www.mdmazz.com - The Art of Healing Blog
The Avian Influenza Tamiflu and the Military
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
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