One of the striking features of the list of countries with many cases of the new H1N1 virus is that a few of them have few or no deaths. How can this be? One possibility is that they simply have decided not to report. However, in some cases, it may be that they are treating their patients more quickly with the most effective drug available: Tamiflu.
Japan is noted for its aggressive treatment of seasonal influenza with Tamiflu. Some would say, too aggressive. However, during the current pandemic, the tendency of Japanese doctors to recognise influenza symptoms and write prescriptions for Tamiflu with little prompting may have greatly benefited the Japanese people. Although Japan has recently reported some deaths, their case fatality rate for the new flu is still very low – .033%.
The effectiveness of the Japanese policy of easy Tamiflu prescription was recently remarked upon by Dr. Sugaya of Keiyu Hospital. From Japan Times, August 22, 2009:
“Compared to other countries, Japan has considerably fewer seriously ill patients, and that is because they give out Tamiflu and Relenza,” he said.
While in other countries these drugs are not widely used, partly due to the cost, Japan has a stockpile large enough to treat 60 million people, and doctors are quick to administer them to virtually all H1N1 patients, he said.
Tamiflu and Relenza are more reliable methods of treating the new flu than a vaccine, which will not be ready by fall and in too short supply to give to all those at risk, Sugaya said.
Despite the late and inadequate supply of the vaccine, Sugaya remains confident that Japan will be ready to fight the infections come fall.
“As long as proper measures are taken and Tamiflu or Relenza are administered, Japan is fully equipped to deal with the wave,” he said.
Yes, Japan does seem to be relatively well-positioned to deal with the next wave of pandemic flu, at least as long as the virus remains susceptible to Tamiflu.
But what about other countries? Well, the ones with lots of Tamiflu will probably do OK.
But what about the ones that don’t?