posted
Here is a good article in U.S. News from 4/4/2005 about local preparedness.
quote:"We at WHO believe that the world is now in the gravest possible danger of a pandemic," says Shigeru Omi, Western Pacific regional leader for the World Health Organization. Those words echo Julie Gerberding, director of the federal Centers for Disease Control and Prevention, who called the current situation "a very high threat."
quote: Officials are also grappling with how to handle the economic and social disruption that pandemics cause. Pandemics last much longer than a hurricane or other natural disaster and typically hit in waves, with a first wave of infections followed by a second wave some three to 12 months later. If children fall ill, parents will have to stay home from work to take care of them, and business will suffer. Ditto if schools are closed to reduce the risk of infection. "We're talking about reducing morbidity and mortality, and maintaining social order," says Matt Cartter, epidemiology program coordinator for the Connecticut Department of Health.
quote:"We've never suffered an event of such magnitude that it shuts down the global economy," says infectious-disease specialist Osterholm. "In 1918 we were much more self-sufficient."
posted
Okay, now we KNOW it's serious. New Zealand is considering cancelling rugby matches. O_O
quote:Research suggests nearly 4000 New Zealanders would die within eight weeks of the virus getting here. A further one million would seek medical attention and 20,000 would be hospitalised, placing huge strains on the health system.
Auckland Regional Public Health Service communicable diseases expert Dr Will Paterson said in the event of a pandemic it was desirable to limit the effect on health services by slowing the disease's spread, even if that meant prolonging its duration.
To do that it would be necessary to impose emergency restrictions, including stopping travel across Cook Strait if people in only one island were infected and closing events where large numbers gathered.
If the virus did mutate into a more infectious form and a plane load of "barmy army" Lions supporters arrived after an Asian stopover, cancelling attendance at rugby matches would have to be considered, Paterson said.
From the New Zealand news site stuff.co.nz here.Posts: 6246 | Registered: Aug 2004
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All this makes me really wonder -- why don't all people have a few weeks worth of water and food stockpiled? Gah.
Posts: 3060 | Registered: Nov 2003
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It seems to be endemic now in Indonesia pigs, which is more very bad news. Pigs can get both bird and human influenza viruses, and serve as an excellent mixing vessel for the two.
quote:Concerns over the presence of a dangerous strain of avian flu virus in Indonesia's pigs are growing, as government tests confirm the existence of infection. In some areas, the H5N1 virus could be infecting up to half of the pig population, without causing any signs of disease.
The initial discovery was made earlier this year by an independent researcher working outside national and international surveillance systems. Chairul Nidom, a virologist at Airlangga University's tropical-disease centre in Surabaya, Java, found the H5N1 virus in five of ten pigs tested from Banten in western Java.
The presence of the virus in pigs is a particular worry because the animals can harbour both bird and human flu viruses, and act as a 'mixing vessel' for the emergence of a strain of avian flu that can easily infect humans. There are now signs that the virus could be spreading unchecked through the pig population.
From an article in that same issue of Nature herePosts: 6246 | Registered: Aug 2004
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Wow, this fictional reporter's blog from the pandemic (it's not fantasy, it's based on the best we know and can predict from the highly respected journal Nature) really says it all. It's chilling.
quote:This flu moves much faster than SARS because its incubation period is just two days. People are spreading the virus the day before they get sick, and asymptomatic patients without even being visibly ill. Tamiflu needs to be administered within two days of anyone showing symptoms.
As I wandered through the streets this afternoon, it wasn't looking good. People are walking around Hanoi coughing and spluttering. They've closed the schools, which is the right thing to do, but what are all the kids doing? Hanging out downtown enjoying the unexpected holiday.
...
On CNN it's now round-the-clock coverage, with a red 'Pandemic' banner running across the bottom of the screen. "We're in the twenty-first century, and they're telling us about how to wash our hands properly, and practise 'respiratory etiquette'," exclaims Jonathan. "Why aren't there drugs? And I can't believe there's no vaccine. This can't be happening in America."
...
There's a lot of looting going on in pharmacies, but to no avail. The drugs are being distributed in convoys, with military jeeps in front and behind. Masks costing a dollar are being sold on street corners for $20. E-mailed ads for counterfeit drugs are filling up my inbox.
...
