Influenza A(H1N1) Pandemic – How Should We Respond?

Introduction
The recent influenza A(H1N1) pandemic has indeed grips many Malaysian with great fear. But fear, in general, indeed can cast a very dark shadow on life; and everyone, to some degree and at some point of time, has been and can be a prisoner of fear - fear of rejection, failure, misunderstanding, uncertainty, sickness, or even death.

As children, many of us were awakened from sleep by night terrors. And as adults today, many of us still look upon life as a continuous series of nightmare because of the fear that has paralyzed our souls.

Nevertheless, in discussing such complex topic, we must not be over-simplistic. Fear, to a certain degree, is healthy. A healthy fear keeps children from playing with fire. The threats of influenza A(H1N1) suddenly opens the eyes of many people regarding the importance of maintaining a high standard of personal hygiene and observing good universal precautions in hospitals and laboratories, as well as in public places. (The details on how to keep good personal hygiene can be known through the Ministry of Health Malaysia website on H1N1; URL: http://h1n1.moh.gov.my/)

Then, there is another kind of fear called the fear of the Lord. The bible says, "The fear of the LORD is the beginning of wisdom, and knowledge of the Holy One is understanding” (Pro 9:10 NIV). The fear of the Lord is a reverential awe for His power and glory as well as a proper respect for His grace and mercy and His wrath and anger. It is a total acknowledgment of all that is of God.

The unhealthy fear, on the other hand, can often be blown out of proportion in our minds, to such a degree as to enslave our personalities. How then shall we respond to this kind of unhealthy fear in general?

Psa 27:1-4 NIV
(1) Of David. The LORD is my light and my salvation— whom shall I fear? The LORD is the stronghold of my life— of whom shall I be afraid?
(2) When evil men advance against me to devour my flesh, when my enemies and my foes attack me, they will stumble and fall.
(3) Though an army besiege me, my heart will not fear; though war break out against me, even then will I be confident.
(4) One thing I ask of the LORD, this is what I seek: that I may dwell in the house of the LORD all the days of my life, to gaze upon the beauty of the LORD and to seek him in his temple.

From this passage, take note that to deal with unhealthy fear:

1. Keep the main focus the Main Focus (Psalm 27:1)
The psalmist starts off the psalm by focusing on who the LORD (Yahweh) is rather than on himself. The Lord is the light, salvation and strength. “For God did not give us a spirit of timidity, but a spirit of power, of love and of self-discipline.” (2Ti 1:7 NIV)

Trusting God is a deliberate refusal to give in to fear. It is a turning to God even in the midst of the threat and in the darkest times and trusting Him that He knows best for me. This trust comes from knowing God and knowing that He is good.

2. Know that Christians are not exempted from threats and sufferings (Psalm 27:2-3)
Psalm 27 does not say that there will be no enemies and threats just because we are trusting in the Lord. Having faith does not mean the absence of sufferings, but rather, having a calm assurance that God, through His Holy Spirit, enables us to face whatever that is troubling us, and know that no matter what happens, it can never separate us from Him and His unending love.

The one thing that underlies all unhealthy fears is the desire for avoidance. The fearful heart says: “When afraid – avoid,” That of course, is possible and should be in some cases. But in other cases, avoidance of fear and threat is a more of a delusion simply because we are living in a fallen world; and in many cases, we are just compounding the problem by blowing the matter out of proportion and turning the fear into a huge monster that blocks our vision of God.

So, how does that relate to the way we should respond to the influenza A(H1N1) scare? First, know that there is just no way we can find a place to totally avoid this threat as of now. There is also no way and no need for us to confirm all cases of flu by testing individuals one by one – it is just too expensive and unnecessarily. Each Polymerase Chain Reaction (PCR) diagnostic reagent testing can be very costly, and most flu illness do not require confirmatory testing, and are mild and self-limiting. More than 90 percent of the flu will get better on their own and some with symptomatic treatment (unless you fall into one of the high risk groups as described in the Ministry of Health website http://h1n1.moh.gov.my/).

In fact, from a sentinel testing and surveillance by the Ministry of Health recently. it have shown that, today, if you have flu symptoms (and especially with a temperature of more than 38C), almost 95% chance that this is caused by the A(H1N1) virus strain.

