Several states have come out with guidelines on individuals’ stockpiling of tamifu in the form of advisories to health care providers from the state DPH.
MA and CO advise against it, and the reasons are spelled out in the documents, each posted to their respective states. Other states are working on guidelines as well, though many are still in draft form.
Both states suggest that making sure there’s enough for this seasonal flu patients is one of the main reasons. The worry is that stockpiling will deplete already tenuous reserves.
Check your state to see if there is anything at the state public health department website. if you find one, post it on the Flu Wiki state page, or mention it here and the editors will do it.
As for what you should do about tamiflu, read the advisories and decide for yourselves. Availability may now be a determining factor, whatever you decide.
As Sandman and Lanard have observed, there’s more to pandemic preparedness than tamiflu and masks.
Monotreme adds Iowa:
As we saw from Katrina, and other recent diasters, one must never depend on others to take care of oneself and one’s family. I have Tamiflu for my immediate family and am expecting another shipment soon a cirlce of close friends. In fact, a good guideline is to do the reverse of any suggested guidelines from any Govt. agency.
I have to agree with Jim. Our government has proven time and again that we cannot count on it to keep our best interests in mind. I will avoid turning this into a political diatribe but let’s face it—asking us to trust that Tamiflu will be distributed equally to those most in need is like asking us to believe that tax cuts most benefit the working class. If the flu hits, the wealthiest and the richest will get it first. For the rest of us it will be life in the Superdome. A country that doesn’t have universal health care is inherently not serious about protecting and caring for its citizens. A president who talks about quarantines and soldiers restricting our movements cares more about control than the welfare of sick people.
Dear BIIC: The rich and wealthy etc already have it…and anything else they’d ever want. The vast majority of the world survived the 1918 pandemic, and they had NO access to antivirals, antibiotics, venilators, ICU’s etc. The world will go on. Self-educate, monitor, pray, prepare, and teach others. And for me, I hope the Web stays up because talking/listening learning here is keeping me balanced and sane.
Dear Grace RN: I disagree with so many of your statements and implications. First, while many who have obtained Tamiflu are no doubt among the wealthier members of our society, certainly not all are. While my husband and I, solidly middle class, have been fortunate enough to purchase Tamiflu for ourselves and our loved ones (at significant financial sacrifice, I might add), many of our wealthier relatives, either due to the inability to get a doc to write a scrip or simply delaying too long, have been completely unable to get the drug. Second, while the vast majority of the world survived the 1918 pandemic (although putting it that way makes it sound like the number of deaths was really no big deal), I suspect many more would have survived if only they had access to the drugs we have today. And I am sure that any parent who lost a child back then would have given anything - ANYTHING! - to have possibly saved their child’s life.
The world will go on, you say, but what a cavalier statement! The world may well go on, but as for me, I am not interested in going on in a world without my children and theirs.
And finally, while stockpiling Tamiflu theoretically is depriving someone else of the drug, in reality, your not buying it would amount to nothing more than an empty, noble gesture. Because what we have here is a country run by power-mad maniacs who have not the slightest interest in the public good. If they did, don’t you think they would have provided anti-viral drugs for more than 1% of the population?
I have not one single doubt that those who have gone to the trouble and expense of obtaining Tamiflu for themselves and their loved ones will do far more to benefit themselves, their families, their neighborhoods, this country, than anything our current leaders will ever do.
I have to agree, Big Bear RN. If those who took this seriously enough to be proactive and get antivirals survive and thus become resistant, they may also be proactive enough to help others during a pandemic.
There’s more than one way to approach this, and it isn’t a right/wrong situation. The public health folks trying to reach consensus on this aren’t the bad guys, by the way.
If you haven’t made up your mind yet, the recommendations are food for thought. if you have, fine. Whichever way you decide, you have nothing to apologize for.
My wife and I are retired. We do not have a lot of income. We chose to stockpile tamiflu again at great financial sacrifice. We believed 6 months ago that it would never be delivered by our government to an old couple in North Dakota. So we bought it while it was available.
While my loathing and contempt for the current US adminstration is beyond any negative thoughts I have had for any previous administration, I do believe that a Democratic President would still have fiddled while we sickened.
There is simply nothing for a US president to gain by providing for the welfare of the American people. Its all about spin and image. Unfortunately, most of us only listen to spin and image. Sigh
I can just hear our leaders looking at the upside of a pandemic. Maybe it will take a bunch of old people off the social security rolls.
If my comment about pols in another post happened to start this, I’m sorry. There’s no doubt that politicians - of most countries - have been pretty slow off the mark. ‘Incompetence’ is the first word which springs to mind, but I think it’s going a bit far to accuse them of *deliberately* putting the lives of their electorates at risk.
If, as Big Bear suggests, the US gvernment has only purchased sufficient anti-virals to treat 1% of the population, that may be bacause (1) they were late submitting their order - and AFAIK Roche are filling orders on a ‘first come, first served’ basis and (2) That the government has actually told the truth (for a change ;) .)
Other countries may have been a little more economical with the truth, or may have phrased their releases to their people quite carefully.
Some weeks ago, the French president announced that in the event of a pandemic, France would purchase sufficient vaccine to innoculate every person in the country, ‘because the people would never forgive us if we didn’t.’ Fine words. - I wonder which vaccine he’s going to buy and when he expects it to be delivered?