Who should get the few mechanical respirators that can mean the difference between life and death? The youngest, or those with the best chances of pulling through? "Our leadership must be prepared to make calculated decisions that will force raw prioritization of life-saving resources," explains a colonel on CNN.
...
17 MAY 2006 The dust settles The pandemic was declared over today. H5N1 will be back next year, or before that, as it replaces the existing seasonal flu strains. But by then, those who have recovered from this bout will have immunity, and we will have a vaccine. Pandemics move faster than governments or international bureaucracies, and the cost is hundreds of billions of dollars more than it would have been had we tackled avian flu in Asia in the first place, and invested in flu research. For millions of families, the cost isn't measured in dollars.
Watching all that military hardware on the streets made me think. We imagined we could encourage pharmaceutical companies to develop innovative vaccines and drugs by offering 'incentives' or modest subsidies. When the military knows it needs a fighter aircraft, it doesn't offer incentives to Lockheed Martin or Boeing. It pays them through procurement to develop the weapon to the specifications it wants.
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People, this may be one of the most significant events in human history that any of us experience. How will we respond as individuals, in our neighborhoods, our families, our societies, our countries, and our species? Will we tear at one another, grabbing what we need for ourselves, laying blame for poor preparation on leaders or on others, ignoring the plight of those around us, keeping supplies and drugs for ourselves and our families, viewing all others as enemies?
Or will we realize that here in a tiny microbe, something too small even to see, we have a common enemy to all humans, birds, pigs, and other species. Will we begin personal preparation now, and call for our leaders at every level to do whatever can be done to prepare on a local, national, and global level? During the weeks when the plague is at its height will we pull together, joining in a spirit of generosity, brotherhood, and deep connection with everyone around us, or will we show only hostility, indifference, self-preservation?
I issue this profound moral challange to all of hatrack. Some of us will not survive. Decide right now how you are planning to act when this thing hits and then measure your actions daily against that yardstick. Each person's actions serve as a model for those around them. What spirit will you model? In what spirit will you live or, if needs be, die?
The human species has an opportunity, in the severe challenge which this virus will bring us, either to sink to its lowest depths, or to rise above, to find a new spirit, to realize what matters in life, to pull together with one heart. It's our choice. Which will we choose?
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Tatiana, I admire you so much for bringing this up!
My family has a retreat of sorts. We're building our own home on a 10-acre lot. We'll heat with wood from our forest. We can grow some of our own food. We can hunt deer, if necessary. And we can stay away from people. I think we'd likely draw away from others, in order to preserve our lives. And then, in the rebuilding, share what resources we have.
I personally know nothing or have little that would help other people in a medical emergency. I'd be willing to take in children to keep them from the hotbeds of infection. I know how to work with them.
But adults in crisis scare me. I don't trust humanity in general to act sanely.
I've long desired to know how to live off the land. I'm likely to research herbalism in a crisis like a pandemic, and become somewhat of a witch. I guess I'd be glad to share what herbal knowledge I had. But I'm not likely to head into the cities when I already live in the country.
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I doubt I'll need to worry about survival. There really isn't any point in me stocking up supplies. I think I'd probably just scatter cat food everywhere in the apartment, fill all the sinks and tubs with water, and head to work and hope the cat survives. I could always stock up on tamiflu for me and the nurses. That's a possibility. But I think modern civilization would truly end if it became a pandemic so I don't think it truly would matter what preparations I make.
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Theca, I do think you and your nurses should take what Tamiflu there is. That's the way to leverage the least drugs into the most lives saved, if all health care professionals take it. There are likely to be several waves of contagion, and the later ones are usually more deadly. By all means it's good for everyone to keep going as long as possible. Survivors of the first waves can do the most good during the later ones.
The fabric of society will certainly be strained, but I have faith that it will hold. People do pull together in emergencies. Survivors will emerge and then society will go on, as it has after past scourges.
I'm planning to do the same thing with cat food and water in my home, leaving many bowls around. I may open a window to let them have a chance to get outside too. Since I don't know if I can take care of them, it seems like I should give them every chance to take care of themselves. On the other hand, the racoons will come in and eat their food if I do that, so I'm not sure if I should.
