Did media go too far on swine flu?

Students hit by H1N1 face a new problem — discrimination from a frightened public

by Setsuko Kamiya and Natsuko Fukue

The swine flu scare seems to be over, at least in Japan and at least for now.

On Wednesday, 13 new cases of people infected with the new H1N1 virus were confirmed in eight prefectures, including Tokyo and Osaka, bringing Japan’s total to 406. But the update was treated as minor news by media outlets Thursday, a far cry from the first few weeks of May when the same news would have been splashed across the front page.

In Osaka and Hyogo prefectures, where most of the swine flu infections have occurred, more than 4,000 schools were shut down in mid-May, but most were back to normal by the end the month. Fewer people are wearing masks and the sense of crisis has faded, helped no doubt by the fact that the flu’s symptoms have been relatively mild.

Yet for students and teachers who came down with the bug, and their families, the ordeal is far from over. To be sure, they no longer have any symptoms and are in good health, but many are dealing with stress and anxiety caused by an onslaught of hostility.

Many schools have been under attack, receiving anonymous phone calls and e-mail criticizing them and their students for “bringing the new flu virus into the community.”

Some observers blame the media for what they say was frenzied coverage that frightened people to the point of panic, and that proactive steps should be taken to ease public fear.

“The new influenza virus is something that can hit everybody. The students just happened to get it earlier than other people,” said Yoshinori Yasui of the Infectious Disease Surveillance Center of the National Institute of Infectious Diseases, who headed the epidemiology research team in Osaka Prefecture.

All the schools that Yasui and his team visited in Osaka and Kobe in mid-May had received phone calls and e-mail blaming them for the outbreak, he said.

School principles were worn out, not just from keeping track of the health condition of their students but also from having to deal with the criticism, Yasui said.

The hostility continued after the schools reopened. Officials in Toyooka, Hyogo Prefecture, where several people, mostly minors, caught the flu, came under fire after a few schools went ahead with scheduled field trips.

“Don’t take the students on school trips. If we find someone catching the virus in Disneyland, we will blame you,” said one e-mail to the city’s board of education.

In response, all students at elementary and junior high schools in Toyooka last Friday began attending special classes where teachers explained what is known about the H1N1 virus and reminded them not to discriminate against those who were infected.

On Monday, Yasui and his investigation team visited Kansai Okura Junior and Senior High School in Ibaraki, Osaka Prefecture, where some 100 students had been infected. The team had already investigated in mid-May how the new flu spread at the school and regionwide, but this time they had a new mission — to assure the students they were not at fault and to ease the pain of the ugly blame game targeted against them.

Yasui explained to the students, who were just returning to classes after the school had been shut down for two weeks, what the experts know about the new flu, saying it was by accident that the virus got into the school and the students were in no way responsible.

Nobuhiko Okabe, director of the Infectious Disease Surveillance Center, said the team wanted to thank the school for cooperating with the investigation.

“We want to tell the students that they did nothing wrong,” Okabe said before the visit. “Rather, we appreciate that they cooperated (with the research), because the data will help people in Japan and around the world.”

It is not the first time Japan has experienced such bitterness.

Yoshiaki Katsuda, a psychiatrist and professor at Kinki Health Welfare University in Hyogo Prefecture, said society’s response to the new flu was similar to that of the SARS epidemic in 2003. At that time, he was a doctor at the Japanese Embassy in Beijing.

According to Katsuda, when the SARS epidemic was first reported, the public developed what he described as a phobia over the mysterious malady. Inquiries to doctors and health centers rose and people started lining up to buy masks, leading to a panic.

“Japanese people who returned to Japan from Beijing at the time of the SARS outbreak were met with slurs,” Katsuda said, citing such incidents as people not being allowed to attend a family funeral for fear they might spread the respiratory disease. There were cases where children were forbidden from going to school, or they were given nicknames like “Mr. SARS” and rocks were thrown at them, he said.

There was so much misinformation and finger-pointing that some of the people who returned from China actually developed posttraumatic stress disorder, he said.

“This time, the reaction process happened at a higher speed, because the infection spread faster,” Katsuda said.

He said the public was already a bit on edge over worries about the more lethal avian influenza, adding fuel to the fire.

Katsuda believes the discrimination against people infected with the new H1N1 virus is deeply rooted in the fact that Japanese society tends to scorn the unconventional.

Media outlets in Canada, Britain, the United States and Australia ran interviews of people infected with swine flu, including their names and pictures, in which the former patients openly described the symptoms they experienced.

In Japan there have been no such interviews, apart from a few articles in which a high school student talked — on condition of anonymity — about his quarantine experience near Narita International Airport.

“People get frightened in every country, but perhaps it’s unique to Japan to have an atmosphere where people cannot discuss their symptoms with their real names” out of fear of attack, Katsuda said.

“It would be better if Japanese society had an atmosphere where people actually do that,” he said.

Meanwhile, lawyer Hidenori Urata said the hostility toward swine flu patients reminds him of the AIDS panic in the late 1980s, when people with HIV were kept from schools and companies because government announcements and the media coverage fed public fears over the disease.

Urata is critical of the swine flu media coverage, saying too much focus has been placed on who brought the disease into Japan.

“The most important thing the administration and media should communicate to the public is that people will recover from the flu if they receive treatment,” said Urata, who leads a group of attorneys representing people with HIV in Kyushu who are suing the government and pharmaceutical companies.

In the 1980s, “magazines reported that HIV can be spread via a hand strap on a train or a toilet seat,” he said. Because of inaccuracies like this, people with HIV — including hemophiliacs who contracted the virus through tainted blood products — could not tell others about their infection, thereby increasing the risk of secondary infections.

Out of concern that what the flu patients are going through resembles the experience of the tainted-blood victims, their lawyers issued a statement May 21 asking the government and media to handle the situation calmly.

If the more virulent avian flu enters Japan, Urata said, people might hesitate to be tested out of fear of hostility.

“People infected with the new flu should be treated as patients who can be cured,” and not as targets of discrimination, he said.

On the media’s coverage of swine flu, psychiatrist Katsuda said that in the last few weeks he has read informative pieces explaining what is known about the H1N1 virus and how to keep from being infected, a followup that never happened during the SARS scare.

The important thing for authorities and the media to do is to reduce people’s worries of the unknown by providing clear and concrete information, he said.

“It’s also important to send a strong message that blaming the victims is wrong, and that should be done quickly,” Katsuda said.