The British government says “We are stockpiling 14.75 million doses of anti-viral medicine which will be sufficient to treat 25% of the population, in accordance with WHO recommendations.” Souds good - but read it carefully. The initial British order (placed early this year) was for a little under 6 million doses - enough to treat 10% of the population. To date, they’ve received 2.5 million doses.( http://society.guardian.co.uk/health/story/0,7890,1593808,00.html )
They’ve recently increased the order to 14.75 million, but the order won’t be filled for at least another year. - There’s a difference between ‘We are stockpiling’ and ‘We have a stockpile of’. I doubt any country is going to have a glut and almost every country will have acute shortages. Yes, the pols ‘got it wrong’ and if a pandemic occurs before the orders can be filled, that may cause a problem. So the only thing we can do is make the best of a bad job and make individual preparations.
If a pandemic occurs, perhaps many people will die of the flu. If the people are not prepared (and we can and should take a large share of that responsibility ourselves - especially if we don’t trust the government to get it right ;) ) a large number of people may die through non-influenza related problems which might have been avoided by adequate personal preparation.
While our government may not go so far as to “deliberately put the lives of their electorates at risk,” I don’t think too many of the current crop of incompetent leaders would lose a whole lot of sleep if a few million or so “lower caste” citizens were to lose their lives to pandemic flu. Unless, of course, said incompetents had to cut short their dinner at Ruth’s Chris Steak House.
That would be a real bummer.
The problem is, those lower caste citizens have friends. And their friends have votes.
I held a beautiful little daughter and watched her die and there was nothing anyone could do. I lost another infant daughter to a virus. I will not lose another child, will not! I have done everything I can to protect my children, including stockpiling both Tamiflu and Relenza for my family. I have done everything to get these drugs, charging some, scrimping to get some, and begging, begging my husband to tap his retirement for some. I know my family would be on the bottom of the anti-viral 1% stockpile food chain, if I had not. I moved my children to the top. My children do not owe their lives to anyone. God was the only one that had a supreme reason to sacrifice his child. There is no eason for me to do it. My children do not owe their lives to anyone. They want to grow up, fall in love, marry, have babies, homes, careers, LONG LIVES! It’s not their fault that the US fell asleep at the wheel!
I just read the Mass. state argument as to why individuals should not have Tamiflu.
http://www.mass.gov/dph/cdc/epii/imm/alerts/antiviral_stockpiling_recommendations.pdf
It is a strange argument. Point one is that getting personal supplies (for example over the Internet) will somehow interfere with certain unspecified ongoing efforts to secure government controlled stockpiles.
The problem for me is that if I could be assured that the government was acting to build a stockpile then I would be less likely to want one of my own. But since no specific assurance is given as to such stockpiling being underway that argument does not work for me. Asking the reader to just assume, without trying to convince him, that there will be a government stockpile is a weak way to make this point to people who might consider a personal supply. And since the implication is that if one orders some for oneself internationally, well then the stockpiling plan of the government may be undercut makes one wonder just how strong this unspecified effort of the government really is.
The next point is that we can’t be sure how well it will work, but this point is undermined later where, to my layman’s ear at least, the statement seems to say that Tamiflu is the only real treatment likely to work.
Then there is the point that in a shortage situation it would be more important for very young people or very old people to get a limited supply. This might be an argument as to why I should donate what I have to such people in a crises, but unless what I have really subtracts from the government controlled stockpile then it is not an argument against me getting it.
Then there is the argument that it would be bad if people started to use it improperly and/or unnecessarily and that medical advice is important. Well I know that it is a prescription drug and certainly would try to get all the medical advice over the phone that I could before giving or using it, but I that seems a sort of paternalistic reason for saying that I should not have it.
Overall I found the Mass. state argument against it unconvincing. It was a good argument as to why the existing stock in, for example hospital pharmacies (however much that is) should not be distributed now to everyone who wants it, but it was not a good argument against people wanting import some while it is still available from overseas sources.
In a capitalist economy- demand stimulates supply. So the more people buy and stockpile Tamiflu, the more Roche and the Generic crowd are going to make in order to supply the demand. If no one buys Tamiflu- then no one will be bothered to make it. Why would they? If having TAmiflu makes you feel safer, by all means, buy some and stash it away. Hopefully it will sit in the cupboards, never used, pass its use-by date and end up down the toilet. Much to everyone elses amusement.
I read the Iowa Dept of Health advisory on Tamiflu. What a bunch.. Their own local staff had never even heard of Avian Flu. Local staff are coming to my elderly Mom’s home twice daily to care for her post-0p. I asked them what was the states plan for a pandemic. They said there was no plan that they knew about, no training, (in fact they were just at a training on terrorist attacks) I found myself giving them the websites to learn. Think I am going to rely on my local health dept to care for me and my family? Not a chance. I have my drugs and preps are well underway.
Dear Grace RN: Thanks for the lecture, but I’m buying it anyway. And frankly, I’m a little skeptical about your advice that I should “pray” instead of obtaining Tamiflu. Much as I love the Goddess, I trust She’d want me to do whatever I can do to take care of my self and my loved ones. I agree totally with Big Bear RN on this, the You’re-Doing-A-Heck-Of-A-Job Brownies and their bosses have made it abundantly clear that they’re both careless and incompetent. Every one has to make their own choices. Please respect mine.
