Christian Nordqvist, Editor and CEO of Medical News Today, lives in Cancun, Mexico for 70% of the year, and in Manchester, England for the other 30%. His blog is about the local impact of the Swine Flu in Mexico.

Cancun has become so peaceful “you can hear the flies buzzing past” (“se pueden oir las moscas”, a translation of a local expression). Yesterday the Cancun Hotel Association announced that a significant number of hotels have closed down temporarily, especially those chains that have more than one hotel in the resort. Vacationers have all been moved to one while the others are temporarily closed. Several restaurants have placed large signs announcing incredible discounts.

Even though the swine flu (H1N1) virus is nowhere near as virulent as originally feared – it is no more deadly than normal seasonal human influenza – shop assistants, cinema sales people, and employees who are in constant contact with the general public are still wearing face masks – not all of them, but a sizeable percentage.

Any bit of hopeful news is announced straight away. This morning I heard that the United Kingdom has lifted the travel ban to Mexico. We also heard that the Centers for Disease Control and Prevention (CDC) in the USA has downgraded its Travel Health Warning to a Travel Health Precaution to Mexico. However, the trickle of tourists everybody is waiting for has not yet begun.

My personal trainer, who also works in the gym of a well known hotel here, was yesterday laid off until further notice. He met my son this morning and told him. The local unemployment this swine flu scare has triggered has been considerable. I hope people have managed to salt away some savings. I am told that the inhabitants of the Yucatan Peninsula, where Cancun is, have historically been good savers. Over the centuries they have learnt to prepare for hurricanes which can wipe out all your belongings.

Again, I must mention at how impressed I am at how Mexicans deal with tragedy. The herd instinct to pull together and solve the problem in the best way possible is palpable. Mexicans tell me theirs is a country with a history of earthquakes, hurricanes, and anguish that have made them good at dealing with crises. With local humor some add “it is a pity we are not so great when there is no emergency.”

Conspiracy theories are circulating briskly. Some say the virus was intentionally started by certain sinister organizations in a lab, while others accuse the authorities of deflecting public attention from the current financial crisis. I try to comment that any conspiracy involving lots of people nearly always ends up with somebody leaking the information to the press and that nobody, no matter how evil, would dare take the risk for that reason. Conspiracy theorists exist everywhere, not just here – England has its fair share, as does the USA.

I sensed a flicker of light at the end of this dark tunnel when an American friend who is from North Carolina told me he is going there in June and had problems getting a flight back. He said June bookings were healthily high. If this could be reflected throughout the USA, surely it must mean that many Americans did not cancel their Cancun trips, they just postponed them.

Mexican authorities are gradually lifting the national five-day virtual shutdown. My son starts school next Monday. He was supposed to start today, but authorities decided to turn the one-and-a-half week national school closure to two weeks. Several universities around the country are operating normally today. In Cancun, cinemas are operating normally. I walked into a cinema this afternoon to see what was on and asked the ticket salespeople what business was like. I was told there was a very meager trickle of die-hard movie goers. They could not decide whether the poor attendance was due to the economic hardship caused by the sudden lack of tourism in the town, or that the locals were still apprehensive about going into closed and crowded places.

I drove along Kukulkan Boulevard, Cancun´s main waterfront avenue today. Traffic was quiet, and the usual flow of tourists was just not there. It felt like a city that had been evacuated. 99% of those walking along the sidewalks were Cancunenses (Cancun locals). Restaurants, all open, were empty. Taxi ranks were full of stationary taxis – nobody was going anywhere.

Everybody here is waiting for the return of foreign flights full of vacationers who come all year round. This afternoon when I was walking down to the corner shop to get some sugar I was invited by a bus driver to board his empty bus. When I told him I lived just down the road he smiled politely, and scanned the area for more prospective passengers. I have never seen that before anywhere – a bus driver getting out of his vehicle to drum up business.

The 79 Mexicans who are back from their ordeal in China have received a hero´s welcome. One lady appeared on national TV saying she, and many others, were placed in a room for five hours with nothing to drink and no access to toilets. I try to explain, whenever I can, that China is still smarting from the SARS outbreak a few years ago – that the country was strongly criticized for not doing enough. It is not easy to break through national pride sometimes. Perhaps it is now time for the diplomats to smooth things out and get the two countries back to warm relations again.

Fear of swine flu has evaporated in Mexico now. Most people realize the virus is no more virulent than ordinary seasonal human influenza. Even so, shopkeepers and their assistants are still wearing masks. There is a growing sense of relief, mixed with doubt – was the response too severe?

