Last week, I became an unwitting participant in an ongoing news story: The morning after arriving back in Shanghai from overseas, I felt distinctly unwell. Facing pressing deadlines and a worsening condition, I went to the doctor, who diagnosed me with nothing other than H1N1 – swine flu.
Except it wasn’t quite that simple. According to government regulations, all patients exhibiting flu-like symptoms and with temperatures of over 38C are required to visit official "fever clinics," even without a test confirming the existence of the specific A/H1N1 virus. The doctor explained that a visit to such a clinic would almost certainly result in a week-long stay in a government quarantine center. He thought I would rather avoid that (he was right).
Officially, therefore, I wasn’t diagnosed with H1N1, and the doctor instructed me that – officially – I had never been to see him. He gave me a course of Tamiflu and sent me on my way, with instructions not to leave my apartment for a week. If I noticed no improvement, I would be required to go to a fever clinic, but I was not to say that I had been to see a doctor before. (I’m now out of self-imposed quarantine, and no longer suffering from H1N1.)
The doctor seemed to have the system down pat, probably due to experience: He told me I was the second case that week, and it would not be revealing much to say I was not there late in the week.
It’s not news that official statistics in China are at best approximations – now more often due to the difficulty of getting accurate numbers rather than any concerted attempt to obscure the truth. But reading in the Shanghai Daily yesterday that the city had 1,538 cases of swine flu did make me pause: How many more unofficial cases are there?
The government’s decision to act aggressively in fighting H1N1 is an encouraging departure from the SARS debacle, but having suffered through the more recent disease, I will say that its new approach seems disproportionate. By imposing draconian measures on what is essentially a bad flu, health officials have created an environment where doctors and patients are driven to lie – hardly an encouraging foundation on which to build future public health initiatives.