Dear Buying It in California: some people, myself included, find praying to be a stress reducer. No offense intended; of course I respect your opinion. I understand where MOM11 is coming from. It sure didn’t help to have another know-nothing dingbat appointed by GW to head the pandemic flu response (another Michael Brown to be sure), ie from today’s effectmeasure: “When President Bush announced to the nation bird flu was a matter of homeland security, he also announced his intention to have sufficient influenza vaccine production capacity to immunize everyone in the country. There has been some buzz about the political hack in charge of that, Stewart Simonson:
He’s the official charged by Bush with “the protection of the civilian population from acts of bioterrorism and other public health emergencies”--a well-connected, ideological, ambitious Republican with zero public health management or medical expertise, whose previous job was as a corporate lawyer for Amtrak. When Col. Lawrence Wilkerson, former chief of staff for Secretary of State Colin Powell, recently speculated, “If something comes along that is truly serious…like a major pandemic, you are going to see the ineptitude of this government in a way that will take you back to the Declaration of Independence,” many of those professionally concerned with such scenarios couldn’t help thinking of Simonson. They recalled his own unsettling words at a recent Homeland Security subcommittee hearing on government response to a chemical or biological attack: “We’re learning as we go.”
“Great. What we need in the middle of a crisis is somebody learning on the job at that high level of government,” says Jerry Hauer, Simonson’s immediate predecessor at the Office of Public Health Emergency Preparedness (OPHEP) and a veteran public health expert who served as Rudy Giuliani’s director of emergency management from 1996 to 2000. “If I was in charge, he wouldn’t be in that position,” says Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University. “We don’t have the best and brightest in the key positions, and this leaves us in a very, very precarious situation.” (Jeremy Scahill in The Nation)”
Trust me, I am as angry and frustrated by the current state of non-government in Washington as anyone. After much effort, my mayor has asked me to speak to her next week re: pandemic flu (I emailed her the part of the DHS pandmic flu plan just released that noted that local governments can expect no help from the county, state or federal level if the pandemic is worst case scenario; then she asked me to speak with her.) if the pandemic is worst case scenario?? we know it won’t take a worst case scenario to get there; N.O. taught us that. I plan to stay in my community and help my community; after it passes, that’ s where I’ll be. Perhaps geography has something to do with it? our state is small but very heavily populated.
Fred in Vermont — If you thought that the Commonwealth of Massachusetts advice on personal Tamiflu stocking (known as “hoarding”) was unconvincing, you should try their Pandemic Preparedness Plan —
http://www.mass.gov/dph/cdc/epii/flu/statepln.pdf
which hinges on this statement (page 21, Assumptions) —
“There will be a minimum of 6–8 months between a novel virus alert and the availablity of vaccine”
Blog commentary here— http://www.twentyfirstcenturyart.com/dakota/mt/archives/002455.html
has anyone found state advisories we’ve not listed here (IA, MA, CO)? Please post.
psyche7…I’m from Jersey- does your note above mean you are too? If so, which county?
psyche7, thanks. I’m sorry I wasn’t more specific. I’m looking for tamiflu advisories.
Grace
You’d be proud of me today. However, I am so exhausted I can hardly move! Two of the children and I have something, we don’t know yet what …but we hurt…all over! Started about 10 years ago for me, 4 years ago for my daughter, and 3 years ago for my son. (my son does have a post strep disease, although his infect. doc. says she thinks he also has something else too) We’ve been given all kinds of dumb diag., but my daughter almost went into kidney failure and had labs indicating a metabolic muscle disease. They did a muscle biopsy in August, but results aren’t back yet. These disorders are genetic (oh yay) and when the results are back, they will see if possibly all 3 of us share the same disorder. Just what we need, more junk! Anyway, we hurt and get tired…but I was a good Mommy today. Left at 10, dropped teeny, beaneys off at Baptist Sunday school (including 4 year old wild child) and ran out the door. Drove the two older ones to Mass at Catholic Chuch, fled back to Baptist Church to retreive the first group, drove back to Catholic Church to pick up second group..whew! Took them to lunch, then wandered all over town (too far to go home), then took little ones back to Baptist Church for an evening program, stopped for pizza, home 10 hours later! I didn’t get to church, but I do feel peace that the children all went somewhere! There was lots of praying today!
PS…We washed our hands many times, used anti-bacterial stuff all day long!!!
DemFromCT — Sorry, I lost context. Here is all that Massachusetts has to say about the issue (this from their Pandemic Plan cited above, which is the sole reference in their online literature to Tamiflu) —
Unresolved issues Should we stockpile antivirals? • Should we have a system in place for purchasing antivirals during a pandemic? (Will antivirals be available for purchase during a pandemic?) • If we have antivirals available, o Who should get them? o For prophylaxis or treatment? o How would we distribute them?
Confidence inspiring.
they’re the right questions, though. And at least they don’t pretend to have all the answers.
It’s not that they’re not telling us. It’s that they don’t know.
Mom11…your day sounds full, even before you wake up. Don’t know how you do it. Keeping you in my prayers.
Question: isn’t scarcity a necessary precondition for Tamiflu to be effective? If every patient received the drug, wouldn’t the virus rapidly evolve resistance? Those without the drug might take comfort that they are acting as a “reserve”, like the rows of normal corn required to be planted around the edge of a field of Bt corn so pests don’t develop resistance to the bacillus and its toxin before the patent expires…
it’s a short term large scale interim thing. If there were vaccine, you’d ring with tamiflu while waiting for vaccine to de delivered and administered.
There are several reasons why each of us should obtain a personal Tamiflu stockpile.