One thing that struck me today is this. It's surprising that people who work in poultry processing plants in Asia haven't come down with it as expected. I wonder if they have developed antibodies, as they've discovered several people who never got sick have done (the grandfather of one of the family clusters, and some people who worked decontaminating farms, and so on). What if it's possible to get immunity through contact with minute amounts of virus over long periods of time, as opposed to those who were hit with a large amount of virus at once (people who slaughtered infected birds at home without any eye or skin protection from the blood, for instance.) I don't really know how that can be helpful but it's something that struck me this morning with the force of an important insight. Posts: 6246 | Registered: Aug 2004
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quote:What about police and fire and garbage and other essential services if half the workforce is out sick?
If enough people are out sick, then public services will shut down, and that will lead to many more deaths.
These type things are talked about in the emergency services fields, and it's just accepted that at a certain point, if the units cannot adequately be staffed, then there will be suspension of fire and medical response calls. There have been suspensions of service before, notably during severe weather events, when it's deemed unsafe to be on the road. Of course, those are short-lived incidents.
That means that sick people with no way to get to the hospital can call 911 and no one will come.
And if there really is a pandemic, I wonder what my husband would do? Would he go to work, to expose himself to a deadly virus he may then bring back home to us? Or would he stay here and help us try to survive? Could we survive? I'd like to think so, we have fresh water sources nearby, plenty of fire wood so we could boil our water for drinking and plenty of food both in the house and available nearby. But having never been tested in that situation, I can't say for sure what would happen. If a pandemic struck and my children died of it how much of a drive would I have to keep on living anyway?
As to whether or not I'd help my neighbors, I would do what I could that wouldn't endanger my children. In other words, I wouldn't take a sick person inside my home to care for them if it meant exposing my kids. But I would share whatever resources I could spare to neighbors in need.
Interesting food for thought. It's not something I normally worry or think about often, I know the chances of dying in a car accident are much higher than dying in a bird flu pandemic right now.
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I've become numb to the idea of a humanity destroyed by disaster. Every year I hear about Global Warming, astriods, SARS, AIDS, avian Flu, terrorism, nuclear war, Y2K or some other thing not in my control that will destroy us all. I'm sorry to say I'm ot any more worried about this than any other potential danger.
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quote:To me all these considerations have much more weight to them, have a deeper ring of truth, than your facile dismissal based on a single experience with some entirely different organism.
Perhaps you should google USAMRIID before you assume I don't know what I am talking about.
I worked with CHICK/VEE, Malaria, Hantavirus, Ebola, Rift Valley Fever, and several others while I was there, and my roomate was on the USAMRIID rapid responce team.
I should know, I was working in the safety office, and helped to train them. I personally went through the blue suit training more times then any other soldier in USAMRIID, although I wasn't certified in it myself....I helped the people who were teaching the classes of people, including the rapid deployment arm of the CDC. They were civilian doctors, world class researchers in their fields. I also maintained the databases reguarding safety inspections of teh SCBA gear, as required by law, and our office also did all the decontaminations of the bio suites, as they are called. I didn't do those at all, but I shared an office with the guys who did, and inspected the passboxes and repaired the untraviolet bulbs that needed replaced on a regular basis.
There are real concerns about this type of situation, and as I said there are things we should do to prepare, but the uncomfortable fact of the matter is that we have no idea which one out of many, many viruses out there will cause the next pandemic. . .if there will ever be one again. There are so many of them that we know little to nothing about that it is not possible to prepare for even the most 5 high risk of them.
I think the situation needs monotering, of course, but I doubt anything will come of this at all.
And I got that opinion from actual experiences woking at a world class biological containment unit, rather than from articles I read sitting in my home.
I could be wrong, but that doesn't mean I an uninformed, just that I disagree with you.
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Kwea, I respect your experience but I still feel that the World Health Organization, the Centers for Disease Control and Prevention, the Department of Health and Human Services, Scientific American magazine, and Nature Magazine combined (they are all in agreement) are more authoritative than your experiences with other organisms. All the world's influenza experts are joined in saying this has a very high risk of being as bad as 1918 or worse. History tells us that 1918 was very very bad. That seems to bear paying attention to, particularly since there are many things we can do to be better prepared than we are.
