"Killer Flu: A Breath Away" - sounds like a fricken made for TV disaster movie

[Del]

So I have to watch this show, which from my analysis, judging from promotional time and general chicken-littlely announcement, has been requested by the World Health Organization. I expect the report to be delivered by dancing bears on stilts, what with all the hooplah.

In short I think it's sort of like a WHO/CNN Emergency Announcement.

 

[LightPhoenix]

The problem with the H5N1 flu scare isn't that it isn't real, and that we shouldn't be worried about it. The problem is with the current state of the media and, in part, politics in the world. Since those subjects are generally taboo and lead to Bad Places, I'll refrain from going into that here.

The biggest problem with H5N1 though isn't the virus itself. As a general rule, infections that are highly virulent also tend to be fragile, and vice versa. After all, you want to spread before the patient dies, not afterward. H5N1 is also, like most influenzas, spread by fluids, not by air. So really, once a human has been infected, quarantine of the infected individual combined with good hygenic safety on the part of the healthcare workers should be more than enough to block the spread of the disease. Also, while I'm sure mutation of the virus to an airborne one is a worry, in all realism it's not particularly likely to happen.

The real problem is the lack of resources to contain and treat the virus.

First off, in a place as big as Asia, where there's lots of avian-human exposure, it's extremely tough to monitor everything. Not to mention rural farmers are scared that the governments will come and kill all their poultry, leaving them with nothing. Even when it's been reported, the damage may be done. And that has been seen in Vietnam, where multiple family members may contract the disease. My understanding is that this is because of a common point of bird-human exposure rather than human-human contact, but that doesn't mean the latter is less important.

Secondly, there's a serious lack of antibiotics to treat the virus. You may have heard of Tamiflu, also called Oseltamivir, which is an anti-viral which targets a viral protein (neuraminidase). The current stockpile is hardly up to snuff, and there's no guarantee that in a mass outbreak situation, a resistant strain won't appear. Additionally, big phama doesn't want to make the stuff, since it doesn't make them money. So they need to be incentivised, which can happen in the "more developed" countries but not in the smaller ones.

Which brings me to an interesting idea that I don't particularly understand. At least here in the US, the government pays lots of money to phamaceutical companies like Roche to get them to make drugs like Tamiflu, vaccines, and the like. Why don't they use that money to start up their own lab/factory to make them? Besides the obvious advantage big phama has with regards to experience.

 

[Daalbar]

Which brings me to an interesting idea that I don't particularly understand. At least here in the US, the government pays lots of money to phamaceutical companies like Roche to get them to make drugs like Tamiflu, vaccines, and the like. Why don't they use that money to start up their own lab/factory to make them? Besides the obvious advantage big phama has with regards to experience.

2 reasons that are not mutually exclusive:
A) that smacks of socialism
B) that's why big pharma has lobbyists


This may sound very cynical (but that doesn't mean it's not true)

 

[Del]

Quote

The problem with the H5N1 flu scare isn't that it isn't real, and that we shouldn't be worried about it. The problem is with the current state of the media and, in part, politics in the world. Since those subjects are generally taboo and lead to Bad Places, I'll refrain from going into that here.

Indeed. The pit-trap of Off Topic Conversation. Say no more.

The biggest problem with H5N1 though isn't the virus itself. As a general rule, infections that are highly virulent also tend to be fragile, and vice versa. After all, you want to spread before the patient dies, not afterward. H5N1 is also, like most influenzas, spread by fluids, not by air. So really, once a human has been infected, quarantine of the infected individual combined with good hygenic safety on the part of the healthcare workers should be more than enough to block the spread of the disease. Also, while I'm sure mutation of the virus to an airborne one is a worry, in all realism it's not particularly likely to happen.

Don't forget the marvel of 747 global air traffic. This is one of the Horsemen that could make an '06-07 pandemic worse then previous deadly flu outbreaks.

The real problem is the lack of resources to contain and treat the virus.

Yap. Tamiflu doesn't grow like weeds.

