What can Tamiflu not do ?

As with many drugs Tamiflu has been rather hyped up as the magic pill for Flu. If you read the popular press, you could be forgiven for thinking that so long as you get your packet of Tamiflu, nothing connected with Influenza can do you any possible harm. So what does it really not do.

• Cure Flu. Nobody has ever said that Tamiflu will cure Flu. Even the people who make it have never made this claim.
  
  
• Make you feel better straight away. Flu usually lasts 5-7 days. The drug must be started in the first two days to do anything. If it shortens the illness by up to one day that means that with Tamiflu the illness will last 4-6 days. Or at least 2-3 days after you start taking the drug.
  
  
• Make you feel better with no risk of side effects.
  
  
• Make you non infectious to others. It may make you less infectious but this is hotly contested.
  
  
• Put you at no risk of complications. It may reduce the risk but there is no agreement about how much it reduces the risk or in which groups of people.
  
  
  
  
  

What can Tamiflu do ?

If an anti-viral like Tamiflu or Relenza is started within 48 hours of the first symptoms of Flu it can.

• Moderately reduce the severity of the symptoms.
  
  
• Shorten the illness by up to 24 hours.
  
  
• It might reduce the liklihood of complications.
  
  
• HOWEVER
  
  
• It may cause side effects such as headache nausea , vomiting and stomach cramps.

You may think this is a short and rather unimpressive list. Speaking personally, I would entirely agree with you..

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The official advice is still to take Tamiflu

Despite the mild nature of the illness so far, the Department of health is sticking to its line of offering anti-viral treatment to all cases, irrespective of severity or absence of at risk status. It would seem that this policy stems from the department considering, that the medical advice that anti-virals were of very limited value in this situation, not being advice that could be "Sold" to the British Public.
You can see their problem. The UK has a huge stockpile of over 40Million courses of treatment (The world's largest stockpile). Yes this drug is to treat Flu. Yes you have Flu but no you can't have the drugs!!

You can see the headlines can't you. "Public left to suffer whilst Government holds on to drug stockpile" and the inevitable jibes about cost-saving.

The Department is in a no win situation here. If they refused to sanction widespread Tamiflu use, they would be crucified in the media. However, by backing its widespread use they are criticised by the Experts for squandering the stockpile, and reducing its effectiveness when the real nasty does arrive. This of course is the real worry.

As a blockbuster, save the population from a deadly plague wonder-drug, Tamiflu is only going to work once. After this amount of Tamiflu has been splashed about, it is inevitable that when the virus does eventually mutate and get nasty, it will have some Tamiflu resistance.

All this is fine butwhat should people do now! Firstly nobody is forced to take any drug. If you are unwell and concerned, then the Pandemic Service will tell you if you have Flu or not. If you do, you will be given an authorisation code to collect a course of Tamiflu if you wish to. It is up to you to collect it or not.

So how does it get resistant? ..................................Close this Box.

Tamiflu and Relenza. Pros and Cons.

So what do you do. Should you Take Tamiflu or not?

Ah. The point I have been trying to avoid! First of all lets take the at risk groups out of the reckoning. There is clear advice based on good evidence that these people should be treated. However these people will be filtered out by the Pandemic Service anyway, and will be directed to a Doctor for assessment, not a help-line.

So for ordinary otherwise fit, healthy children and adults who happen to get this not very severe Flu, should they take an anti-viral drug such as Tamiflu or Relenza? This weeks advice is probably not. It is now September 4th, and on performance so far, the advice may well have changed by next week. I say this not to be facetious ( well not totally) but because this is a rapidly changing, evolving situation, and advice is bound to change as circumstances change.

To take or not to take ?

At the moment the medical advice from the experts is that Swine Flu is a much milder illness than was expected. Tamiflu whilst effective up to a point, is not without its side effects. The gain in what Tamiflu can actually do, probably does not justify the risk of being as unwell from the side effects as you would be from the Flu. Also as we keep being told, it is highly likely that the virus may mutate into one that causes a much more severe illness. If or when that happens, how effective will Tamiflu be if you have already taken it for this mild illness? This is a point of very serious concern.

Sorry lots of ifs and maybees, but whilst it is clear what should happen on the basis of the population, making that into advice that is relevant to individuals is not so easy. If I got Swine-Flu tomorrow, would I take Tamiflu ? probably No. Perhaps that says as much as all the Government advice.

At the end of the day, no matter how much advice you have, and how expert or otherwise are the people giving the advice. You have to decide for yourself if you are going to take a drug or not once it has been prescribed. Nobody else can make that decision.

The point, about effectivenss of treatment next time, does not get much prominence, but some worrying questions are being raised by the experts. Basically we have absolutely no evidence at all that it will work second time around. The situation has never arisen, so it has never been possible to find out. Unfortunately there are some very good reasons why it would be very much less effective. Now as it is not exactly a wonder drug first time around, I am not sure that I would want to be in the situation of getting some horrible mutated flu later on this year, but having already taken Tamiflu for no very good reason now.