Furthermore, we should also be aware that this pandemic is not going to go off any sooner – it is expected to be here to stay for at least a year or two before, as in the words of Dr. David Quek, the president of Malaysian Medical Association, “it burns itself out, by hopefully mutating into a more benign form, indistinguishable from the seasonal flu bugs; or because it is finally controlled to near-eradication by specific vaccines. But there is that possibility that it can also mutate by reassortment into a far more lethal form, that much feared second or third wave, which would then demolish all our efforts achieved thus far!” (for a full length reading of Dr. Quek's comments, see footnote below)

In other words, it all boils down to our own personal responsibilities. Know our facts, be well informed and updated in our knowledge, be cautious but do not be overly anxious so much so that it paralyzes us. If we are not feeling well with flu symptoms and fever, seek advice and treatment and avoid going to public places. Keep our body healthy, take good personal hygiene – proper hand washing and proper cough etiquette. Practice some form of social distancing (keeping a distance of about 1- 2 metres, especially from anyone suspected with flu or if we ourselves have flu), and be socially responsible: do not go to public places and infect others.

Wearing mask? Well, unlike the previous SARS outbreak, where N95 masks were needed, for A(H1N1), the 3-ply surgical mask is adequate because it is the large droplets that is the main concern. But I am seeing another problem cropping up since the heightened awareness of using mask: the used masks are being thrown around even in hospital compounds. So, for those who are wearing masks, we should show good examples as Christians, to dispose our used masks properly because the used masks can be a potential biohazard source. In my opinion, the people who should be made compulsory to wear masks are those down with flu and fever. It is also just not possible for everyone to wear masks every waking moments of their lives. If you are out in crowded places, then probably you should wear masks; but hospitals just can't be supplying everyone with masks for their every day use. Be aware also the masks cannot be re-cycled again and again. It should be thrown away when it is wet, or about three to five hours' use. And if you wear it, you need to wear it properly to cover the nose snugly. To learn more about the proper precaution measures and on how to properly wear masks, visit the KKM website here: (http://h1n1.moh.gov.my/h1n1PreventionGuidelines.php)

3. Make a deliberate attempt to dwell continually in the presence of God (Psalm 27:4)
The Hebrew word for “dwell” in verse 4 is “yashab”, which brings the connotation of continue to settle, to return, etc. In other words, it is not a one-off event. It is a continuous deliberate effort to return into the presence of God, feasting and meditating upon His Word, allowing His Spirit's presence to fill us unceasingly. 1 John 4:18 says “There is no fear in love. But perfect love drives out fear, because fear has to do with punishment. The one who fears is not made perfect in love.” (NIV). Where do we find perfect love? In the presence of God. Resting in His love – a love that will never let us go, not even the external calamities and our internal sin struggles. With God holding our hands, we can move into any fearful situation with a confidence that transcends all fear. When fear says: “Avoid”, faith says “Confront”.

Conclusion
In conclusion, writing on this topic reminds me the chorus of the all familiar gospel song, “Because He lives”. The lyrics speak for itself:

Because He lives, I can face tomorrow.
Because He lives, All fear is gone.
Because I know He holds the future,
And life is worth the living just because He lives

Finally, coming back to the question posed in the title of this piece: how should we, as Christians, respond? Is there any difference between how a Christian should respond to this pandemic as compared to others? The answer is yes and no. Yes, because we have a God who is our loving heavenly Father, who is bigger than all threats, and illnesses and who is still sovereignly in control and He has overcome even our final enemy - death. Yes, because we have a hope that is bigger than life. But no, because our heavenly Father does not insulate us in a giant spiritual bubble, where we can be immune from all sufferings and sicknesses. Calamities still do befall upon good Christians, sometimes even for seemingly unknowing reasons like in the case of Job.

We still have a personal responsibility like all people. We should still be vigilant to take care of our personal hygiene not just during the scare of A(H1N1) or SARS, but every moment of our lives because our lives belong to God, and we are exhorted to exercise good stewardship over the temple of the Holy Spirit (1 Cor 6:19). And our personal responsibilities should goes beyond battling A(H1N1). We often forget that there are other infectious diseases threat that are lurking and snatching lives away – dengue, tuberculosis and HIV are among the prevalent ones in Malaysia. Have we forgotten them? The question really is: have we learned our lessons well?

Disclaimer:
This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organization the author is associated with.

Footnotes:
In addition to the Ministry of Health's website which contain many good practical advices, Dr. David Quek, president of Malaysian Medical Association (MMA) has written two excellent balanced articles on A(H1N1). Go to:

1. http://medicine.com.my/wp/?p=7537

2. http://medicine.com.my/wp/?p=7613