Flu drug ‘too expensive’

Health officials have admitted cost played a part in their decision to abandon a planned stockpile of an anti-viral drug that is now being used to treat swine flu.

Mexico City

A man wearing a face mask holds a statue of Saint Jude, the saint of lost causes, outside the Saint Jude Thaddaeus church in Mexico City, Tuesday, April 28, 2009. Despite the church closed doors and calls from authorities to leave due to the swine flu outbreak, hundreds of faithful arrived to pray and pay their respects to Saint Jude at the entrance of the church. Photo: AP

The Government’s 2007 Influenza Pandemic Contingency Plan said health officials would stockpile enough of the drug, Tamiflu, to treat 25 per cent of the population – anywhere between 13,500 and 16,250 courses of the drug – but instead it only has enough to treat 25 -30 people.

To make matters worse, most of those few packets are approaching their use by date.

‘The reality is that this is a very expensive medication with a limited shelf life,’ said Dr. Greg Hoeksema, the Health Services Authority’s Medical Director at a Monday afternoon press conference. ‘Is it the right investment to spend $650,000 to have medicine on the shelf that we may never use?’

‘We said ‘OK, it’s going to expire after four years and at that point we would have to invest a further $650,000 for medication we may or may not use,’ he said.

Also on hand at the press conference were the Minster of Health Anthony Eden, HSA CEO Lizzette Yearwood and Medical Officer for Health, Dr. Kiran Kumar.

In a press release Tuesday, the HSA said it has secured additional supplies of the drug, which should arrive by the weekend, although it did not say how much of the drug is headed to Cayman.

Mr. Kumar said Monday that UK officials have previously given informal assurances that the Cayman Islands will be able to tap into the UK’s national Tamiflu stockpile, but those assurances had not been confirmed by Monday. Officials had also expressed hope of being able to access supplies from the Pan American Health Organisation and hospitals in Florida.

While there is no vaccine against swine flu, Tamiflu is proving effective in reducing the severity of several strains of influenza, including swine flu.

Swine flu spreads

As the number of countries with confirmed cases of swine flu rose to seven, the World Health Organisation raised its alert level to four – two steps short of a full pandemic.

But the WHO has recommended that borders not be closed nor travel bans imposed, noting that that the virus had already spread and that infected travellers might not show any symptoms.

While there have been no local cases reported, Tourism Minister Charles Clifford has acknowledged that the pandemic fears could further worsen what has already been a bad year for the country’s tourism industry.

In a Tuesday morning teleconference with reporters, World Health Organisation deputy chief Keiji Fukuda said the virus can no longer be contained and countries should focus on mitigating its effects.

In Mexico, 20 fatalities have been confirmed, and the number of deaths considered likely to have been caused by the flu rose to 152, up from 149 on Monday, according to Mexico’s health minister. The number of people believed to be infected surpassed 1,600.

In the United States, the number of confirmed infections stood at 68. Preliminary tests by health officials in New Jersey had identified five probable cases – four people who were recently in Mexico and one who had been in California, The Associated Press reported.

Other cases have been reported in Ohio, Kansas, Texas and California. Most of the cases were concentrated in New York, at a high school in Queens where a group of students had recently travelled to Mexico. At least 28 students at the school tested positive, and another 17 were suspected of having the flu.

In Mexico, state health authorities looking for the initial source of the outbreak toured a million-pig hog farm in Perote, in Veracruz State. The plant is half-owned by Smithfield Foods, an American company and the world’s largest pork producer.

Travel warning

Mr. Kumar has advised all Cayman Islands residents to avoid non-essential travel to Mexico and is cautioning them to be diligent in their travel plans to other countries affected by the swine flu outbreak.

Mr. Eden was due to brief his cabinet colleagues Tuesday and health officials said Mr. Eden could convene a special emergency multi-agency committee to guide Cayman’s response to the situation by as early as Tuesday afternoon.

Another committee, similar to the National Hurricane Committee, which is to be chaired by Governor Stuart Jack, is expected to meet before the end of the week to review the country’s overall preparedness and to ensure appropriate businesses continuity plans are in place.

Mr. Kumar said authorities here have stepped up surveillance measures and while authorities can’t test everyone presenting with flu symptoms, they will run tests on anyone that has travelled to affected areas that has symptoms; anyone that has been in close contact with a swine flu sufferer; and anyone with severe flu symptoms.

He explained it is impossible to immediately distinguish between swine flu and regular flu, as the symptoms of both are the same. Tests of any suspected cases in the Cayman Islands will have to be sent for lab analysis in Trinidad, with results taking up to a week to be reported back.

Mr. Kumar said anyone that has flu like symptoms and has recently travelled to an affected area or has come into contact with someone that has been diagnosed with the virus should seek immediate medical attention.

Discussing Tamiflu, Mr. Kumar cautioned that the anti-viral is no magic bullet for treating potential cases, ‘but we need to have it,’ he said, adding that it must be taken within 48 hours of the onset of flu-symptoms to be effective.

Announcing the flu pandemic contingency plan in 2007, Governor Stuart Jack said having a stockpile of Tamiflu would be a ‘critical component’ of the Cayman Islands’ response to a flu pandemic.

The document itself acknowledges that the availability of anti-viral drugs ‘cannot be assured at the time of a pandemic, when international demand will in any case be high.’

The document said Tamiflu would shorten illness by around one day, reduce the severity of symptoms, and reduce the need for hospitalisation, reducing the strain on hospitals by about 50 per cent.