The first relates to the fact that the US Department of HHS did err in their choice to delay ordering the drug from Roche. Even though a number of additional suppliers are now going to begin making the drug, if Roche’s statements regarding the difficulty in its manufacture are true, it will take them quit a while to get up and going. The National Strategic Stockpile will not be adequate to provide protection for even 20% of our population for at least 18 months.
The priority list for who will receive access to medicines and vaccines first in the event that supplies are limited which we are fairly sure they will be is my second reason. This list was first published by the US CDC last summer and reiterated in the November 2005 HHS Influenza Pandemic Plan. The priority has 3 tiers and begins with medical personnel, first responders, and vaccine manufacturer staff in the first tier with the children to age 14, adults aged 50 and over, and adults with chronic disease in the second tier, then come everyone else. I can understand the genesis of this list and support it in the event we had a shortage during a routine flu season. A pandemic is different. The highest death rates during the 1918 pandemic were in the age 15 to 40 year old groups with the peak at age 25. The current guidelines place these folks at the end of the line. Since they do most of the work in the US, if a large number of them are incapacitated or dead as a result of the flu, who is going to provide for the rest of us?
I too share the concern of others regarding the ability of the US Government to efficiently deliver components of the National Strategic Stockpile to the state and local emergency management agencies in a timely manner and for those agencies to be able to distribute these scare supplies to the public. Once the pandemic begins, I think its worldwide spread will be much faster than most imagine. There is the distinct possibility that it could very quickly reach the US and lead to a disruption in the transportation and communications infrastructure very rapidly. It is expected that the pandemic will be a nationwide event with multiple centers of high intensity scattered throughout the nation occurring virtually simultaneously. To expect our federal, state, and local agencies to coordinate with each other and act efficiently under those conditions when the contrary has been the case during recent emergencies that were purely regional in nature and not nearly so server is not credible.
So, for these reasons, I encourage each and everyone who is concerned about the risk we face from pandemic Bird Flu and who is able to persuade their physician to write them a prescription for it, to do so and do so now. In my opinion, it is much better that there be a cadre of folks in the country that have access to the drug and hopefully have taken the time to learn how to use if properly for use during the pandemic than for the drugs within the National Strategic Stockpile to remain in warehouses guarded to the last man by the US Army waiting for orders from FEMA that never arrive.
Grattan Woodson
Dr. Woodson,
Thank you so much for the work you are doing. I have printed out copies of your “The Coming Influenza…” for family and friends. Appreciate it so much.
As for the Tamiflu. Is it even possible to still obtain it in the U.S.? I thought Roche had cut off supplies. My family does have some, but I have called pharmacies in my area (southern California) in the attempt to obtain more, and they are out for unknown amount of time.
Also, what do you think of Relenza?
Dr Woodson, what about the use of probenicid with tamiful to keep levels up higher and longer,rather than drinking urine to recycle it?
Hi SC and Grace,
Contrary to what I thought in October, Roche has not stopped supplying Tamiflu to North America. What they did was prevent their wholesaler’s from filling large orders for corporate buyers. These entities were placing orders for 500 courses (5000 tablets) at a time and stockpiling it at the company. They planned to give it to their employees should the pandemic strike. It was this type of purchase that Roche has stopped supporting. So, the drug stores are pretty well supplied and anyone can buy it in the US. Canadian pharmacies may have stopping selling it to US buyers but I am not certain of this.
If you take Tamiflu with probenecid it increased the effect and time it stays in the body by 2 times and 2.5 times respectively. This means that if you take probenecid 500 mg 4 times daily you need only one 75 mg Tamiflu tablet to obtain the same benefit as you would have with two Tamiflu tablets without probenecid. So, the combination more than doubles your effective Tamiflu stockpile.
Probenecid is available as a generic for about $20 for 40 tablets in US pharmacies.
As for the urine re-administration strategy; it is possible that this has become a mute issue. See http://www.fluwikie.com/index.php?n=Forum.RecyclingOseltamivir
Hi SC and Grace,
Contrary to what I thought in October, Roche has not stopped supplying Tamiflu to North America. What they did was prevent their wholesaler’s from filling large orders for corporate buyers. These entities were placing orders for 500 courses (5000 tablets) at a time and stockpiling it at the company. They planned to give it to their employees should the pandemic strike. It was this type of purchase that Roche has stopped supporting. So, the drug stores are pretty well supplied and anyone can buy it in the US. Canadian pharmacies may have stopping selling it to US buyers but I am not certain of this.
If you take Tamiflu with probenecid it increased the effect and time it stays in the body by 2 times and 2.5 times respectively. This means that if you take probenecid 500 mg 4 times daily you need only one 75 mg Tamiflu tablet to obtain the same benefit as you would have with two Tamiflu tablets without probenecid. So, the combination more than doubles your effective Tamiflu stockpile.
Probenecid is available as a generic for about $20 for 40 tablets in US pharmacies.
As for the urine re-administration strategy; it is possible that this has become a mute issue. See http://www.fluwikie.com/index.php?n=Forum.RecyclingOseltamivir
Had no problem getting the Tamiflu here in Jersey two weeks ago. My doctor mentioned that it was a suggestion that doctors here not write scripts. Since I was rundown, first a cold, then the Shanghai Flu and had just recovered he asked which I prefered, the Tamiflu or Relenza. I think he has been bombarded with requests. The first pharmacy did not have it in stock, the second a half a block away did. I bought it, but haven’t really too much faith in it. Will get the probenecid the next time I see him. I think the recipe for Kim chi will prove of more value. The only reason I had to get it is that my family is on the other side of the country and I will take care of myself as I always have since my husband passed away. I am very self reliant, and the only thing I will do is call a neighbor if I think I might expire so they can cart me out. I somehow don’t really think this will happen. I am psychic about major tragic events and always seem to know, which is the only blessing to being psychic.
