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Should We Save Our Supply of Tamiflu?

Marc Lipsitch, an epidemiologist at Harvard, argues that we should not be using up our supply of Tamiflu, the leading anti influenza-virus drug. The medication is not a vaccine – it can be given to people after they fall ill. (Ohio, Illinois, New Jersey and Kansas have apparently called out the National Guard to protect Tamiflu stocks. The CDC says we have 50 million courses Tamiflu and other drugs in hand, while the states and the Department of Defense have tens of millions of additional doses.)

Lipsitch argues that viruses learn very quickly to adapt to medications, and if the drug is used too widely too soon, we could end up losing the most potent weapon in our arsenal. Using second line treatments for patients, Lipsitch says, can conserve Tamiflu for when it might be essential. If a virus develops immunity to the drug, it could harm patients not only this time around but the next time the virus comes calling.

But what makes public health sense may not make clinical sense. Can you imagine being one of the people sick with swine flu right now and being told by your doctors that they can’t give you the best treatment available because they have to hold it in reserve for when other people get sick?

By Shankar Vedantam  |  April 30, 2009; 5:01 PM ET
Categories:  Prevention , Q & A  
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Next: What is a Pandemic?


There is SOME sense to Lipsitch's argument. However, Tamiflu is only effective if given in the first 48 hours. By the time a person is life-threateningly sick, it's too late to give Tamiflu.

What we ought to do is prevent mass panic and people taking Tamiflu "just in case" they've been around an infectious person, or simply hoarding it.

If doctors decide it's best to treat only selected cases with Tamiflu, they ought to do it fairly and rationally: people with chronic illness or compromised immune systems, such as cancer patients, should be given Tamiflu.

Posted by: jennypeekaboo | April 30, 2009 9:22 PM | Report abuse

It's a little late for this -- aren't doctors already routinely prescribing Tamiflu to patients who have ordinary, non-life-threatening flus? If we're already prescribing Tamiflu for routine winter flus, there is no value in withholding it here.

Regarding people with compromised immune systems -- is it possible that these people are LESS likely to suffer ill effects from the current swine flu outbreak? Remember that the flu is most dangerous for the 20-40 age range due to the strong immune system response it provokes. Does it follow that those with compromised immune systems are not at risk here?

Posted by: stuckman | April 30, 2009 10:10 PM | Report abuse

These drugs only have a shelf life of four years, according to an article I read in another section of this paper. Holding on to them might mean we have to dump them. Since these drugs started being stocked during the Bush years, many may now be out of date. Does anyone know the truth of this shelf life?

Posted by: clairevb | May 1, 2009 9:26 AM | Report abuse

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