First off, in a place as big as Asia, where there's lots of avian-human exposure, it's extremely tough to monitor everything. Not to mention rural farmers are scared that the governments will come and kill all their poultry, leaving them with nothing. Even when it's been reported, the damage may be done. And that has been seen in Vietnam, where multiple family members may contract the disease. My understanding is that this is because of a common point of bird-human exposure rather than human-human contact, but that doesn't mean the latter is less important.

One case before I think so far of human to human. However this case was extreme close contact between a mother and her sick daughter. But ya, this thing hasn't mutated yet.

Secondly, there's a serious lack of antibiotics to treat the virus. You may have heard of Tamiflu, also called Oseltamivir, which is an anti-viral which targets a viral protein (neuraminidase). The current stockpile is hardly up to snuff, and there's no guarantee that in a mass outbreak situation, a resistant strain won't appear. Additionally, big phama doesn't want to make the stuff, since it doesn't make them money. So they need to be incentivised, which can happen in the "more developed" countries but not in the smaller ones.

I heard Roche is makin' deals with several other pharma heavy hitters to get production moving for us all.

I actually plan to hit up my GP soon for a prescription of Tamiflu. I know a pharmacist who is connected. Gotta pay out of my own pocket but that's better then in the USA where I believe you can't get it privately.

Which brings me to an interesting idea that I don't particularly understand. At least here in the US, the government pays lots of money to phamaceutical companies like Roche to get them to make drugs like Tamiflu, vaccines, and the like. Why don't they use that money to start up their own lab/factory to make them? Besides the obvious advantage big phama has with regards to experience.

The USA I believe, after Many Things We Shant Discuss, is strapped for cash. Not the worst idea though.

 

[diaglo]

Yap. Tamiflu doesn't grow like weeds

and it is only our best guess. we still don't know if it will work when there is a true pandemic.


in response to Daalbar about why the government doesn't make huge amounts of drug X to combat disease Y... that is why commercial companies make the big bucks. they take the risk of developing the drugs (which ain't cheap). the government if we had the money to waste on developing the drugs would do it. but we are responsible to the tax payers. without showing a return for the wasted money we get in big time trouble.

should we take 5 billion dollars away from Hurricane Katrina relief to work on a drug that may not work vs the pandemic flu?

or should we let Roche, Merck, Smith/Kline, Pharmacia, etc... do it and we pay them when we need it?

 

[Umbran]

Secondly, there's a serious lack of antibiotics to treat the virus.

I know what you mean, but let's be clear for the readers out there - "antibiotics" treat bacterial infections. If you walk into a drug store and buy an "antibiotic", you won't be arming yourself against a virus.

Why don't they use that money to start up their own lab/factory to make them? Besides the obvious advantage big phama has with regards to experience.

Besides that big advantage? You make it sound like that's an advantage that cvan be set aside lightly. It isn't in the least. Or would you prefer your anti-virals to be made by a non-expert?

But, besides that big advantage - if the Government decided to do it, much of that money would have to go into re-inventing the wheel, building up new facilities and infrastructure that Big Pharma already has. That's wasteful.

And, overall, it is a simple matter of efficiency. As a practical matter, government rarely does something more efficiently than the private sector can. It is a basic tradeoff - Government is big, and has power it can assert just about anywhere it needs to. But it is slow to change, clumsy, and inefficient. The private sector has far less power, but it's faster, more efficient, and more flexible by far.

 

[Thornir Alekeg]

Another reason the government does not get involved in the drug making business is that they are responsible for regulating the makers of drugs through the FDA. If the government makes the drugs, suddenly regulation of those drugs becomes a lot more complicated and political than it already is.

As I recall, the government has on occasion briefly taken control of a facility producing "essential" drugs in order to keep them going (I think the US Army did it for a facility producing smallpox vaccine at one point), but they try to find a buyer for the company as quickly as possible.

 

[Cheiromancer]

I remember seeing old pictures of folks wearing masks to guard against the spanish flu. Would that work? If wearing masks (and gloves, I'd imagine) protects you from getting the flu, who needs drugs?

 

[diaglo]

I remember seeing old pictures of folks wearing masks to guard against the spanish flu. Would that work? If wearing masks (and gloves, I'd imagine) protects you from getting the flu, who needs drugs?

go here for more information about what we do recommend: http://www.cdc.gov/flu/pandemic/