Facing facts?

As the number of cases of swine flu continues to rise, Shaden Shehab assesses the public mood

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First one case, then seven, 10 then 12. The numbers keep growing. As of Wednesday 29 cases of swine flu had been confirmed in Egypt.

Public reaction to the escalating numbers has been varied. While some people are clearly panicked by the spread of the virus, others seem unperturbed.

The government, meanwhile, seems keen to maintain transparency over its actions to contain the virus's spread.

"It is a disaster. I am afraid to go out," says Alia Mounir, a housewife. "I bought tens of masks, a stock of Tamiflu, hand gel, antiseptic soap and wipes. We have to take precautions."

She is not alone in her thinking so. In better off residential areas particularly, it is now a common sight to find people wearing masks and greeting each other at a distance.

"Egyptians should stop kissing when they meet with friends," says university student Hanaa Gabr. "The flu provides the perfect reason to change unhealthy habits."

Although fatality rates are less than one per cent worldwide, schoolteacher Soha Gamaleddin regards the appearance of swine flu as a "matter of life and death".

"It is essential that everyone react in order for the virus not to spread. If people don't take precautions there will be hundreds of cases," she says.

As people stock up on precautionary supplies prices have risen. Masks that cost LE1 are now selling for between LE10 and LE40, while a pack of Tamiflu, which a month ago was retailing for LE120, now costs between LE400 and LE800. The price depends on the expiry date -- the more distant it is, the higher the price. Meanwhile, the Health Ministry has warned that counterfeit drugs are now being sold, with no effective active ingredients. Public hospitals are the only valid outlets for Tamiflu, say officials, and any pharmacies selling the drug are doing so illegally. The public has also been warned not to take the drug unless they have already developed symptoms, since to do so will boost immunity to the vaccine.

Media campaigns fostering greater awareness are being broadcast repeatedly, urging people to wash hands regularly and avoid crowded areas. To a public accustomed to bad news being buried, the speed with which new cases are reported has surprised many. Almost inevitably, it has spawned rumours that the situation is far more serious than it appears, and that the number of reported cases is a fraction of the real figure.

"There is no need to panic. If I, or anyone of my family, get the virus it's just a matter of going to one of the Health Ministry's hospitals and being tested. This is not a fatal disease," says Maha Anwar, an accountant.

"I have just come back from Germany where there are far more cases of swine flu but no one is panicking," says Hisham El-Agroudi, an engineer. "Of course in Egypt there is the additional worry that the environment is virus-friendly as a result of overcrowding and poverty. The way avian flu spread is not a good precedent."

The first human case of bird flu in Egypt was reported on 16 February 2006. Since then 80 cases have been recorded, 25 of them in the last five months. A total of 27 patients have died.

Since the virus was first detected government campaigns to contain its spread have proved unsuccessful. Poultry continues to be raised domestically despite the risks being well publicised. An estimated 30 per cent of the population depends on breeding fowl to help feed their families and supplement incomes.

Patterns of habitation leave Egypt particularly vulnerable to any virus. The vast bulk of the population is concentrated on just five per cent of Egypt's land mass, leading to the kind of overcrowding that facilitates the spread of viruses.

Many experts stress that it is the poor, once again, who are most at risk. If the inhabitants of overcrowded shantytowns feel unable to afford to stop keeping fowl at home, they are unlikely to go out and spend what little money they have on purchasing masks and hand gels.

"What is this swine flu?" asks Ateyat Mohamed, a maid. "All this talk of bird and swine flu is nonsense, an excuse for the government to cull birds and slaughter pigs. God is our protector. Poor people like us have to think of how to make ends meet rather than waste time worrying about flu."