West Nile Fever Is Rising and the Debate Has Collapsed Into a Calendar: How Many Times You Sprayed Is Not the Same as How Much It Helped

When a crisis gets reduced to a calendar of dates, it usually means nobody is measuring results - they are measuring activity. And that is exactly where the mayor of Skopje and the opposition collided over West Nile fever.

The numbers are climbing fast. On 19 August the opposition spoke of 35 confirmed cases in Skopje, four dead and six in serious condition in intensive care. A day later, SDSM leader Venko Filipče spoke of 38 patients and five dead - which by his count means a 50 percent rise in a single week, from 26 to 38.

The defence: a calendar

Mayor Orce Ǵorǵievski answered the criticism with a chronology. He stated that pest control began on 7 May this year, against 3 July in 2018 when SDSM ran the city, and produced a list of aerial and ground treatments carried out from May to August, with more announced.

"Public health is not protected through press conferences," Ǵorǵievski said, "but through systematic work, continuous prevention, expert recommendations and timely activity on the ground." He argued that the opposition, after the water crisis, is trying to turn yet another serious health issue into daily political points and to manufacture fear.

The question a calendar does not answer

SDSM shot back that a list of dates is not proof of effect. If the spraying started on 7 May and worked, why is Skopje the epicentre of the epidemic?

Filipče lined up the whole series of questions that every citizen with an elderly parent is asking themselves: "Was the effect of the spraying ever checked? Were the mosquito breeding sites properly targeted? Was it done in time? Were GPs warned? What protocol are they working to in order to recognise early symptoms?"

The party is also demanding answers about untreated bodies of water, about instructions issued to the public too late, and about the contradictory messages sent to those most at risk.

Both are right about different things

Ǵorǵievski is right that the virus is not new and that it circulates across Europe and in the neighbourhood. That is true, and it is not a defence - it is the reason the measures should have been ready in advance, not an argument for why they were not.

The opposition is right that a start date is not the same as an effect. But it is speaking from the position of a party that ran this exact job until recently, which takes some weight out of the reproach.

Between the two positions sits a group of people in intensive care. They are in neither calendar.

What is still missing from the whole exchange is an independent check on the effect of the treatments - not how many times the spraying happened, but what changed on the ground after each round. Until that exists, both sides will keep quoting dates, and the number of patients will keep changing every day.