategy. But what if the strategy itself is faulty – not just the detail of its execution? That would be a much more serious matter.

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Not a good start for the new UK  National Pandemic Flu Service.

India Knight, writing in the Sunday Times, wishes a state-employed magician could come along and make her feel better about swine flu. As that’s not possible, she’s putting her faith in larceny and homeopathy.

We’re not supposed to take our swiney selves or our swiney children into doctors’ surgeries, and doctors are far too busy for house calls, so, as far as I can see, we’re all in the dark. Also, I don’t like the sound of Tamiflu, with its side effects and lack of long-term trials. But then I don’t like the sound of death, either.

No wonder every parent I spoke to last week was in a state of controlled panic — except for the ones who’ve had swine flu, who were all cheerful and said, “Pah, it’s not so bad; you just go to bed for a few days” — although they all said there was absolutely zero support or advice available to them other than: “Don’t go to work.”

This — “it’s not so bad” — had been my take on it until healthy people started dying. Now I’m hovering between, “Yes, but healthy people still die of normal flu — not many, but some, just as some women still die in childbirth and nobody gets pregnant and then starts running around wailing about death,” and, “Oh my God, oh my God, what are we going to do?”

So far I have failed to come up with a plan. I used my low journalistic cunning to sweet-talk two chemists into telling me where the stocks of Tamiflu for my area of London were held, so now I know where to break into if we suddenly find ourselves burning up in the middle of the night. And I’ve ordered some homeopathic remedies.

Update: In the comments, Eleanor suggests a dose of homeopathic A&E.

A worrying factoid from CNN (courtesy of Chris Blattman):

In each of the four major pandemics since 1889, a spring wave of relatively mild illness was followed by a second wave, a few months later, of a much more virulent disease. This was true in 1889, 1957, 1968 and in the catastrophic flu outbreak of 1918, which sickened an estimated third of the world’s population and killed, conservatively, 50 million people.

As the small print in stockbrokers and pension funds’ ads always tells us (if only we’d listened), the past is not always a guide to the future, but if the swine flu scare wanes over the summer, it would be dangerous to get complacent.

In the New York Times, think tanker, James Jay Carafano (areas of expertise: homeland security, defense, military affairs, affairs, post-conflict operations, and counterrorism) gets hot under the collar about “news stories [that] play fast and loose with terms like ‘outbreak,’ ‘epidemic,’ and ‘pandemic.’”

His advice: “We should all just wash our hands and go to the doctor if we have flu symptoms.” Er, wrong. According to the Centers for Disease Control and Prevention (area of expertise: public health):

If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

CDC is happy for people to contact their doctor if they need advice, but it only recommends adults seek emergency medical treatment if they have: (i) Difficulty breathing or shortness of breath; (ii) Pain or pressure in the chest or abdomen; (iii) Sudden dizziness; (iv) Confusion; (v) Severe or persistent vomiting. (The advice for children is similar – the list of warning symptoms different.)

In the UK, health authorities are even more explicit about the fact they don’t want people with flu sitting around in doctor’s waiting rooms. “If you have flu-like symptoms and have recently travelled to Mexico or been in contact with someone who has, stay at home and contact either your GP or NHS Direct on 0845 4647,” advises the NHS. Treating people without requiring face-to-face contact with healthcare professionals is at the heart of of the UK’s pandemic flu plan.

Carafano’s sins are minor compared with this preposterous Guardian article by Simon Jenkins (core expertise: frothing at the mouth).  According to Jenkins, swine flu is “a panic stoked in order to posture and spend” – with the public too moronic to resist having the wool pulled over its eyes:

We appear to have lost all ability to judge risk. The cause may lie in the national curriculum, the decline of “news” or the rise of blogs and concomitant, unmediated hysteria, but people seem helpless in navigating the gulf that separates public information from their daily round.

The government was “barking mad” to convene its emergency planning committee, Jenkins argues, while the World Health Organization is not really worried – it’s just making a pathetic bid to shore up its funding. Attention-whore doctors, health and safety hysterics, and rapacious drugs companies are all in on the plot, while ‘professional expertise’ (presumably from shrinking violent newspaper columnists) is being completely ignored.

BSE, SARs and avian flu, meanwhile, provide cast iron assurance that no pandemic is on the way. (more…)

Paul Kedrosky has dug up this interesting map of the spread of the Black Death in Europe in the 14th century – a process that took place gradually, over a span of four years.