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quote: I issue this profound moral challange to all of hatrack. Some of us will not survive. Decide right now how you are planning to act when this thing hits and then measure your actions daily against that yardstick. Each person's actions serve as a model for those around them. What spirit will you model? In what spirit will you live or, if needs be, die?
I would far rather wake up every morning as if it were the first morning of my life than wake up every morning as if it were the last. Even though I would live it no differently.
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ak, they aren't saying anything new, that was my point.
Also, USAMRIID was the inital training point for both the WHO and the CDC. USAMRIID developed teh protocols they refer to when dealing with these situations, and conducts cross training for both those orginizations.
They aren't saying that this IS going to happen, if you reread those papers, they are saying it is possible. They really have no idea how likely it is to EVER happen, and they can't make any sort of real predicitions regarding the spread of this, or any other, possible pandemic.
In the past 10 years I have heard cery similar situations described about at least 10 different pathogins, and none of the estimate or predicitions were correct.
I am not saying ignore the problem, but I am saying that blowing it out of proportion cause panic, and that panic leads people to act in an irrational manner.
The whole point of the chicken little parallel is that when you come to a conclusion based on indaequate facts (and anyone claiming to be able to predict the future path/progress of a possible pandemic variety disease is doing so, IMO) you can cause a panic that is worse than the possible disease.
They were wrong about Ebola, but that doesn't mean we should stop looking at what caused it. Same thing that goes for Hantavirus, and Rift Valley Fever, and Lassa, and on and on and on....all of those at one point were candidates for a pandemic outbreak, but the "experts" were wrong about them too.
It could happen, but then again a black hole could swallow us all tomorrow too.
posted
I'd just like to take this opportunity to inform everyone that, according to the ad at the bottom of this screen, vampires are real. Everyone go buy silver and garlic!
Seriously, though, I suspect that sooner or later, we will have a pandemic of some kind. I'd prefer to see an increase in the production of Tamiflu or other antivirals known to protect against avian flu. I also hope that some research will go into better means of vaccine production, so that if a pandemic does hit, we can develop new vaccines quickly. However, I'm not sure that we all personally can do much more than try to stay healthy, and make sure that we have adequate supplies of food and clean water. General disaster preparedness never hurts.
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Part of me wishes for a pandemic, becauseI know that our population needs to be cut down. With this many people, the possibility for illness is so high that it's an inevitability rather than a possibility.
Even saying something like this, I know that with my weak lungs, any illness that traveled through the air would kill me very quickly. But I guess when and if this happens, I'll have to be sacrificed for the good of the gene pool. But that won't keep me from trying to live.
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Letting you die won't necessarily improve the gene pool. It will only select for people who have high resistance to influenza, or healthy immune systems. Not to mention that "good genes" is somewhat subjective. What if the pandemic kills off a higher proportion of altruistic people because they get infected while helping others?
Also, I'd much rather see the population controlled through the use of contraception. Massive die-offs may be natural, but that doesn't make them the preferred method for preventing the overpopulation of humans.
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quote: Would doctors know how to go about buying antiviral drugs [elsewhere Tatiana mentions stockpiling antibiotics as well--Morbo] to keep on hand? That seems really wise and useful to encourage everyone to do, and yet I think they are not available without a prescription. Is there some process we can initiate to change that? Or some way to work within the current laws but still allow this to happen? Pharmacists or doctors, do you know?
This strikes me as a very bad idea. Antibiotics are already overused now, by prescription. Selling them over-the-counter would only lead to more AB-resistant bugs. This would be worse than a hypothetical pandemic that might never occur.
ak, I'm afraid I agree with Bob the Lawyer and Kwea: a possible pandemic is no reason to go on spending sprees, including distribution of likely ineffective vaccines.
But I support more investment in public health resources in general.
quote: Kwea, I respect your experience but I still feel that the World Health Organization, the Centers for Disease Control and Prevention, the Department of Health and Human Services, Scientific American magazine, and Nature Magazine combined (they are all in agreement) are more authoritative than your experiences with other organisms. All the world's influenza experts are joined in saying this has a very high risk of being as bad as 1918 or worse.
But what is that risk? Less than 1%? Far less? I think the main thing your quoted sources agree on is a possibility of a pandemic, not that it's more likely than not.
People and governments are strapped for cash, and cannot prepare against every possible risk--it's impossible.
