Waking Up to a Pandemic: H1N1 in Mexico, 2009

Beyond the shock, no two pandemics are alike, explains the FSO who was deputy chief of mission in Mexico City in 2009, when swine flu swept the world.


On April 26, 2009, during the swine flu pandemic, people gather at Metropolitan Cathedral in Mexico City.
Sari Huella / Wikimedia Commons

Waking up to a pandemic is like walking toward a beautiful garden and hitting a plate glass door. Without any warning, the expectations you never questioned are violently disrupted. Your brain reels, unable to process the brutal warping of reality. The British call this “gobsmacked.” A health crisis professional might describe this as the prelude to a “pandemic response.”

At the end of April 2009, Mission Mexico was anticipating a brief respite from months of high-impact diplomacy. Thousands of American spring-breakers had come and gone across Mexico’s white, sandy beaches. Newly appointed Secretary of State Hillary Rodham Clinton had made a very successful trip, inaugurating a new consular pavilion and holding wildly popular people-heavy events in two Mexican cities. She was followed on April 16-17 by President Barack Obama, on a historic visit to Mexico City accompanied by a large Cabinet and congressional delegation. We were happily returning to our routine obligations—visas, American citizens services, trade initiatives, environmental programs, law enforcement operations and, for State Department folks, evaluation season. It felt good to be back to normal.

On April 24 I sent my daughter down the steps to get on the school bus and began to pack up my briefcase and head to work. My personal goal was to steal an hour during the day to face the multipage checkout list that detailed all the things I had to get done before we could move in just a few weeks. As I reached the front door, my daughter walked back in, a big smile on her face and a letter in her hand. All schools in Mexico City were closed for an indefinite time because of a public health emergency. Gobsmacked.

Random newspaper reports of occasional flu deaths over past weeks had morphed into a new, unknown strain of swine flu called H1N1, confirmed through tests of Mexican samples conducted in Canada. With the results in, the government of Mexico informed the Pan-American Health Organization and World Health Organization and, overnight, implemented dramatic protocols to impose social distancing, first in Mexico City and then across the country.

By the following Monday we had dramatically curtailed public services, procured masks and gloves for embassy team members, and redirected anyone we could to supporting the waves of CDC experts who began flooding in to expedite pandemic response. Colleagues who only weeks before had been mapping out presidential motorcade routes were now donning full protective gear and accompanying CDC doctors into labs to act as translators, procurement specialists and helping hands. Their contributions were vital.

Colleagues who only weeks before had been mapping out presidential motorcade routes were now donning full protective gear and accompanying CDC doctors into labs to act as translators, procurement specialists and helping hands.

Within days Mexico City—and shortly thereafter all of Mexico—evolved into what we see now across the globe during the coronavirus pandemic. Empty streets, closed venues, masked citizens maintaining “social distance,” and elbow bumps instead of the traditional warm abrazo. Conferences, concerts, sporting events and cruise ships fled to other destinations. The economic and social costs were enormous.

Then as now, the CDC scientists both with us in Mexico and on endless conference calls with Washington, were categorical about following the science. No two pandemics are alike, they insisted, and they would not make educated guesses about anything until they had data. Dozens of scientists came to Mexico despite the risk, and across the globe experts began pooling knowledge, sharing insights and reporting new developments. They worked days and nights alongside exhausted Mexican counterparts.

That global cooperation was central to the successful management of the pandemic. As hard as they all worked, the pace still felt slow to those of us anxiously awaiting news on when our lives could return to normal.

The uncertainty was—and is—the hardest to manage. Today I sit at home and watch news loops about coronavirus deaths, and better appreciate how anxious our housebound community felt in 2009. We held Emergency Action Committee meetings almost daily, but we found our planned pandemic tripwires were completely irrelevant to our H1N1 reality. Borders were open and commercial flights kept moving, so we did not go on authorized or ordered departure (nor did we close our border with Mexico).

We piloted web-based American virtual town hall meetings during which, in English and Spanish, I shared what we knew and what we were planning to do. This was a real breakthrough for that time, made possible by our creative public affairs and information technology teams. But after every virtual town hall, I took multiple calls from enraged family members who had cabin fever in a foreign country and wanted answers I didn’t have. Moreover, after the United States also declared an H1N1 public health emergency, embassy community families looking to finish the academic year in the United States found they weren’t welcome. This was another blow to morale.

The author and then Mexican Under Secretary for North American Affairs Carlos Rico during a panel focused on H1N1 cooperation, May 2009.
Embassy Mexico City Public Affairs Section

Crucially, we were fortunate that few in our community fell sick, giving us the grace of time to see how the situation evolved. In one instance the child of a same-sex couple became infected, and our MED unit was not initially authorized to provide the nonemployee parent with prophylactic support. Thanks to Management Counselor Isiah Parnell we overcame that, anticipating reforms in department policies that were still a few years away.

Within months, however, a new normalcy evolved. CDC, Mexican and global experts collected enough data to establish disease transmission rates and verify mortality rates—both were better than initially anticipated. Medical facilities across the country (and around the world) were soon equipped to identify and respond to the disease. As more facts became known, schools in Mexico reopened, with masked teachers taking the temperature of every child before they were admitted onto the campus. Step by step, we recovered our newly appreciated normal lives.

Looking at our world today, I am reminded yet again of the one lesson CDC officials seared into my brain then: No two pandemics are alike. It is impossible to “fight the last war,” as the military is often accused of doing, because public health experts understand that every single pandemic is unique.

The H1N1 virus was first identified in the United States in April 2009 and spread rapidly through the Americas; it also affected Western Europe, several countries in Africa, Turkey, Saudi Arabia, India, China, Australia and parts of Southeast Asia. The pandemic lasted for a year, until April 2010. According to CDC estimates, in that year there were 60.8 million cases, about 274,000 hospitalizations and 12,469 deaths from the virus in the United States. There were 151,000 to 575,000 deaths worldwide, with 80 percent of the deaths occurring in people below age 65.

The impact of the H1N1 pandemic was less severe globally than previous influenza pandemics, states the CDC. During the 1968 H3N2 pandemic, mortality was 0.03 percent of the world population, and global mortality was 1 percent to 3 percent during the 1918 pandemic. By contrast, the 2009-2010 pandemic had an estimated mortality rate of 0.001 percent to 0.007 percent. The H1N1 virus that caused that pandemic is now a regular human flu virus and continues to circulate seasonally worldwide.

What the medical experts hope to count on across pandemics is the integrity of scientific evaluation, the strength of institutional relationships, the shared commitment to fact-based recommendations and the globally heroic effort required to tame disease. Our experience in 2009 Mexico exemplified the best of pandemic cooperation, and the Mission Mexico team, as well as their social-distancing, housebound families, played a key role.

Leslie Bassett retired in 2017 from the Senior Foreign Service. She is a former U.S. ambassador to Paraguay. Ambassador Bassett also served as deputy chief of mission in Seoul, Manila, Mexico City and Gaborone, among other overseas assignments.