So how would such a map look if used to plot the spread of a pandemic today, Kedrosky wonders? Well:

there would be similarities, of course, but there would also be big differences. Instead of contiguous, banded advance you would see viruses hurled ahead of the index cases by air travel, like spot fires a mile ahead of a Santa Ana-driven wildfire. Instead of bands you would have clusters and jumps, mostly corresponding to airline disease vectors. And instead of four years to travel through a corner of the known world, you would have the virus around the world in four days, as is the case today with this H1N1 swine outbreak.

Interesting coda: in comments, Matt Dubuque notes that when the Black Death wiped out a significant chunk of the English labour force in 1340, remaining agricultural labourers were able to crank their wage rates sky high. Presto! – major resource transfer from rich to poor.

Over on the public health section of the always-excellent Change.org, Alanna Shaikh has helpfully written The Definitive Swine Flu Post.  Here’s her advice:

1. Swine flu will spread globally. The only question is whether it will be a mild flu or a severe one. It could still go either way. My best guess would be that it will be bad, but not mass-death-1918 pandemic bad.

2. If you want to routinely protect yourself from swine flu, wash your hands every single time you enter a building with facilities to wash. This means when you go into your house, your office, a restaurant, a bar, whatever. Carry hand sanitizer, and disinfect your hands before eating if you are away from home and can’t wash your hands right before. Do not kiss your friends hello. Don’t share food, or eat the unwrapped mints from that bowl in the foyer of the Italian restaurant down the street. Now would be a very good time to quit biting your nails.

3. If your city sees an outbreak of swine flu, avoid crowds. Don’t take public transport, or attend public events like concerts or sports games. Limit your social contact by reducing your shopping trips to once a week. Wearing a mask is overkill unless your local health department recommends it.

4. If you have flu symptoms, stay home. Call your doctor, and describe your symptoms. She will decide if you need to go to a hospital. (Do NOT go straight to an emergency room.) Don’t go to school or work. If you do have to go out (like you live alone and need food), wear a mask and choose a time that minimizes human contact. Avoid contact with the people in your house. Cover your mouth when coughing or sneezing, and use paper tissues and flush them once they are used. Clean surfaces like doorknobs with a regular cleaner, like Lysol.

5. If you are genuinely terrified of bodies-in-the-streets mass public health hysteria, then prepare. It will make you feel better, and in the unlikely event your worst fears come true, it will help. If you can afford them, emergency supplies are always good to have. Any number of websites can help you make a plan. The CDC is a good place to start.

To which I’d add: if you do live alone, then you’re more vulnerable and you need to be thinking ahead.  The vulnerability here is less to infection per se than just the lack of backup: someone to go and get your Tamiflu from the chemist, or to get some food in for you.

So as Charlie recounts in his excellent new pamphlet Resilient Nation, the kind of preparation you really need to be thinking about is less a cupboard full of Tamiflu or a cellar full of canned food than a social network you can rely on.  So if / when you get to the point when infection rates are rising in your area, then agree to buddy up with friends and check on each other regularly. Swap phone numbers with your neighbours, so that if one of you falls ill then you can keep in touch without sneezing all over each other. Think about who else might need help in your circle or on your street.

From 9/11 truther mission control, Infowars, comes stunning news: “deadly swine flu… was cooked up in a lab.”

Yes – the first swine flu conspiracy theories are hitting the Internets, providing a rare opportunity to view these numb skull paranoids as they struggle to assemble a few fragments of information into a suitably cunning plot.

Here’s how it goes:

Evidence: The flu virus is reported to combine “genetic material from pigs, birds and humans in a way researchers have not seen before.” Implication: the virus was probably deliberately released.

Evidence:  ”In all U.S. cases, the victims had no contact with any pigs.” Implication: Pigs are evil… er they caught it from other people… er pigs never had anything to do with it.

Evidence: A public health official says: “This strain of swine influenza that’s been cultured in a laboratory is something that’s not been seen anywhere [before].” Implication: The poor guy wasn’t referring to standard identification techniques, but letting slip vital details of a dastardly scheme. WE TOLD YOU IT WAS DELIBERATELY RELEASED.

Evidence: The world has huge stock piles of Tamiflu. “Top globalists and Bilderberg members like George Shultz, Lodewijk J.R. de Vink and former Secretary of Defense Donald Rumsfeld” have a financial interest in Tamiflu. Implication: THEY’RE BEHIND THE ATTACK.

Evidence: The 1976 swine flu scare didn’t add up to much. Implication: RUMSFELD WAS BEHIND THAT TOO.

Now I am sure the story will become more polished as additional information is available to be distorted. But remember. This is how it started. And this is how little evidence these cretins need to start spinning their fantasies…

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