RECOMMENDATIONS.

Otago Daily Times, Issue 17659, 24 June 1919, Page 6

RECOMMENDATIONS.

INPLUENZA COMMISSION'S REPORT. Tho interim report of tho Influenza Commission regarding tho best methods of proventing or dealing with a recrudescence of the epidemio was submitted by the Minister of i'ublic Health (Hon. G. W. Russell) to tho Clu-istehureh nowsi>apers on Saturday. Tho report stated that at the date of tho epidemio the dominion had not tho benefit of tho experiences of tho English medical men with this pandemic outbreak, but since then a mc.morandum on the subject had been issued by tho Royal College of Physicians, London. This report 6tated that it was manifest that the closer the contact the inoro readily would tho transmission of the disease occur, hence tho paramount importance of avoiding Overcrowding. It was important, therefore, that the public Bnov'.id have a clear idea of such measures of personal prophylaxis as were available against infection. Tho individual must bo taught to realise and aoquiesco in his duty to tho community. Well ventilated, airy rooms promoted well-being, and to that extent at any rate were inimical to infection. Draughts were duo to unskilful ventilation, and were harmful. Good, nourishing food and enough of it was desirable. Alcoholic excess invited disaster, but within the limits of moderation each person would be wise to maintain unaltered whatever habit experience had proved to bo most agreeable to his own health. The throat should be gargled every four to six hours if possible or at least every morning and evening, with a disinfectant gargle of which one of tho most potent was a solution of 20 drops of liquor soda chlorinate m a tumbler of warm water. A solution ot common salt, one teaspoonful to a pint of warm water, was suitable for the nasal passage. Iho commission states that giiice it was uncertain of the primary camse of influenza no form of inoculation could bo guaranteed l. against tho disease itself; from what they knew as to the lack of Enduring protection after an attack of tho disease it might in any case be assumed that no vaccine could protect for more than a short period, but the chief danger of influenza lay m i its complications, and it was probable that much might bo done to mitigate the severity of tho affection and to dinimish its mortality by raising the resistance of uie body against the chief secondary infecting agents. No vaccine should be achninistered except under competent medical advice, no drug as yet having been proved to have any specific influence as a preventative of influenza. On the important question of inoculation there appeared to bs a definite tendency both at Home and in the dominion to take a more favourable view of its value as a prophylactic although its use as a therapeutic agency was still cioubtcd. 0 There seemed to have been'a difference among medical men in the dominion on tho °f inhalation as a preventative as it nad hitherto been applied. It may be safely said that inhalation was only advisable, if at all, in oroperly constructed chambers, and with as iittle contact as possible with others diumg the process. There was a complete agreement as to the 'value of niasivs in the cases of medical men. nurses and attendants. As to their general use indoors or in the street there was some differ-t-nco of opinion. r^ 0 ,51 11 cstion of the value of alcohol in* combating tho epidemio was not dealt with oy many witnesses examined by the commission. The weight of modical evidence was updoubtedly in favour of alcohol judiciously administered as a stimulant during an attack and in convalescence. . With regard to ventilation, the commission sa/id that the medical men whose opinions they had received were unanimous as to the paramount importance of fresh air in combating the epidemic. Excellent results had been obtained rrom almost a practically fresh-air treatment. The necessity for open windows and the freest ventilation was as generally realised as it was habitually ignored. In this connection the importance of the avoidance of crowds should be fully impressed upon all. The packed crowds of Carnival Week in Christcnurch and the premature armistice rejoicings were largely responsible for the extraordinarily rapid spread of tho disease.

Phc commission stated that considering the subject of quarantine as a means of preventing or dealing with the epidemic, it must be evident that as tho disease was highly infectious and spread very rapidly, chiefly by personal contact, every reasonable precaution should be taken by the Health authorities in the direction of enforcing strict examination of all ships, passengers, and goods arriving from infected places and, placing them under quarantine if necessary. As precautionary measures the commission counselled that all convalescents and contacts in quarantine should b e released only on terms of their reporting and submitting themselves to examination by a health officer. Provision should at onee bo made for improved accommodation, equipment, supply of stores and extra services at the quarantine stations, particularly at Auckland and Wellington. From all the evidence and knowledge gathered it did not appear that tile people could look for absolute immunity as the result of strict quarantining. The medical testimony throughout favoured the isolation of persons infected by the disease, and the commission had heard strong views expressed in favour of applying practically quarantine conditions to all infected districts within the country. However, it was not prepared at this time to'advise such a course of action as being necessary. The commission recommended that in order to meet a possible recurrence of the epidemic the Public. Health Department should be added to in the administrative, medical, and sanitary branches. A strong policy ot definite initiative on the part of the head office and of all district centres was essential. All departmental branches, the several local authorities and the citizejis' organisations directly concerned should be early informed of a scheme of operations to' be followed, and the specific seryices required of each of them. The Minister and the department should concentrate their attention upon coordinating the whole of the forces required to combat the epidemic and lead the country in creating precautionarv safeguards before the attack had reached the stage of virulent intensity. The first, if unwritten, duty of' the local authorities was to assist energetically the Minister and his department in all measures necessary to combat the disease. It should be clearly understood that the duty fell upon every local authority to help and they should be ready to act with the Government and voluntary organisations. Each local body _ should appoint a health committee. The important matters of sanitation, house inspection, and general hygiene should have special attention. A special epidemic committee, should be appointed by each hospital board, and should make arrangements for auxiliary and temporary hospitals throughout their districts, providing full nursing staffs, the securing of medical services for all institutions, the establishment of dispensaries where required assistance in regard to transport, co-operation with the general organisations throughout their districts, and the giving of special attention to the relief and supply of reserve assistance in respect to the medical and nursing services. Each board should as^ early as possible compile a list of its various requirements, and conies of these lists should be supplied to "the Health Department in order to secure general supervision over the whole dominion. In the earlier stages of the last campaign two mistakes with regard to general organisation were manifested, and these had a considerable effect for a time. The first was in the direction of having all activities centralised in the one depot, and the other was in tho opposite direction of having scarcely any centralised oversight or control. The opportunity should be taken to perfect the organisation before another general outbreak of the disease takes place. Tho organisation best suited for the "more sparsely populated portions of the country should be in the direction of having special countr Y committees formed, each under the direction of an officer of the Health Department. Special attention should be given to the case of Maori settlements, and somo Europeans should be appointed to assist tho Maori committees. The work in oaoh of the Maori districts should be under the direction of an officer of the Health Department. In conclusion, the commission said that tho outstanding lesson to be drawn from tho mass of evidence which it had received was that to procure the best methods of preventing or dealing with any recurrence of the epidemic, tho impediment of personal bias must be laid aside in favour of united 00-operatrve action. Ordered forces, disciplined and co-ordinated throughout' from the "Minister of the Crown to the smallest Boy Scout, were necessary. In the ultimate analysis the commission found that the responsibility rested upon the public for the existence of so many defects and weaknesses attached to tho publio health system. People had been too much disposed to regard affairs relating to nublic health as being almost exclusivelv the proyince < of tho medical expert and the specialist, mstead of being the concern of the general body of citizens as it should be.