Swine Flu and Megacities

by Alanna Shaikh

Published July 27, 2009 @ 11:10AM PT

(photo credit: nfalsey)

Swine flu is going to hit megacities hard. The virus is spreading globally, and fast, but so far it's not much more intense than ordinary seasonal flu. It hasn't had a substantial impact on everyday life. Megacities may be the exception. The dense living conditions let the flu spread quickly, especially since poor people have less immune resistance to infectious disease. In addition, pollution and living conditions will make the flu more severe in people who contract it, and people often lack access to quality health care services. In my opinion, Mexico City's huge size was a major factor in why swine flu was so much more severe in Mexico than in the United States.

H1N1 is already highly transmissible; it spreads easily and rapidly from person to person via aerosolized droplets of saliva or mucous. It can live for more than seven days on a hard surface. In areas without consistent access to clean water for hygiene and housecleaning, people will be exposed to those viruses on surfaces much more often. In densely packed households, far more individuals are exposed to aerosolized droplets. As a result, megacity slums will see extremely high rates of viral transmission.

That high transmission rate will be compounded by substantially increased death rates from swine flu in megacities. The risk factors for death from swine flu are asthma, cardiovascular disease, obesity, and diabetes. All of these things are more common in the megacities of the developing world. Asthma is a particular risk factor, and it's made worse by air pollution.

The death rate will be made worse by lack of health care. Megacity slums are consistently deficient in access to good health care. Residents may be unable to afford health care, facilities may be poorly equipped or staffed, or there may simply be no health care provider available.

So, a lot of factors are going to come together in an ugly interconnected way. More sick people being hit harder by the virus, and no health care providers to look after them. It could be devastating. My grim guess, however, is that misery and death from swine flu in megacity slums will be ignored, just as we ignore misery and death in the slums from everything else.