Tamiflu stockpiles

Building on from the corruption thread and the recent Katrina threads, I did a google about Tamiflu (what is viewed as the most effective way to combat avian influenza) stockpiles. This site came up, with references, so I'm going to go on it's numbers.

Useful numbers,

US - 2.3m doses, pop 295m (approx) so less than 1% coverage.

France - 14m doses (planned for end of 2005), pop ~60m so around 25% coverage.

UK - 14.6m doses over the next two years, pop~60m so around 25% coverage again.

New Zealand - 835,000 doses by end of the year, pop~4m so around 20% coverage.

Australia - 3.5m doses, pop~20m, so around 17% coverage.


Now given these numbers (and especially to those in the US given the low coverage rates), do you think there is a fair chance of you actually getting access to those doses after essential services have taken theirs? Or is it going to go to politicians families, corporate families etc. with only token amounts dribbling down? Personally I can see politicians getting access to it (to preserve leadership) along with all essential services, but beyond that I think everyone should have an equal chance at it. Do you think there is any hope that everyone will have an equal chance, or is the average citizen of your nation going to be scrapping at what's left over?

I get the flu almost every year, so no.

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Originally Posted by Kaiser of Arabia

I get the flu almost every year, so no.

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So do I but that's not what I'm talking about. You don't need tamiflu for that as demonstrated by you posting here.

Ireland has numbers similar to the US , doses for about 1% of the population .
Though they do have plans , the plan is that 50% of medical staff may be affected , so the health service will be functioning at an even worse level than usual .
Which is probably why they are not bothering to increase the stocks as people will probably only recieve the vaccination 3 years after they are dead .

There are going to be a rush for it for sure. Already happening here in Indonesia...

I heard that a bunch of Chinese chicken farmers had been pumping (human) vaccines into their chickens like nobodys' business thus buggering up the usefulness of potentially helpful vaccines.

Or so the story went.

Doesn't seem all that likely since the vaccine would be worth more than the chicken, surely? Also IIRC the antigen in the vaccine is actually cultured in chicken eggs so I don';t know if it would do any harm to put it back in chickens. I suppose it might mean the chickens incubated some other strain instead, maybe.

If there is a pandemic of a strain of flu not covered by that years vaccine more or less everyone is going to get it. So the difference between 25% and 1% coverage with Tamiflu is really a detail (oooh, get her, she sounds just like Stalin). Once you've covered the health and emergency services and those living in institutions (eg schools, the forces, Hmm, I wonder if they would do prisons, that would cause a stink), you might as well let everyone else take their chances.

ABC News Primetime did a segment on the shortage of Tamiflu in the United States. Here's a link to the transcript. It's short and worth a read.

Unfortunately, it appears that the administration just dropped the ball on another matter of national security. Avian flu has killed 55% of those it has infected so far. Apparently that makes it "the most lethal flu we know of that has ever been on planet Earth affecting human beings." All those who have caught the flu so far have gotten it from birds, but it is probably just a matter of time until the avian flu strain mutates and becomes easily transmissable between humans. When it does so, modern transportation will take it around the world in no time and we should start to see huge body counts and a breakdown of economic activity wherever it reaches. The only effective treatment known so far is Tamiflu.

Unfortunately, the US government didn't act in a timely manner to start stocking up on Tamiflu supplies. The Roche company has taken orders on a first come, first served basis... and the US is way down the list.

From "Primetime":

"Do we wish we had ordered it sooner and more of it? I suspect one could say yes," admits Leavitt. "Are we moving rapidly to assure that we have it? The answer is also yes."

When asked why the United States did not place its orders for Tamiflu sooner, Leavitt replied, "I can't answer that. I don't know the answer to that."

Even leading Republicans in Congress say the Bush administration has not handled the planning for a possible flu epidemic well.

Senate Majority Leader Bill Frist, R-Tenn., says the current Tamiflu stockpile of 2 million could spell disaster.

"That's totally inadequate. Totally inadequate today," says Frist, who is also a physician. "The Tamiflu is what people would go after. It's what you're going to ask for, I'm going to ask for, immediately."

Leavitt says deciding who gets the 2.5 million doses of Tamiflu currently on hand in the United States is part of the federal government's response plan. However, he also admits that thought has motivated the government to move rapidly in securing more doses of the medicine.

"It isn't going to happen tomorrow, but if it happened the day after that, we would not be in as good as a position as we will be in six months," he says.

However, in the end, even the country's top health officials concede that a killer flu epidemic this winter would make the scenes of Katrina pale in comparison.

So, basically, we have to hope that we get lucky and the flu doesn't mutate for another couple of years so that Roche gets around to filling US Tamiflu orders. Even in the "six months" that Leavitt mentioned, we would probably only have a few million more doses.

In a rational society that was threatened by bio-terrorism and naturally occurring disease outbreaks, you would assume that something like our "Homeland Security" department would be on the lookout for these kinds of problems and would move to counter them. Unfortunately, unlike the countries that have taken timely preventive measures, we don't have a national health service that is in charge of providing for the health of the population. That's a big problem when you are trying to deal with a nationwide or global pandemic.

The seemingly obvious thing to do would be to declare this a national emergency before the flu actually strikes, and to take steps to ensure that Tamiflu is produced in this country in the quantities needed. Of course, there may not be time to even start production in the US if the flu hits this winter... but it could make a critical difference if we get lucky and have a little extra time. Hopefully, ideological concerns about patent rights, and political concerns about drug company money won't get in the way of a rational response; but I'm sure they probably will.