After witnessing this region´s source of revenue and jobs dry up as a result of “precautionary measures” carried out by airlines and governments and agencies, I wonder whether the experts should not sit down again when this is all over and think through a less draconian set of guidelines. How many people in Cancun will lose their homes because they cannot keep up their mortgage payments, how many will commit suicide over the next 12 months, how many will become physically and mentally ill as financial difficulties mount up? A mild virus´ spread seems to have been stemmed – but at what cost?

The May 1st Labor Day parades were all canceled in Mexico. Once a year, as in many other countries, workers and trades unions parade down main city and town avenues to celebrate the Day of the Worker (Dia Del Trabajo = Day of Work = Labor Day). Any event where large numbers of people are likely to congregate and raise human-to-human infection risk has been canceled.

We met some friends at a bar last night. At the Aqua hotel – a lovely place in the Hotel Zone of Cancun, just across the road from La Isla, a Venice-like shopping center. There is an open-air spot I like there just by the swimming pools with sofas and lovely armchairs and a bar. At night you can see moonlight bouncing off the sea and hear the waves – the place is magic!!

Unfortunately, that bar was closed for the evening. We had to go to another one in the same hotel. All the bar staff were wearing protective masks – at first it looked as if they had dressed up for some fancy dress event. However, on closer inspection I could tell they were wearing them for medical reasons.

A waiter came up to us with a bottle of bactericidal gel and offered it to us. We all placed our hands out and received a squirt. I have heard from people in England that the press there is saying there is a wall of silence in Cancun hotels – that hotels are not telling their guests anything. From what I have seen – about 15 different hotels during the last week – I suspect that at best they are reporting on an isolated case or two, and worst they are short of material and are making it up as they go along.

The place we were sitting at has a capacity for at least one hundred people. Apart from the four of us, there was just one other table with four people and that was it. The rest of the place was very quiet – extremely unusual for Cancun on a Friday night. We also noticed that the streets were much calmer than usual on our way there – at about 9pm. The streets were not empty, but the Friday night bustle was definitely not there.

One of our friends has a music band and plays at various hotels in Cancun. He told us that his contracts are still good and long-term, but that there are fewer and fewer people listening to his band each evening. He had just been playing at a fairly large hotel and counted just 15 people, compared to the usual hundred or so.

To add to the local stress, three major American airlines announced yesterday that they were significantly cutting flights to various Mexican destinations, because of a serious fall in demand – United Airlines, Continental and US Airways. This is on top of the scores of European airlines that had already stopped flying people to Mexican destinations, as well as Canadian airways. Cancun, and most Mexican resorts have a tourist industry which is drying up alarmingly quickly.

We are going through a weird period, both globally, nationally in Mexico, and locally in Cancun. During the second half of last year the world’s financial institutions started going into major meltdown – heads of states ran around like headless chickens pouring money in the hope of halting a domino effect. The price of oil dropped from a $140 per barrel peak to under $40 and has never really shown any real signs of coming back up. As people in the developed world, which for Mexico means the USA, Canada, and Western Europe, started tightening their belts and cutting their vacation destinations, the Mexican economy was already taking one hell of a knock. Mexican remittances – money Mexican workers in the USA send home – started dropping, their oil income plummeted, and their tourist income fell. Mexico’s three main sources of strong currency income are oil, remittances and tourism. Now the tourism is on free-fall with the current swine flu scare.

I call it a scare because swine flu is a mild H1N1 virus. It is nowhere near as virulent as the H5N1 bird (avian) flu everybody is worried about. Virtually everybody who catches swine flu will get better fast, especially if he/she can get to a doctor. I predict that over the next few weeks we will hear that the number of deaths in Mexico is not as high as first thought – and that becoming infected with swine flu is not such a dreadful thing.

It is still wise to try to stem the spread, if possible. The swine flu virus might infect a person who already has the normal seasonal human flu and exchange genetic material with that virus. The result could be a new virus, a mutation. If the numbers of infected people rise fast, the chances of a mutation are greater. However, a mutation does not necessarily mean we would have a new killer flu. It just means there would be another new virus – this happens all the time with viruses. Hence, I stick to my prediction that this will die away and everything will soon go back to normal. For the sake of the hundreds of thousands of workers in Cancun and down the Mexican Caribbean coast whose livelihoods depend on tourism, I really do hope I am right.

