Heroes Not Zombies

How accurate are the published figures about swine flu?

Once the decision was taken to skip swabs and diagnose on symptoms only, the figures have likely to have become very unreliable. Is anyone objectively studying the percentage of those who have a swine flu diagnosis from the questionnaire only, who actually have evidence of swine flu virus, so we can understand just how accurate, or inaccurate the figures are? Reports such as “100,000 new cases of swine flu last week alone” do indeed generate alarm. What are the real figures? If nobody is interested to discover the real figures then maybe at least the reporting should be changed to “100,000 new cases of flu-like illnesses last week”, or something similar.

Why are so many patients being prescribed Tamiflu? What we know about Tamiflu is that it may be able to delay the spread of the virus for a short period of time (but not prevent it’s spread ultimately); that it can shorten the duration of the illness by about a day [Treanor JJ, Hayden FG, Vrooman PS, et al. Efficacy and safety of the oral neuraminidase inhibitor oseltamivir in treating acute influenza: a randomized controlled trial. JAMA. 2000;283:1016-1024] (but not that it can save lives or even prevent serious complications of the flu); that it is “an unpleasant experience” to take with side effects ranging from nausea, vomiting, and hallucinations to serious, rare effects like Stevens-Johnson Syndrome and toxic epidermal necrolysis .

As we have no evidence that it is safe to take in pregnancy, and best practice would therefore suggest that it should only be prescribed when there is significant threat to the foetus, but that’s not the standard being used. An interview with a pregnant woman on BBC news last week showed her picking up her Tamiflu even though she personally thought she only had a cold, because she’d been advised to take the medication on the basis of “better safe than sorry”.

Finally, if seasonal flu kills 8,000 to 9,000 people every year in England, (and up to 19,000 in 2002), is the management of swine flu leading to a different way of dealing with seasonal flu in the future? Will we now see seasonal flu diagnosable online and by telephone by non-medical staff and the mass prescribing of Tamiflu every winter?