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I was just thinking, maybe I should start plotting out which mormon family lives closest to me, with their year supply of foodstuffs stored away. Posts: 1990 | Registered: Feb 2001
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quote:Originally posted by Theca: I was just thinking, maybe I should start plotting out which mormon family lives closest to me, with their year supply of foodstuffs stored away.
LOL, I was thinking the same thing. In an emergency, I would convert in a flash if they have pop-tarts and peanut butter.
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The head of the WHO recently said the risk of pandemic is risen to 50%. The mortality guesses range from 20 million to 1 billion. They are all guesses, yet they are informed guesses.
I thought like you, "why worry about it before it happens?" until I read the information about 1918, and the genetic information about the influenza virus and how it behaves. I challenge everyone on hatrack to read the WHO pdf file that's linked above (and again here for ease of reference). It's excellent.
There's no scare mongering going on, if anything, the warnings are too muted for fear of seeming alarmist. It's definitely serious, and the warnings are falling on mostly deaf ears.
After the fact, then people will pay attention. Then there will be a 9/11 type commission asking who knew what and when they knew it, and why they didn't do more. Britain and France have enough Tamiflu for 25% of their populations. We (the US) have enough for 1% of ours. Why were our leaders so shortsighted? Because we elect the sort of leaders who reflect our own level of unwillingness to conceive of new events that seem so impossible beforehand, maybe?
After the fact, people will pay attention, the sad thing is that we're already after the fact in one sense. We lived through 1918, we should have learned from it. Must everything happen in each generation before we believe in it? Another challenge: read a journal of someone who was an adult in 1918 to learn what it was like. Or ask someone old if they remember their parents' stories about it.
Again, I'm not saying to people "be mortally afraid but do nothing". What I'm saying is "prepare yourselves and your families, and call loudly for more preparedness from our leaders". When we are prepared as much as we can be, then we will be at peace. When everyone knows the right thing to do in advance, then there will not be panic when the time comes. Instead we will all pull together and the overall losses will be made much less than if we are caught totally off guard, and everyone panics in the clutch.
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My mother takes this seriously because she heard about it from her mother who was a young adult in 1918.
When the tsunami hit in Southeast Asia there was a group of 500 or so primitive fisherfolk living on two remote islands whom the Indonesian government had feared would be totally wiped out. Weeks later when they got around to sending a helicopter to check on them, they threw spears at it. They had all survived. They said their parents and grandparents had taught them when the earth shakes, to move to high ground. All 500 of them picked up their reed baskets and ran to the hills when they felt the quake. There's something funny about the fact that we in our culture of instant global communication were caught so off guard while these stone age people had it totally covered.
Maybe the difference is that they, in their small group, realize they have to exercise their own judgement, and be proactive about interacting with their environment. We in our vast network of care come to feel that everything that matters will be handled by someone else, and is not our responsibility or concern. But how loudly we yell when "they" turned out to have dropped the ball, weren't prepared, didn't protect us.
I think some time in the last ten years the responsibility for everyone's safety and the health and well being of the whole planet became mine personally. Unfortunately when that happens, you become like a parent saying "son, watch out for this danger, it's wise to do this and this to stay safe," and the world is like your recalcitrant teenager saying "oh moooooom, you're such a downer! Leave me be, I know what I'm dooooooooing!"
So then what do you say? "Your choices are your own, but they have consequences"?
It wasn't the iceberg that sank the Titanic so much as everyone's belief that it was unsinkable, you know?
quote: Indeed, the potential for social unrest is a major concern for those laying pandemic plans. And demand for Tamiflu could exacerbate the problem. Who will, and who will not, be treated with this scarce but valuable resource? "It's not easy — we know there won't be enough for everyone," says Theresa Tam of the Public Health Agency of Canada. Britain, which is among the best-prepared countries, has ordered enough for about 25% of its population; Canada has stocks for just over 5% of its people; the United States currently cannot even cover 1%.
In practice, a significant proportion of supplies might be used for prophylaxis of health-care workers — for up to two months as the influenza wave passes through — leaving less for treating the sick. "It is not a happy situation," says Klaus Stöhr, the WHO's chief influenza expert. Canada, wary of the potential for a public backlash if health workers were perceived to be saving their own skins, included an ethicist on its Pandemic Influenza Committee.
