Re: Swine Flu Treatment Will Now Cost
Link:
http://yle.fi/uutiset/news/2009/07/swine_flu_treatment_will_now_cost_888533.html
Swine Flu Treatment Will Now Cost
published today 07:20 AM, updated today 07:49 AM
A government decision to remove swine flu from the list of generally hazardous communicable diseases officially comes into effect on Monday.
Cases will now be handled in the same manner as seasonal flus.
Experts say that the H1N1 has become so widespread that special measures involving individual treatment will no longer prevent its further spread.
Most treatment of the virus will now be transferred from specialist hospital wards to health centres. They will concentrate on treating patients belonging to risk groups such as pregnant mothers, the long-term ill and small infants.
The decision also means that patients will now be charged for physicians' services, medication and possible hospital treatment.
different targets:
1. preventing further spread:
Combinations called targeted layered containment (TLC) of influenza antiviral treatment and prophylaxis and nonpharmaceutical interventions (NPI) of quarantine, isolation, school closure, community social distancing, and workplace social distancing WORK !
http://www.pnas.org/content/105/12/4639.full.pdf
2. Preventing complications and fatal courses:
Early use of antivirals is useful in preventing complications and fatalities
Finland's stockpile of antivirals in 2007 had been at least 25 % of treatment courses of its population (see below page 23). IMO they should use it now !
http://www.atrakatellis.gr/Events/19/Final report (3).pdf
A high level policy debate report: Pandemic influenza in the EU:
Are we sufficiently prepared?
Brussels, European Parliament, 12 June 2007
Antiviral stockpiles and their national and international use
The stockpiling of antiviral treatments has so far been the most visible element of pandemic preparedness measures across Europe. EU countries have so far bought close to half of all Tamiflu? doses produced globally according to Dr. Magn?sson. Commissioner Kyprianou highlighted that antiviral treatments are the first line of defence and will remain so until vaccines are available.
Taken together, EU Member States currently have a stockpile of treatments for 16.5% of their population even though coverage varies a lot between countries (from 0 to 50%).
The speakers spent an important part of their interventions debating many stockpile-related issues such as the prioritisation of their use, the type of use (for treatment or for prevention), the shelf life of the products, the issue of national vs. regional stockpiles and finally the principle of solidarity or the use of national stockpiles for assistance in foreign outbreaks.
a. Prioritisation
The prioritisation of treatment arose as one of the key issues with current preparedness plans in the EU during the debate. It is a highly sensitive issue with ethical implications and Member States have taken, in some cases, radically opposing views on what should be done.
As an example, Norway recommends the early protection of medical workers whilst Finland does not3.
The dilemma arises from the
possible dual use of currently available antiviral treatments. In addition to their original
use for treatment of contaminated patients, antivirals can also be used for ?pre-emptive? protection of healthy individuals (
prophylaxis).
Prof. Trakatellis believes it is vital to use antivirals for both purposes. If there does not seem to be any issue with regards to the use for treatment, the question of who receives pre-emptive protection and in which order remains unaddressed.
All EU pandemic preparedness plans include the stockpiling of antiviral treatments. However, given that the way in which antivirals would be used is not always clear, it may be hard to evaluate whether the appropriate amount of medicines have been stockpiled. One must also keep in mind that the prioritisation of the use of stockpiles will also determine the logistics of their distribution. This element must not be disregarded as the treatments? effectiveness is very much dependent on the speed with which they can be administered.
These issues only concern the use of stockpiles at national levels. However, pandemics know no borders and in order for national protection to be optimal, surrounding countries must be safe as well. (...)
