Sales of Tamiflu continue to rise and the news
media raises the anti of terror by the minute. But let
us stop and think, those of us old enough to remember,
when in the early seventies the scare was all
about the swine flu not the avian flu. The goverment
whipped up a quick batch of flu vaccine and
starting with President Ford they administered it to
many Americans. The net result was the Swine flu
which had infected pigs never materialized as an
epidemic in people. The vaccine however ended up
putting a number of people on ventilators and some
died from Guillain-Barre syndrome.The government ended up
settling all the lawsuits. Tamiflu apparently is the
only anti-flu drug which works on the avian flu. The
older meds such as flumadine do not work. Stockpiling
the drug will cost a lot of money and has the downside
that it will only be useable for a short period
of time and yet the time frame for when this deadly
strain may hit is more likely many years. In 1970's
the CDC was also sure it was to come soon. The other
problem is that with increased use of Tamiflu resistant
strains will develop. The Presidents 7.1
billion dollar strategy in addition to stockpiling
also includes 2.8 billion to develop new cheaper and
faster methods to make the vaccine. This is money well spent
if it is done correctly but if the money all goes to
the companies and little to fundamental research in
university type labs then it might be much less effective.
Also money should be allocated for further drug development.
Part of the plan is to allow the companies not to be sued
if they have a product with adverse effects like in the
1970's. I say this is a very bad idea. While we
want to encouage the industry this is one perk
which is not helpful. It also seems that his plan calls
for military enforcement of the rules of the pandemic game.
These rules could be quite complicated. For example
only cetain emergency rooms would be designated for
screening severe cases anyone going to the nearest ER
would be turned away if symptomatic. NO one may want
to go to ER's anyhow since they would fear getting
the germ. There may be priority lists for who gets
the tamiflu and with that delays in obtaining it.
This won't do you any good since after 2 days it is not effective.
Add to this mix having the military to enforce the rules
and lists would be a problem. Further in 1918 flu it was
the age group 15-40 that had most deaths unlike most flu
where elderly and the very young are more likely to die.
Many soldiers may become ill. Studies of 1918 flu also showed
that for some towns where a big company dominated the
town the company helped set up areas for ill workers etc and
kept their mortality way down whereas the inner city poor of
the day were neglected and took very heavy losses.
Quoting Jim Higgans of Lehigh University "What happens
when people on the south side of Chicago or Compton or the
Bronx see people dying of this while others get the care they need?
What happens if the hospitals which traditionally serve the
the needs of the inner city begin to run out of beds?
Do you think the people in the inner city will sit pat in the
projects and poor neighborhoods of our country and watch
as their friends and family die? I don't see why there won't
be civil unrest." Will the military make such matters better
or worse. Has anyone planned for such inequity as
also happened with Katrina or is it just a military solution
to every problem we face. Isolation of index cases with rapid
diagnostic methods to identify them is the key
to preventing the spread of the disease. This might be more
difficult in poorer areas where people might not comply
with such such programs as readily so a concerted effort
needs to be made in these areas to make it
happen. Money alone does not stop an epidemic. Let us hope
this is not the year of the epidemic for we are not ready. 11/04/05