Situation in Ukraine – October 30, 2009

There have been recent reports of deaths from the pandemic H1N1 virus in the Ukraine, in the western oblast of Ternopil. The number of confirmed dead varies from 1 to 11 to 30. However, even if 30 are confirmed, this would indicate an incidence of death of .06 per 100,000, a relatively low number compared to many countries. For example, the incidence of death in the US is approximately 0.4 per 100,000. Yet, the Ukranian government has taken extraordinary steps to control the outbreak. These include:

  • Closing all schools for 3 weeks
  • Banning all public gatherings (movies, concerts, etc.) for 3 weeks
  • Restricting movement into and out of the affected region

School closures and limitation of public gatherings were imposed in Mexico and Argentina at the height of their outbreaks. However, internal movement restrictions were never implemented even though the number dead was much higher in these two countries than in Ukraine now.

So, why the dramatic steps in a country with a relatively small outbreak and relatively few deaths compared to other countries? Some possibilities:

  1. The government is panicking. They never expected any deaths, had no plan and are over-reacting.
  2. The number of deaths is much higher than has been admitted by the government.
  3. It is the pattern rather than the number of deaths that is raising the alarm.

Ukraine is in desperate financial trouble. The measures taken today are likely to further damage an already sick economy. It seems unlikely that the politicians would suddenly panick and destroy their economy for a relatively few deaths. So, possibility 1 seems unlikely.

Many governments have been hiding deaths. Option 2 is possible.

There have been reports of health care workers who have died and rapid spread of the virus within a relatively small area. This could mean a more virulent strain of virus. So, option 3 is also possible.

The methods announced today by the Ukrainian government are old school techniques for limiting the spread of disease. They can be effective when rigorously applied. Without large amounts of Tamiflu or vaccine, which the government does not have but is pleading for, social distancing is the only tool they have to limit the spread of the virus. They are wise to use it.


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