Tamiflu: worth "considering"

The UK Department of health clearly gets it.

The chief medical officer, Sir Liam Donaldson, said: "We must assume we will be unable to prevent it reaching the UK. When it does, its impact will be severe in the number of illnesses and the disruption to everyday life."

So today the UK announced its bird flu action plan to reduce the spread of an influenza pandemic by closing public gatherings like movies, concerts, sporting events, schools and some public spaces (Guardian Unlimited). These kinds of "social interventions" are to be kept "in reserve," to be used only if necessary. There were no current plans for quarantine or curfew.

In addition the UK announced it will buy 14.6 million courses of oseltamivir (Tamiflu), which if given within two days of onset may reduce the severity of the disease, and could have some prophylactic value for essential populations like health care workers, police, transport workers and firefighters. The purchase will be made in two 7 million-course buys, this year and next year.

And what about the US? CDC and DHHS undoubtedly have a plan, just as the UK does (although the public version has been in "draft" form since August and hasn't been finalized). But what the public announcement in the UK does is alert everyone, from local health officials and politicans to the general public, that extraordinary action might be needed and allows them to start making their own preparations, in substance and psychologically. Right now too many politicians who control scarce resources are under the impression this is another "Chicken Little" episode. But those who know don't think so.

Professor John Oxford, of Barts and The London, Queen Mary's School of Medicine and Dentistry, London, said on Tuesday governments needed to do more to accelerate planning to combat the threat of a flu pandemic.

"Whilst experts agree that over one million people could lose their lives in the next influenza pandemic, only about a dozen countries have pandemic plans in place, and even fewer of these have stockpiles of antivirals assembled," he wrote in a paper in this month's Lancet Infectious Diseases journal.

Roche's pharmaceuticals head William Burns told reporters on Monday that the United States, which has so far ordered a stockpile of 2 million Tamiflu doses, was among countries considering buying extra supplies. (MSN)

Two million doses? If the estimated quarter of a population is infected, that's 75 million courses of medication for the US, not 2 million. But don't worry. They are "considering" buying some "extra supplies."

Dr Anarfi Asamoa-Baah, assistant director general for communicable diseases at the World Health Organization, said the plan showed that Britain was at the forefront of international pandemic preparations. "We hope that every country will develop their preparations to the same high degree." (Reuters)

Yeah. Well Hope Springs Eternal, I guess.

Update, 3/1/05: Anita Manning at USA Today reports this:

France has ordered 13 million five-day treatment courses of Tamiflu, enough to cover 20% of its population, and Canada has asked for 8.6 million treatments, which would cover 17% of its population, says Terry Hurley, spokesman for Tamiflu maker Roche.

In comparison, the USA ordered 2.3 million courses of treatment last year and none so far this year.

Julie Gerberding of the Centers for Disease Control and Prevention says the stockpile is being expanded, but Health and Human Services spokesman Bill Pierce won't say whether more Tamiflu is being ordered. "We're constantly evaluating the composition of the stockpile," Pierce says.

And then there's this postscript in Manning's article:

Tamiflu is produced in Basel, Switzerland, but Hurley says at HHS request, the company will start making it in the USA this fall.

Is that what this is all about? Made in America? Jeez.