…I am psychic about major tragic events and always seem to know, which is the only blessing to being psychic….
So, do you see, fell a major tragic events is coming?
I generally know about a day in advance. Sometimes its a dream, and if I try to avoid it its only delayed to about 10 days and it happens. A few times I’ve stepped out of my car and looked up at the sky and thought that plane is going to crash. I look around a think, now where, and the next day I read about it in the paper. (Once it was a bird that flew into the engine.) Sometimes its a terrorist attack. The last time I couldn’t get the subways bombings out of my head (have been to all those bombed) I kept thinking Leeds Castle, and a few days later the bombers were traced to Leeds. Not to Leeds Castle. Its a sixth sense many of us have, more developed in some people. Precognition. Its generally about a tragedy, sometimes personally its a warning about an accident. Sometimes its being absolutly certain one doesn’t have cancer when tests seem to point in that direction. That is comforting. Otherwise its warnings from the inner voice we all have when we are thinking.In many instances I have warned people but it doesn’t help even if I am specific. Its out of the blue, I think a form of magnetic energy that I certainly have no control over. It comes and goes as it pleases, whatever it is. It has saved my life so I take it very seriously.For others, I can’t change their fates, as it is interferance.Its like one is in a plane and can see far ahead what is happening, but if you are the ground you are only aware of what you see in your limited range.I don’t like it, but its there, and many have it to one degree or another. Primitive man needed it to warn him of dangers beyond his sight. Sometimes I’ll think, deer ahead, and around the bend a deer will jump in front of me, but I’m mentally alert to avoid it. Sometimes its something you avoid, not knowing why, and then you read about something horrendous that happened where you didn’t go. And you are grateful that you were shuddering and shivering and didn’t go there. Animals have it. I think people instinctively know a great deal that we call intuitive thinking. That is a combination of intelligence, experience and an openess to the world around you. I think many have it in various professions, things don’t feel right, they have a hunch even if everyone else disagrees, they just know. What I call it is Knowing. Others call it a sixth sense. Generally its refered to as psychic ability or a sensativity.I don’t know what will happen with this Bird Flu but my intuition, (not sixth sense) smells a big dead rat in China.
I know what you mean. I sometimes feel things coming too, like I felt heartquake in 1989 where I lived at that time.
I went out from the house, go to my car, looked at the house, and I was thinking: “something will happen, something will happen” and I didn’t know what it will. I understood after the earthquake!
I made dream also. In a dream I saw my father with a closed coffin. 1 year later, he died. 3 days before he died, I had another dream, more like a family nightmare dream.
But for that *maybe* pandemic, I really don’t know. If I listen to scientific, I would say yes and sometime my imagination let me imagine how it will be if this happens. Not really nice, but it’s just my imagination!
The arguments brought forward against stockpiling are not convincing me, and there are flaws in the logic behind the arguments.
The most immediate reason for me to stockpile is a very simple one: Tamiflu needs to be taken within the first 48 hrs after incubation to be useful. The trouble here is, I do not normally go to the physician after I see where the cold I have caught is leading me; sometimes its a light one, sometimes not - but in any case, I am not going to see the doctor within the first 48 hrs. If I would do what the anti-stockpilers are telling me, I would not have Tamiflu, go to the doctor, he would - if I am lucky - find that I have the avian flu, but it is too late for me.
Therfore, I have acquired not only Tamiflu, but also the testing stripes !
Why has the US government not provided antivirals for everyone? Lets get real here; ONE-No one knows for sure if they will even be effective, TWO-No government has provided for all their citizens, the supply simply is not there to even come close to meeting that quantity. With Roche adding several new plants this year they sill expect it would take several years to make that much THREE-How would this be paid for? 300 million people in the US at what $200 per course? $6,000,0000,000 for something that may not even work? This sounds like a devious liberal plan to get the President impeached for wasting even more money the government does not have.
The government has no responsibility to provide for each and every need of its people. I believe the Constitution says the government will “promote” the general welfare, it does not say a thing about providing it. If you want to live in a socialist state please find one that works and move there and stop your whining.
Ditto for the concept of universal health care. Please find a country with one that actually works, tell the rest of the world about it, and move there. I guarantee it will not work better than what we have here now. Blame the lawyers, the law suit happy blood suckers, and the jury awards for our health care woes, they are the reason it costs so much and why the common man cannot afford it.
Unbelievable! With all the talk here about self-reliance, with all the evidence through out the world, through out time that the bigger a government or organization the less efficient it is, there are still those who chose to blame the government for every thing under the sun. Cripes there are actually Hollywood liberal “heroes” blaming the President because they cannot quit smoking.
Oh man don’t get me started with that “I am owed an good and easy life at the government expense” crap. Try living someplace else for a year or two, find that dream land where all your needs and wishes are provided and then come back and complain about what handouts the US government doesn’t give you.
And they’ve a mind to die, then let them get on with it and reduce the surplus population
Our County Health Officer briefed department heads on Avian Flu several weeks ago. She said that the Health Department has stockpiled enough Tamiflu for fifty (50!!!) individuals. Excellent! That takes care of her staff…
My question: How do you get a Doc to write an Rx for you? My hubby asked his friendly GP, no dice. I asked mine, no dice. And these are docs who generally give us anything we ask for.
