Now that swine flu appears to be waning in Mexico and has generally caused mild illness in the United States, people are starting to ask: Did the government overreact?

Did hundreds of thousands of schoolchildren need to stay home? Did cartons of Tamiflu need to be shipped to states by the federal government? Did we need round-the-clock media coverage?

The head of the World Health Organization, Dr. Margaret Chan, defended herself recently against criticism that WHO unduly caused alarm by raising the pandemic level to 5, signaling that a pandemic was “imminent.”

She said the new flu – such viruses are notoriously unpredictable – could return with a vengeance in the fall and that she would rather “over-prepare than not prepare.”

That’s the same conclusion one hears from health officials, school officials, politicians, scientists and advocates: Better safe than sorry.

But they say a fine line exists between alerting and alarming people. When the feared infection turns out to be fairly mild, what’s the risk no one will listen the next time?

“It’s the ‘crying wolf’ problem,” said Arthur Levin, head of the Manhattan-based Center for Medical Consumers. “What if this happens five years from now? Will people say ‘oh boy, here we go again’?”

Suffolk County Executive Steve Levy agreed: “If you speak too much, people might think you’re exaggerating. If you don’t speak enough, people are not being informed.”

Both gave health officials high marks. So did Stephen Morse, a flu expert from Columbia University’s Mailman School of Public Health.

He said authorities steered well between the “mental landmark” of 1918, when officials underreacted to the flu pandemic that killed millions, and the 1976 swine flu outbreak, which fizzled after officials developed an unneeded vaccine that ended up paralyzing hundreds. The 1976 missteps are widely seen as promoting a long-lasting public fear of vaccines.

Referring to the response by the Centers for Disease Control and Prevention this time around, Morse said: “Their advice was pretty conservative: There’s no reason to close the borders; there’s probably not a lot of reason to cancel flights.” And, he added: practice good hygiene and stay at home if you are sick.

But, Morse said, “mistakes were made and will always be made.”

Deer Park school officials, who closed the district for a week, criticized the CDC for first learning of revised guidelines on school closings from the media.

CDC spokeswoman Karen Hunter said that was “regrettable.” But, she said, “our aim is to get guidance . . . out as quickly as possible.”

Local officials say they learned lessons for the future. Both Nassau’s health commissioner, Dr. Maria Torroella Carney, and Suffolk’s health commissioner, Dr. Humayun Chaudhry, said keeping school officials, politicians and health care workers in the loop was key to getting accurate information out as it unfolded and to killing rumors.

Carney said the department is now compiling an e-mail list of all doctors in the county – who need to answer patients’ questions – so that they can be included in updates in the next health emergency.

Chaudhry said his daily e-mail updates on the flu now go to 1,000 people – a list he, too, said could come in handy in the future.

http://www.newsday.com/news/printedition/longisland/ny-liflu0712738552may06,0,1031463.story

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