Tonight Skopje gets its thirteenth mosquito spraying of the season. More than twenty are planned by the time the season ends. Thirteen carried out, twenty announced - and in the Clinic for Infectious Diseases there are patients with West Nile fever.

According to published figures, 35 patients in Skopje have been confirmed with West Nile fever this year. Six are in a critical condition. Three have died.

What the city says

Mayor Orce Ǵorǵievski explains that the activities are carried out according to the Annual Programme, statutory obligations and the study drawn up by the Skopje Centre for Public Health, approved by the relevant health authorities. The sprayings are conducted „continuously, on time and according to a pre-established schedule”.

The schedule really is dense. On 20 August, ground spraying against adult mosquitoes; on 21 August, aerial spraying in the early morning hours; and from 23 to 26 August, terrestrial spraying. So far this season six larvicidal treatments have been carried out - three aerial and three on the ground - plus several treatments against adult mosquitoes.

None of these numbers is in dispute. What is in dispute is what stands next to them.

The figure missing from the press releases

When a programme is carried out to plan, on time and in full, and there are still critically ill people and deaths in the infectious diseases ward, that does not automatically mean someone failed to do their job. It may mean the plan is not enough. It may mean the treatment is aimed in the wrong place, or lags behind the mosquito's cycle, or that the problem is not solved by spraying at all but by the small pools of standing water nobody is counting.

The problem is that there is no public analysis of any of those possibilities. There is a list of treatments carried out and a list of treatments scheduled. Effectiveness is not measured by the number of sprayings. It is measured by the number of cases - and that is precisely the number rising in parallel with the sprayings.

What is left to people

Doctors report that most of those hospitalised have symptoms affecting the central nervous system, such as meningitis and encephalitis, a common complication in older people and those with chronic illnesses. The public is advised to wear long clothing and use repellents when outdoors in the evening.

So protection comes down in the end to long sleeves and a spray from the pharmacy, bought out of your own pocket. The city sprays, the citizen rubs on repellent.

Beekeepers have again been urged to take timely measures to protect their colonies. They are the one group that gets a specific warning with an exact time.