Suggestions?
Check out Goldpharma.com: http://goldpharma.com/?show=deal. Apparently they will ship Tamiflu without a prescription sent by you. If I understand this correctly, their doctor checks out your questionnaire you fill out and determines whether you qualify for the prescripton (no contraindications for you). I can’t say whether they are legit or not. A few people on Flu Wiki have gotten Tamiflu through this company and they thought it was OK — real Tamiflu, and they received it in two weeks. I can’t verify anything about this company. Check for yourself. I think you can e-mail them with your questions.
Sorry, here is the real English version: http://goldpharma.com/?show=deal.
OK, that didn’t work. You just have to log on and go to American English, not English English!
EOD,
If our health system is so good, why do we have one of the poorest life expectencies in the industrial world and one of the worst infant mortality rates?
EOD – at 15:15 “Ditto for the concept of universal health care. Please find a country with one that actually works, tell the rest of the world about it, and move there. I guarantee it will not work better than what we have here now.”
We have universal health care here in New Zealand and it has never let me or my family down. It is not perfect- but I never worry about health care- most people here never do. If you need help, you get it, within reason.
Eod, we have a pretty good government funded universal health system in Australia that works better at a lower price than what the US pays. So do many other countries that are not so paranoid about anything that might be construed as socialism.
The biggest problem with tamiflu if a pandemic appears will be in distribution. Except for the very lucky few who happen to get admitted to a healthcare facility with the drug on site, the vast majority of people who get sick will not be able to get the drug within 48 hours. And some experts believe with good reason that the 48 hour guideline is too long to ensure survival.
In a sense, compared to 1918 where no specific treatment was available, the conflict over availability and equitable distribution of anti-virals is likely to become a serious source of social divisiveness, tension, and potential violence. Sadly and paradoxically, science may have provided us with a poisoned chalice, if the fall-out from this conflict becomes catastrophic in some communities.
I am not buying Tamiflu… I can’t afford it.. but I have a plan..
I am going to stick my head in the sand until it is over thereby not getting sneezed or coughed on and not getting exposed.
JPT
EN at 14:14: What are the “testing stripes” you mention?
I tried to register at the GoldPharma site today…and oddly enough there was no option for either “United States” or any other wording to describe the US in their country menu.
Without being able to choose a country, the form would not allow registration.
I work in computers, and tried using both Internet Explorer and Firefos.
Anyone else having trouble registering at the GoldPharma site?
I did not have a problem. I am in the USA. I could choose from English English, American English, or Irish English. However when I tried to copy the link, it would only come up as English English.
So is the little winger tantrum that EOD@ 15:15 just vomited up on us considered political and off limits on this site? I mean I’d love to answer this, but I thought we were supposed to keep this place free of politics. Things seem to be unraveling rather quickly around here.
I recently read that “officials” are suggesting the optimal amount of Tamiflu to have on hand is three courses for each member of the family. Why? And, it’s hard enough to get one course, so if you don’t have three are you s*** out of luck?
There has been research on mice that indicates that 1 course was not sufficient with H5N1. Mice with 2 courses fared better. Doctor experience in human patients seems to besr this out. We are all waiting on a definative answer. There is also the feeling that some cases may be Tamiflu resistant.
Do you do the two courses back to back? And, is a third really optimal?
I just ordered from this site. The prices are great, and no problem shipping to the US or Florida.
Use discount code 206057 for a $25.00 discount
No, this is not spam. I just ordered 90 pills for $354.95 plus shipping. It was the cheapest I found after about 4 hours of searching. (Google did better than yahoo!).
“Do you do the two courses back to back? And, is a third really optimal? “
I’m wondering if three a day (like other antibiotics), would be more effective than 2 a day? Particularly if it becomes a “resistant” variety?
Yes, two courses back to back. 2 pills a day for 5 days is one dose pack, then repeat.
The third dosepack is speculation on my part. I have read nothing about that. I did read that children metabolize it much more quickly than adults. I think 8 times faster. That is probably where I got the third dosepack idea.
I got mine a year ago before any of this hit. The Dr. laughed at me but gave it to shut me up. I don’t think you could get that now unless you have a doctor in the family.
I tried to get probenecid after reading that children metabolize it so fast but the doctor refused.
So we put our hope in the Tamiflu I have already.
The problem in the mice was it killed the virus for the first 5 day course but it revived and killed most of the mice afterwards. The 8 day course had 80% (i think) survive. So you do need to spread it out and not take 3 a day unless you are a child.
They have not figured out yet what is optimal for children.
Here’s the link to the mose study via CIDRAP http://tinyurl.com/fmhl5
there’s another tamiflu thread here telling, that when you have probenecid, you only need half the dose of tamiflu.
Our country hasn’t placed the order to Roche for the additional 12.4 million doses of Tamiflu yet, just a letter of intent. The wheels are grinding slow. It could make a big difference in whether US gets the order by the fall or not!
{Terence Hurley, a Roche spokesman, disagreed. “We have to fill orders from around the world as they come in,” Mr. Hurley said. “Delays in ordering can affect delivery schedules. We do require firm orders to get into the queue. We can’t produce or hold or allocate product off ‘letters of intent.’ We have to start with a contract.”