From that excellent issue of the journal Nature this week, from this article.
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Does anyone know how I can buy this single issue? All the bird flu articles are included full text on the web, but I still just want a hard copy to keep and highlight and so on.
I've tried B+N, Books a Million, and The Little Professor locally and none of them carry it. Does Amazon sell single issues of current magazines?
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No, it wasn't the belief of unsinkability that sent the Titanic to the sea floor. The iceberg did that just fine on its own. It WAS the unsinkable belief that cost so many people their lives however. There's a fine off-topic line to point out there. Maybe it even proves your point better.
A concern I have about stockpiling things like Tamiflu is when the pandemic happens in seven years instead of in two, and has mutated beyond the effective spectrum covered by the drugs. Do you honestly think governments would or could replace their stockpiles every so often for an extended period of time? There's another fine line between preparedness and prudence I suppose.
I've only glanced over the thread, so this question may have been answered. Are there any projections as to whether or not population density will have an effect? If this becomes a pandemic, then eventually nearly everyone will be exposed to it, but it seems densely populated areas would have their illnesses front loaded while more sparsely populated areas would see theirs drawn out over time. And is either of those scenarios preferable?
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I just called a local bookstore at which I thought I remembered seeing it, Anne Kate, and the guy told me that it wasn't available for sale at newsstands, period. Your best bet would probably be to go to your local university library and photocopy the issue in question.
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quote:Originally posted by Theca: I was just thinking, maybe I should start plotting out which mormon family lives closest to me, with their year supply of foodstuffs stored away.
I know what you mean! I've been LDS for 4 years now, and have seen myself starting to change in many ways, but I still totally feel like a grasshopper among ants. Mormons are so prepared!
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"I think some time in the last ten years the responsibility for everyone's safety and the health and well being of the whole planet became mine personally."
Does this make you popular at parties? Posts: 37449 | Registered: May 1999
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Oh, thank you, Noemon! I am copying the text of all the articles posted online, so I guess I can print those out for a hard copy. Still, the picture of the Asian chick with the skull and crossbones facemask on the cover is just so cool! Maybe if there are any leftovers, it'll be possible to buy it as a back issue.
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Looks like Tamiflu protects against both A and B strains of influenza, Feyd, so while it's possible that the virus could evolve in such a way as to render Tamiflu useless against it, it isn't all that likely. As you pointed out though, it would be a good idea not to be dismissive of the possibility.
So what is the shelf life of Tamiflu, anyway? How long would a stockpile of it be good for? Also, how long do its effects remain in people who take it?
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Sure Anne Kate! I was hoping to be able to pick up a copy for you on my way home from work tonight. Another possibility for actually getting your hands on a copy would be to see if any of the science departments on campus (assuming there is a college near you, of course) have a departmental copy floating around that they'd be willing to part with after everyone has had a chance to look at it.
You know, I could *swear* that I've seen a copy of Nature at Books and Company. I'm not utterly sure that the guy I talked to knew what he was talking about.
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If I remember the Nature articles correctly, Noeman, Tamiflu has a shelf-life of 10years. However, the manufacturor's 2003 statement of shelf-life was 4years for Tamiflu capsules, and 18months for TamifluOralSuspension powder.
May have to do with the assumed different methods between pharmacist storage vs government storage, and/or an impressive re-engineering of inert ingredients&capsule and/or of the drug itself.
quote:Originally posted by Shigosei: Letting you die won't necessarily improve the gene pool. It will only select for people who have high resistance to influenza, or healthy immune systems. Not to mention that "good genes" is somewhat subjective. What if the pandemic kills off a higher proportion of altruistic people because they get infected while helping others?
Also, I'd much rather see the population controlled through the use of contraception. Massive die-offs may be natural, but that doesn't make them the preferred method for preventing the overpopulation of humans.
Quit being logical and let me die!!
And you're right, I suppose, about contraception. A pandemic would just cause more overpopulation in the long run. (sigh) I guess I don't have the answers, then. I hope nothing bad happens, anyway.
