FOR seven weeks, Singapore kept the H1N1 flu at bay, delaying the onset of local transmissions even after the flu was imported into Singapore by travellers.

That is no mean feat given how globalised and densely packed the country is, with flights carrying possibly affected passengers arriving here from the world over.

Some credit must go to the Government’s pandemic preparedness plan, which kicked in immediately once the H1N1 flu spread beyond Mexico in April.

Thermal scanners were placed at borders to screen returning citizens and visitors for signs of flu.

Contact tracing took place round the clock, to try to contain any possible local spread.

These labour-intensive actions may have picked up only one in four imported cases, missing the rest. But those efforts helped keep the infected apart from the rest and prevent the virus from circulating in the community.

While not belittling the efforts of the Health Ministry, border control officers and others who have been busy contact tracing, the biggest credit for the containment of the flu so far must go to the people themselves.

Singapore’s first flu victim, a Singapore Management University undergraduate, immediately went to the doctor when she felt feverish on her return from New York. Her quick action prevented the flu from spreading.

The athletic teams taking part in the Asian Youth Games were equally responsible in their actions, even though it meant that their trip here was wasted as they had to forego participation.

Of the 194 cases identified so far, many were people who voluntarily came forward. The reason their infection did not turn into a rapid community spread is that their family and friends were equally responsible.

People here might be self-centred and uncaring during normal times – hence the ‘ugly Singaporean’ tag.

But in a crunch, it is the ‘beautiful Singaporean’ that emerges. This facet of Singaporeans also surfaced during the Sars crisis of 2003. While some did behave badly, shunning nurses for fear of getting the disease, many supported them with notes of support, free lunches and gifts of appreciation.

But more importantly, they heeded the call for greater personal hygiene measures, and when sick, went to see a doctor quickly to avoid spreading germs.

Because some people with the H1N1 could be asymptomatic, yet able to spread the virus, community spread is inevitable.

How fast it spreads is the question. Melbourne, for example, saw over 1,000 cases in just two weeks of community spread.

Singapore is now being put through the litmus test. With the June holidays nearly over, and people returning from vacation abroad, a spike in infections can be expected.

But if everyone continues to act responsibly, then the spread will, in Health Minister Khaw Boon Wan’s words, be a slow burn rather than a wildfire.

Why is this important?

Simply put: the more people who get infected, the higher the number of deaths.

About 600 people here die each year as a result of the seasonal flu. According to international statistics, mortality for seasonal flu is 10 per 10,000 infected.

For H1N1, mortality is higher. In the United States, the rate is 37 out of 10,000 infected.

Globally, 231 have died out of 52,160 confirmed cases.

Given the worst case scenario prediction that about a third of the population is likely to get infected – that will work out to 1.6 million people here – or 6,000 deaths.

And unlike seasonal flu, H1N1 seems to infect younger people more than older ones. World Health Organisation experts think this might be because people who are 52 years and older have some immunity from flu viruses active half a century ago which have since died out.

Another difference is that this flu not only kills more people, but also spreads faster. Experts estimate that it spreads two to five times faster than seasonal flu, largely because of the lack of any immunity among the general population.

If the infections can be kept to a minimum until vaccines are available, then the number of total infections and deaths will be significantly lower.

If flu patient numbers are kept small at any one time, those who are sick get better care than if there are hundreds or thousands down. If health-care services are over-stretched, death rates may mount.

In spite of everything the Health Ministry, hospitals, GP clinics and border controllers can do, rapid spread of the virus cannot be controlled without the active help of everyone.

So people here have to continue to act responsibly: staying away from others when they have flu-like symptoms, staying away from school or workplace for a week if they have been to countries with active community spread.

Lone thoughtless acts can have grave social consequences.

Like parents who send their sick children to school or childcare because they do not want to take leave from work to stay home with them.

Or someone who is sick but doesn’t want to miss a party. Or a worker who turns up for work after a holiday in an affected country.

Employers too should do their social duty and not make it difficult for people who need to be home quarantined.

During Sars, one vegetable seller with the disease went to work, causing the closure of the Pasir Panjang wholesale market, and sending 2,400 people into home quarantine.

While the flu appears mild compared to the more deadly Sars, there are still people who die of it.

Certainly nobody would want to be guilty of making others sick, and even possibly killing them.

This requires all of us to be vigilant and to take any flu symptoms seriously and responsibly by staying away from others.

This is a fight that we as a nation can win.

salma@sph.com.sg