Pig farmers in Mexico are suffering from a significant drop in pork meat and pork products sales. Swine flu, which in Mexico is called Fiebre Porcina (pig fever), is thought by many to mean that anything to do with pigs and pork is dangerous. From what I have read, this fear is not exclusive to Mexico – pig farmers in the rest of North America and Europe are also concerned about the fall in demand. Veterinary associations in Mexico are trying to get the message out that the consumption of pork meats in no way increases your chances of catching swine flu.

The two main opposition parties in Mexico, the PRI and PRD, are urging President Calderon’s government to offer urgent financial support for the country’s pig farmers. We are informed here that the FAO (Food and Agriculture Organization of the United Nations) will send experts to Mexico next week to determine whether the current swine flu H1N1 virus exists in pigs, as well as to verify whether there is any link between the current outbreak and pigs.

News agencies tell Mexicans that there is no evidence at all that links the current swine flu outbreak to pigs – and quote FAO experts who say the same.

A division of Mexico’s largest trades union, the CTM, reports that the sale of pork products and meats have dropped 80% nationally. They blame the inadequate public broadcasting of proper data. Scores of abattoir (slaughterhouse) workers stand idle at their places of work – many have been laid off (made temporarily redundant) without pay.

The Confederation of Mexican Pig Farmers (Confederación de Porcicultores Mexicanos) is urging President Felipe Calderon to change the name of the current outbreak from Swine Flu (fiebre porcina) to North American Influenza (Influenza Norteamericana). I have read that this request has been made by pig farmers and pork associations in many countries, as well as by several eminent experts.

Agustín Carstens, Mexico’s Treasury Secretary (Secretario de Hacienda), announced that the Mexican economy will shrink by between 3.8% and 4% during 2009. This is a slightly more optimistic estimate when compared to the one made by the Bank of Mexico. I tell local people that Mexico is not alone in suffering badly from the global financial crisis. I don’t think it offers them any comfort. Telling someone that his pain is not unique does not make that pain go away.

According to the newspaper La Jornada, 3 million people have stopped using Mexico City’s subway (underground train) system since Monday, after four subway workers came down with flu-like symptoms. Three of the workers were found not to have swine flu, while the other one is under observation. Authorities report that all four workers’ places of work have been thoroughly disinfected.

The Linea 1 (Line 1) subway route in Mexico City will stop operating as from today until 3rd May at seven stations, where maintenance work will be carried out, informed the Sistema de Transporte Colectivo (The Collective Transport System). The closed stations are Cuauhtémoc, Insurgentes, Sevilla, Chapultepec, Juanacatlán, Tacubaya y Observatorio.

We are told on the news that masks are effective in stopping infected people from spreading disease, but not so good at protecting healthy individuals. I have tried at various pharmacies to get hold of some – only to be told that they have run out.

I went for a walk late this morning along Boulevard Kukulcan, Cancun’s main seafront avenue in the Tourist Zone. There are some tourists walking about, but nowhere near as many as there should be at this time of year. I am not sure how much the fall in tourism is due to the global financial crisis, or this swine flu outbreak.

We were going to go out this evening to meet up with some friends in a bar in town. I managed to rearrange to a quiet outdoor place in front of the beach where there are no crowds and a good breeze. So, I suppose I am becoming jittery about walking into crowded closed areas. I think we all are.

I talked to a couple of waiters today who told me the latest rumor is that the authorities may close the hotels down. They were not sure whether this was one of the measures to stem the spread of the virus, or because there just weren’t enough people in them. I told them this is highly unlikely and for them not to worry about it. Restaurants are still open in Cancun, and local people are not staying at home. We have not yet reached the levels of restrictions people are going through in the resorts on the Pacific coast or in Mexico City.

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Nobody likes having to close down their business – even if it is for the common good. Marcelo Ebrard, President of Mexico City Council, went on television to explain why he has ordered the partial closing down of all restaurants. Restaurants can only sell takeouts (takeaways), but customers are not allowed to sit down and eat. Mr. Ebrard explained that he is carrying out recommendations issued by the World Health Organization. He stressed his government’s number one priority is to stem the spread of swine flu infection.

Ebrard said he is not closing down the city’s extensive urban subway system (underground railway), nor any of the rest of the public transport system. He explained that doing so would create too much hardship for the city’s 24 million inhabitants.

Ebrard stressed he has so far complied with all the World Health Organization guidelines, and that there would not be any further restrictions. All schools are closed, cinemas, theatres, sports stadia, and anywhere where large numbers of people may congregate. Churches and places of worship remain open. Ebrard admitted that restriction levels would only be increased in the unlikely event of a massive increase in current infection levels.