Mr. Hurley said Roche expected to deliver the entire 12.4 million courses ordered Tuesday by the fall. He said he could not predict when the company could deliver more drugs. “It depends if other countries put an order in between now and then,” he said. “If no other country puts an order in, we should be fine. But if we get orders from five others between now and then, it will affect when product will be delivered.” Sixty-five countries have placed orders to fill pandemic stockpiles, Mr. Hurley said. Roche expects to have enough capacity by the end of the year to produce 300 million courses of Tamiflu yearly.
Despite the urgency and the need in the event of an avian flu pandemic, the administration is slow-walking the much-needed dollars because of their overall budget problems,” Senator Charles E. Schumer, Democrat of New York, said. “That is wrong.”
I just got my Tamiflu on Monday. Ordered from an online pharmacy www.bbonlinepharmacy.com They delivered my order in 10 days and i am really satisfied with their service. And the expiration date was great 10/2010 maybe not very cheap but cheaper than the most online pharmacies.
Twoolf- In Florida and Marcia, Thanks for the information. How were you convinced that this pharmacy and medicine was legitimate? I want to order.
Am really new to all this - are these online pharmacies safe/legit - are you getting the real thing? Just never ordered anything online like that before.
Just ordered one box of Tamiflu from www.pharmacydistribution.com . I received it within 3 working days in UK. Great delivery service. Very happy with order. Give them a try
AAK – at 09:21
Am really new to all this - are these online pharmacies safe/legit - are you getting the real thing? Just never ordered anything online like that before.
Alas, you really have no way of knowing. Buyer beware. Counterfeit drugs are certainly being confiscated at the US borders (google it).
Has anyone else had any dealings with this outfit? www.bbonlinepharmacy.com ? I went to their website and it makes me nervous when they list no phone numbers or addresses…
scout - we did. Took three weeks and we never got our Probenecid… I am emailing but no response. As for the Tamiflu-packaging looks different then other photos on this site. our packaging was in Russian. I am going to take mine to my pharmacist to see what he thinks… Good luck
bbonlinepharmacy doesnt carry only Tamiflu. thay carry hundreds of medication there so all cant be fake. And there were batch numbers on each box too. seems manufactured in Switzerland. i also checked the pills on google images, if they are same as mine. They look same and there were original leaflets in boxes and labeled too. The medications came from Ireland. hope this helps.
also, it seems common that people from the pharmacies post in forums pretending to be buyers. There really should be one relyable testing institute, who buys items, tests them and reports the results. Some US.gov could do that, but then, apparantly, for some reason they don’t want US-citizens to buy Tamiflu in Canada.
buyer beware see gs’ note above.
GoldPharma is now $650/60 tabs. Don’t really have the cash, but would scrape it up if they’re OK. Do y’all think they’re safe?
sorry. jumped into crisis mode. damn spam.
The government should be grateful that there are citizens who are actually taking their advice and looking out for themselves by acquiring Tamiflu. This would reduce the number of patients trying to get into their doctor’s offices for treatment and then trying to get to a pharmacy for the prescription. It would also reduce the number of sick people driving their cars on the highways.
I am very surprised there is even a debate on fluwikie about buying it or not. My impression of the vast majority or posters here is that they are doing everything in their power to prepare for a worst case scenario. I am very surprised that people would do everything else but then dot buy a drug that could be a “cure.” No jury will convict you of breaking some ludicrous law if you bought tamiflu some round about way. “Yes I am guilty of not wanting to watch my family die, would any of you done any different?” My understanding after reading all 200 some entertaining pages of the govt’s plan is that your on your own. We are not here to bail you out. The govt pretty much told you if you are intelligent enough to read between the lines, to get everything you need to make it on your own. I take that to mean drugs as well. I understand its expensive and if you have no food it does no good to have the tamiflu, but the opposite holds true as well. Its only money, you can always make more, and you cant spend it if your dead.
The current plans of Roche to expand Liscenced Production and indeed the invention of new manafacturing processes is Market driven Yes the Governments of the world are big producers but Roche claims that the Market for Government sales will be largely saturated in 18 months. Private sales could stimulate production for several more years.
The end result, The free market is responding rapidly to demand. Much more than it was left entirely to health departments planning forecasts.
Tamiflu did not seem to be of much help with that latest cluster in Indonesia and that was with three times the normal dose being given! Maybe it was started too late and, then again, maybe Tamiflu will just be one very expensive, ineffective placebo. (By the way, this isn’t “sour grapes”. A year-and-a-half back I ordered in a supply for all of my immediate family).
If you can stand the rigors of a nutritional regimen, that would probably give you just as good or a better chance of making it through an exposure and/or infection.
Last I heard, 4 times the amount was slightly more effective. They did that in Turkey and I thought they did that in Egypt too. Twice as much for twice as long, started within 48 hours. -I thought this was the new directive?
-Which is why the US gov’t will really only have 25% worth of the stockpiled drugs it thinks it will have.
anon: Looks like my family will have to draw straws to see who gets the whole stockpile, if more than one of us is stricken at the same time. And I thought at the time that I was getting enough in for a stranger or two, as well. Ah, well-laid plans……..
O.K. You have one course of treatment, and 4xapproved dose is actually needed. I would not stock it, but do have one course. Now I will simply take 4x normal dose, than use everything else in my arsenal from Lomatium, galic pills, wine, you name it and I’ll wash it down. Absolutely useless? Why are people even trying to buy this now? Simple magical thinking involved? Your token dose of Tamiflu. I had been thinking, take 2x and get help if possible before you can’t move. Now its take 4x dose. Soon it will ratchet up to take 10X dose.So there will be a lot of people out there with their one useless packet.
