Thursday, December 22, 2005
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Why panics, pandemics, and policy don't mix
Concerns about a looming avian flu pandemic have prompted a lot of commentary and blog chatter over the past few months (including from yours truly) about whether governments are adequately pepared to combat an outbreak of avian influenza. However, panicked calls for governments to "do something" without contemplating the costs and risks that come with each strategy generally leads to bad policy. Consider, for example, that many developed-country governments have been scrambling to load up on the drug Tamiflu as a way to treat the H5N1 variant of the bird flu. In the Financial Times, however, Andrew Jack explains why this might be a problem: Fresh doubts were cast on the efficacy of Tamiflu as a treatment for bird flu on Wednesday night when one of the world’s most prestigious medical journals published new reports of resistance to the drug and deaths in patients in Vietnam.Here's a link to the actual NEJM paper for all of the M.D.s in the house. Dr. Anne Moscona has a commentary on the paper in the NEJM that's worth reading for non-doctors as well. One disturbing implication: It is therefore worrisome that personal stockpiling of oseltamivir [Tamiflu] is likely to lead to the use of insufficient doses or inadequate courses of therapy. Shortages during a pandemic would inspire sharing of personal supplies, resulting in inadequate treatment. Such undertreatment is of particular concern in children — the main source for the dissemination of influenza within the community, since they usually have higher viral loads than adults and excrete infectious virus for longer periods. The habit of stopping treatment prematurely when symptoms resolve (a well-established tendency with antibiotic therapy) could also lead to suboptimal treatment of influenza and promote the development of drug resistance....posted by Dan on 12.22.05 at 05:45 PM Comments: I am both less worried and more worried than you are. We don't have a "frontline defense" in the first place. We never had a feasible plan for distributing tamiflu either. Resistance is a) expected, and b) a non-event; see the recent post over at Effect Measure for lots of technical details. posted by: Tyler Cowen on 12.22.05 at 05:45 PM [permalink]We couldn't have distributed the drug anyway. That happens when you eviscerate your public health infrastructure. posted by: Matt Stoller on 12.22.05 at 05:45 PM [permalink]Post a Comment: |
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