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What would happen if we just procured (just like for Iraq) by government funding, enough Tamiflu and other drugs (in case resistance develops) and went ahead and began on the cell based vaccine that is so much faster to develop? (It's ironic that chickens have several vaccine options now but there are none for humans.) That would give us the best protection possible. If we are lucky enough to have time, it will mean the US comes out way ahead worldwide. We can take care of our own people and also reach out to the other nations of the world and help them as well. If we can't do it simply because it's the right thing to do, then we ought to do it because it's smart. It would increase our prestige and political standing tremendously on the international front. That would be taking leadership.
Why, for something that may quite likely cause a thousandfold more deaths than 9/11, do we not just spend the money to combat it directly? Is it not an enemy that can strike deeply at our entire social fabric? Might not our whole civilization be at stake? Why does this not merit at least as much concern as Al Qaeda?
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For how long does a course of Tamiflu confer its benefits to a patient? It must not be for very long--one of the Nature articles Tatiana linked to above mentions an injectable anti-viral, peramivir, as being a good drug to be used prophylactically since it only has to be given once or twice a week. I take it that Tamiflu's benefits are more short lived than that?
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quote:The recommended oral dose of TAMIFLU for treatment of influenza in adults and adolescents 13 years and older is 75 mg twice daily for 5 days. Treatment should begin within 2 days of onset of symptoms of influenza.
The recommended oral dose of TAMIFLU for prophylaxis of influenza in adults and adolescents 13 years and older following close contact with an infected individual is 75 mg once daily for at least 7 days. Therapy should begin within 2 days of exposure. The recommended dose for prophylaxis during a community outbreak of influenza is 75 mg once daily. Safety and efficacy have been demonstrated for up to 6 weeks. The duration of protection lasts for as long as dosing is continued.
posted
Okay, so it pretty much has to be taken constantly to provide protection. I see why the injectable antiviral is a better choice for prophylactic purposes. I think that in the long term it would be a good idea for the government to fund research into something like Tamiflu--long shelf life, available in pill and powder forms--that provided protection for a longer period of time. If we had something like that, it could be extremely useful. Supplies of it could be cached in various area in the third world hotspots where this flu might emerge, and be distributed to the population there at the first sign of an outbreak. There would still be distribution problems, of course, but as long as the medicine could be stored for long periods of time at room temperature I think it would be possible to overcome them.
Posts: 16059 | Registered: Aug 2000
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posted
Yes, I agree that if we could find a drug that needed to be taken less often, we'd be better off. I think all the drugs we do have now are useful in different ways. I understand that it is believed that resistance to Tamiflu will be the most difficult for the virus to develop, or else render it mostly harmless in the process.
Also during the height of an outbreak health care professionals are likely to be incredibly overburdened, so an oral form might be far better than injections just because it's so much easier for people to self-administer.
In addition Tamiflu shows the least tendency to cause side effects of any of the flu anti-virals. Particularly when giving drugs prophylactically to prevent illness rather than to treat an existing illness, it's important to choose those drugs with lowest incidence of side effects.
Lastly, it does have a shelf life of 10 years, according to the information I've read.
I believe for all those reasons Tamiflu is the preferred drug for stockpiling against the threat of a pandemic. However, we should also have more weapons than one in our arsenal, in case resistance does develop. One approach they're discussing to prevent resistance is a multi-drug treatment regime, similar to what they are doing now against HIV. Vaccines and the other antiviral drugs that have been shown to be effective against influenza should certainly not be neglected.
Posts: 6246 | Registered: Aug 2004
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Yeah, that's what I thought I'd read in Nature. However, Roche's 7Jan2004TamifluFactSheet states that the shelf life is 48months for the capsule and 18months for the oral suspension. But then 13months previously, Roche announced a Tamiflu shelf life of 3years for the capsule and 1year for the oral suspension.
Assuming a trend, the 2005 Roche FactSheet may contain a shelf life higher than 4years: there are many nonRoche websites claiming that Tamiflu has a 5year shelf life.
posted
I found This to be an interesting read. Having read it a few years ago, I guess this latest news is less shocking. I don't watch news often, but I caught the piece on News Hour about this last week. There is also a Nova episode about it, I believe. Or maybe I just got visuals of it in my head as I was reading the Gina Kolada book. I mean, how can you not read a book by Gina Kolad? Posts: 2010 | Registered: Apr 2003
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New Scientist has an article up today that talks about the possibility of H5N1 developing resistance to Tamiflu.
Posts: 16059 | Registered: Aug 2000
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