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To the health minister

Rubaiul Murshed
OUR health minister said that there is no reason to be scared of "swine flu." He probably wanted to mean that creating panic would not be right But with due respect to his views, we have to really be very cautious about this unpredictable natured H1N1 virus. According to WHO, "it is a sloppy, capricious, and promiscuous influenza virus."
Our closest neighbour, India, has already formulated proper guidelines along with knowledgeable specialists and management experts regarding this crisis. They are heading towards a National Preparedness Program. And despite the rapid spread of "swine flu" in that country, mortality rates are still low. Of course, the danger remains.
For us as well — it’s an opportunity to learn about the "infection disaster man-
agement" properly. Please, do not forget that this is the first phase of the pandemic and that's why it is milder in nature. Although your ministry has opened some exclusive wards in public hospitals, the investigation facilities are inadequate.
Then again the antiviral drug "Oseltamivir” (Tamiflu) works like magic but people are confused about the availability of this medicine. As a reputed clinician of this country, you know, most of the fatalities take place due to delay in treatment.
WHO says it may stay for months. Yesterday it was bird flu, today it's H1N1 and who knows what's waiting for us the day after tomorrow! And this is the time to think about "National Health Security Preparedness." Strategic planning requires strategic thinking. And to be up to date, we need to change often along with the worlds' everyday scientific progress.
At the moment, we need to strengthen the surveillance immediately, not only with your government structure but also involve nongovernmental bodies. Increase the number of investigation centres --involve all private clinics/hospitals that have more than 100 beds. Do not forget to monitor them by a strong monitoring cell involving people in and outside the government. Regarding the proper medicine, kindly make the scenario more transparent and make it available within affordable price, or free for "those who have less."
Although it started in Mexico and America, "swine flu” is now in our country. It's not easy for our doctors to diagnose the illness quickly as investigation facilities to confirm are unfortunately still inadequate. As crowded places are one of the risk factors — health ministry should order to close down schools right away and, meanwhile, improve the
awareness- program and manage the epidemic properly before opening after the Eid holidays. H1N1 is highly infectious and spreads very fast -- which is probably the major difference from other influenzas.
Although facemasks are very popular these days there is no real evidence (apart from the N95 respirator) that proves wearing a facemask will stop you getting the virus. Import this N95 respirator, which is considered the best with 95% protection.
Finally, one of the most important issues, "custom screening" at sea, land and air ports, should be carried out very strictly, and our finance and civil aviation ministers can cooperate with the health minister in these worrying times of need.
Dr. Rubaiul Murshed is a Professor, Health Care Management.