346 additional people were seen by doctors in Mexico City’s public hospitals with flu-like symptoms yesterday, of which 41 were hospitalized. One patient died of swine flu yesterday (28th April). 17 patients were released from hospital after being successfully treated for swine flu.

Business groups throughout Mexico have been lobbying government trying to get some restrictions lifted. However, there is massive public support among the general population.

Mexico is a country that has a great deal of experience of national emergencies. I was in Mexico City when an earthquake measuring 8.1 on the Richter scale devastated the city in 1985. I was also in Cancun in 2005 when hurricane Wilma caused untold damage. Mexico has a history of earthquakes and hurricanes and their people respond rapidly to contingency plans. I wonder how my countrymen and women in England would fare under such limiting conditions.

We went to the supermarket yesterday, and saw some people wearing masks, most of them elderly. On grabbing a trolley an attendant came and wiped our hands, as well as the parts of the trolley we were most likely to touch. There were moist tissues at various strategic places throughout the store. This is in Cancun, nearly 1,000 miles from ground zero (Mexico City).

Most people I know have their radios on, tuned into some 24 hour local news channel.

In Cancun there is serious concern for the economy. This resort relies almost completely on tourism for employment. Each day airplanes are coming in empty and taking the European tourists back home. Airplanes from North America (USA and Canada) are still bringing people in, but in much smaller numbers. There are fewer tourists about and taxi drivers are parked in ever-longer queues. I talked to one who said (in Spanish) “This is the last thing I need. Three-and-a-half years ago we had hurricane Wilma. It took me until about now to recover. God knows how I am going to be able to survive this one.”

I tell anybody who asks me that this flu is completely treatable and describe what flu-like symptoms are. Flu in Mexican Spanish is gripa (in Spain it is gripe) and is a widely used term that is often used instead of the common cold (resfriado). Some people think gripa includes just having a runny nose and nothing else.

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My son came back from school today and told us school is closed for the next two weeks. You would expect jubilation from a 15-year-old. Although he was pleased at the prospect of an unexpected two-week vacation, there was not the jumping up and down with joy one would imagine. His face was pensive, apprehensive and humble. His expression was that of a child who seeks reassurance, who needs to be told that everything is going to be fine.

I live in Cancun, on the Caribbean coast of Mexico, about 1hour and 30 minutes by plane from Mexico City. Mexico City is the Swine Flu ground zero. A few days ago most of the Cancun population watched news coming from Mexico City with detachment. “This is over 1000 kilometers away,” I heard one person say “we are fine.” Gradually, local attitudes have changed.

Yesterday we all watched the national news and heard that restaurants, nightclubs, schools, theatres, sports stadia, and anywhere that might hold large groups of people had not only been closed in Mexico City, but along the vacation resorts of the Pacific coast – Acapulco, Puerto Vallarta, Zihuatanejo. Can you imagine the economic consequences of closing restaurants, bars and nightclubs in tourist resorts?

Friends in Mexico City phone me and describe empty streets. The few who do venture out wear masks and go about their business as swiftly as they can.

The whole of Mexico is scared. “Will I get this? If I do what will happen to me? Am I hearing the truth? They say it is not so bad and easily treatable, but they would say that, wouldn’t they?”

My nephew came to stay with us and flew in last Sunday from Manchester, England, where he lives. My wife and he have gone to the airport to see if he can get back as soon as possible. His airline, Thomson, have just announced in the UK that all flights to Mexico have been cancelled. The Foreign Office (UK) is telling British people on vacation in Mexico to come back home ASAP. If flights are not coming in, how can people get back home? Perhaps my wife will get some answer at the airport.

Doctors here have told me that this swine flu (called fiebre porcina in Mexico) is easily treatable. They added that there are lots of antiviral drugs, such as Tamiflu, which are very effective. With over 150 deaths in Mexico City, one wonders how they could have died if treatment is so effective. I am told they did not seek medical help. Also many of the deaths (I am told) happened to people with weakened immune systems – people who may have struggled equally if they had come down with normal human seasonal flu. While we all feel for those who died, we hope that what we are being told is true.

The global financial crisis hit the Mexican economy – which depends so much on the health of the US economy – hard. Mexico’s main sources of hard currency income are oil, tourism and remittances from workers abroad. The tourist industry is gradually drying up as governments tell their people only to go to Mexico for ‘essential’ travel.

Come back tomorrow for an update.

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Written by – Christian Nordqvist, Editor of Medical News Today, from Cancun, Mexico.