The Environment and the Flu

Is the new flu pandemic an environmental issue. It certainly is something happening in the atmosphere and to people, so I would call it in the environment. The flu outbreak presents an unparalleled opportunity to gain knowledge to better protect the public. We will soon see if our hospital beds, butchered by the HMOs and PPOs is adequate to a real pandemic. The spreading H1N1 influenza, now found in 40 countries and confirmed in some 10,000 patients. In the United States, the Strategic National Stockpile contains two drugs for influenza — oseltamivir, known by the trade name Tamiflu, and zanamivir, called Relenza. The Centers for Disease Control and Prevention’s Web site recommends that these drugs be given to selected patients who have the flu and be considered for other people in the patients’ households who are at risk of serious complications if they become infected. But there remain unanswered questions about how well the drugs work.

One of these is how soon the drugs must be used to keep flu from spreading. One clinical trial conducted by the maker of Tamiflu looked at what happened when people in the household of a flu patient were given the drug within two days of the patient’s symptoms. Only 1 percent of them caught the flu. But it’s unusual for healthy people to go to the doctor in the first two days of feeling symptoms of a cold or flu. Now that doctors’ offices are crowded with flu patients, it may be especially difficult to obtain quick medical attention. So we must wonder, if a flu patient doesn’t see a doctor in the first 48 hours, can the drugs still prevent illness in other members of the household? Would they be less effective as time goes by? These questions could be asked of both Tamiflu and Relenza.

Another important question is how well the drugs can work to save lives. In clinical trials conducted by the manufacturer, Tamiflu was shown to shorten the time in which influenza patients have symptoms like fever, headache, cough, muscle ache and fatigue. Patients who received the drug felt ill for 1.3 fewer days. How much money will we pay for lives? Sounds like another attack of the budget cutters, they don't want to pay for new drugs.