bird flu 88.
(photo credit: )
An inalienable part of an Israeli childhood is watching for the autumn arrival of the wagtail (nahlieli). This charming and lively migrant, famous for its clockwork gait and undulating flight, is a perennial favorite and possibly the subject of Bialik's prototypical Zionist verse: "Welcome delightful bird back to my window from warmer lands."
This geographically diverse, tiny country straddles the crossroads of three continents, making it a popular stopover for numerous species of avian transients flying southwards to escape harsh winters. One of this country's greatest attractions, next to its holy places and historical sites, is its unique ornithological wealth. Israel is bird-watchers' heaven.
This year, however, that very attribute may put us in possibly precarious straits. With the bird flu scare - exaggerated though it may be - gaining momentum, it's prudent to be mindful of the fact that our feathery visitors each fall might put us - in theory at least - in greater dangers than other countries. The fact that avian flu has already been identified in the Balkans and in Asia Minor, almost next door, isn't incidental. They are on the migratory path which eventually leads right here.
That said, there's no justification for panic. An avian flu pandemic isn't a fact but a possibility. How likely or remote it will turn out to have been will only be realized in hindsight. All that's now certain is that the virus has to a limited extent infected human beings who came in close contact with ailing domestic fowl. There's yet no evidence of human-to-human contagion. The danger, however, is that the virus might mutate - possibly via contact with known flu viruses - whereupon it could become the agent of the dreaded outbreak.
This demands of us, and most of all of the Health and Agriculture ministries, a very delicate balancing act - not always an easy feat. The professionals mustn't lose composure and fall for the hype to make PR capital. At the same time they mustn't belittle the dangers, either. It's all too easy to pooh-pooh what is for now only a hypothetical hazard. The easiest course, and the most frugal, is to scoff at international warnings and forget Israel's location and migratory-bird population.
From experience, we know that our authorities manifest predilections for going to extremes - either dismissing dangers or magnifying them in order to cover themselves (as with the gas mask distribution on the eve of America's invasion of Iraq).
Any such response - either over-the-top or negligent - is bad public policy.
Adequate supplies of anti-virals are never a bad investment, as there is no cure for specific viruses, only broader-spectrum symptom-alleviators. Regular flu vaccines for as many Israelis as possible - even if young and healthy - are always a good idea, which eventually pays for itself.
Perhaps indeed the most important thing Israel can do now is to gear itself up for the coming common-flu season. It's pointless preparing for an epidemic when we never seem to cope with the routine cold-weather plethora of respiratory infections.
Every winter, with the eminently predictable onset of very ordinary flu, our hospitals become chronically and acutely overcrowded. It's as predictable as the change of seasons. Each year the sorry state of our hospitals is rediscovered, as if the advent of winter were a total surprise. Every year the beds in the corridors, the indignities to which patients are subjected, the overworked staff, conditions that aggravate ailments and even take lives - make headlines all over again. After a few days of much sound and fury, the commotion peters out.
In winter, some internal medicine wards reach 130 percent occupancy and last year some hit the 170% mark. The western European average ranges between 75%-85%.
The best way to cope with a possible pandemic is to deal with mundane needs.
The unimplemented notion of "winter wards," proposed by the medical association, should be seriously considered. Each hospital can juggle beds and wards to seasonally expand internal medicine wards. True these are merely palliatives that won't eradicate our underlying hospitalization malady, but without immediate symptomatic treatment we won't be ready for any winter affliction - neither ordinary nor extraordinary.