Well all things condidered you get the indonesian strain and there is nothing you can do except ameliorate the pain and say goodbye while you can!
I walked into my doctor’s office today with a copy of Dr. Woodson report found on this site and got my scrip for Tamiflu ! My doctor said he has Tamiflu for his family and said many doc’s expect the pandemic to start this fall. Although he stressed it may not have the high lethality as now predicted.
probenecid may help extend the tamiflu treatment by raising serum levels. And there’s been plenty of debate about tamiflu here. Lots. Mucho.
Just no consensus. ;-)
Annoyed Max @13:46 - I agree, it is surprising. I’m a fairly serious prepper and I’m still on the fence, mainly for the expense. I need so many things - a first aid kit, a wood-burning fireplace, a back-up heating system, not to mention a retirement account, college educations for my children, and the ususal daily expenses. For those of us with families, Tamiflu is such a big amount of money for something that may not work, may not be needed, and will eventually expire and be thrown away. At least I can eat all of the beans and rice in my closet. I’d venture to guess I’m not the only one here who is waiting for something (I don’t know what) that will show me that Tamiflu is not a waste of money.
My perceptions re Tamiflu - (I’m not a doctor/RN or other medically trained) …
Tamilfu is a neuraminidase inhibitor, which acts to limit the replication of the virus. see: http://www.niaid.nih.gov/factsheets/fludrugs.htm
Two items I think affect the level of Tamiflu required for effective treatment -
o Early detection of Infection to minimize Viral Load in body o H5N1 resistance to Tamiflu, etc.
o As a virus is already replicating in your body before you get major symptoms,
the sooner you take Tamiflu after you detect the flu symptoms, in theory, the lower the viral load. It may make sense to take your temp 2x or 3x a day and chart over a period of time (if/when Influenza Pandemic does occur) so that a spike in temp is ID’d quickly. Of course, there may be *other* reasons for a spike in temp then a potential Pandemic Influenza strain. I would suspect there is a direct correlation between treatment start time (relative to infection start time) vs amount/level of Tamiflu in body (above a minimum level) required for effective treatment.
o H5N1 resistance to Tamiflu - most likely increasing
o I am planning for 2x std doses, (taken over a 7 day period) - trade-off between level
of Tamiflu in body vs length of treatment. The CIDRAP mouse trials (2005) stated that: Survival rates for the mice depended on their daily dose and regimen length. Five of 10 mice that received 10 mg/kg/day for 5 days survived, but all the mice that received lower doses for 5 days died. Among mice on the 8-day regimen, the survival rates were 1 of 10 on the lowest dose, 6 of 10 on the middle dose, and 8 of 10 on the highest dose. “The eight-day dose of oseltamivir allowed more time for virus levels to fall and less chance for avian flu to rebound after the drug was stopped,” the NIAID said. In mice on the 5-day regimen, analysis of the lungs showed that the virus survived and grew again after the treatment ended. Most of the mice that died had severe neurologic symptoms. … They conclude that it is “encouraging” that the 2004 virus was sensitive to oseltamivir in mice, even though a longer treatment regimen and higher dosage were required. http://tinyurl.com/f8qxn - yes the data is almost 2 years old, yes it is with mices not peoples, however, it is a good starting point, in my opinion. I would prefer to have 3 treatments + per person, right now I have enough for 2x doses per family member. My prep priorities based on importance / difficulty to purchase when needed: 1 Tamiflu (2x per family member) - if/when family members are sick. 2 N95 masks (100 per family member), disposable gloves (200 sets each) - minimize getting sick. 3 Pnuemonia vax - in case of secondary infection 4 Food, Water, consumables -
Hi!
When i stopped at the Sams, in Hendersonville, Tenn., they had posted Tamiflu for about $65. That is the cheapest I have seen anywhere. This was about 2 weeks ago and maybe some of the other Sams carry it.
I was lucky enough to get a script for Tamiflu from my child’s pediatrician the last time we went in. I told her why I wanted it and she was ok with it since my child is asthmatic and sick a lot anyway. Well, I attempted to have it filled at Walgreen’s yesterday, and the pharmacist said he didn’t have any; he had just shipped it all back to the company as they had been advised that the flu season was over and Roche wanted it all back (wonder why?!!). Then he called another pharmacy nearby and they still had some, so I was able to get it filled. This is disturbing to me…that the manufacturer is recalling the drug from pharmacies. The store I got it at was going to be shipping theirs back also. Maybe we soon won’t be able to get it at all, even with a script, at US pharmacies. Or do you suppose that this is a common practice?
Tamiflu isn’t a magic bullet. At best, it may shorten the course of flu by a day or so. Spending your resources on this drug may not be the best allocation of cash.
Demfromct—Using probenecid with tamiflu link (on the info page) goes to site that says that info has been moved. I know I am being vague but wondered if there is another link to info about that combo? Thanks
Melanie at 09:39 and others. I’m thinking you are right about this not being the best way to spend prep funds-which for me are very limited. I was talking to a pediatric nurse yesterday-as worried Mom friends, not as nurse/patient, and she said they were not seeing Tamiflu help their patients that much-even her own daughter who took it when she came down with seasonal flu. Perhaps they didn’t take it quick enough- I know peple drag their feet about going to the Doc-is it just a cold, can I just ride it out. And then what if the pandemic break and you take your tamiflu for what turns out to be a cold, or sinus infection, and then dont have it when the real flu comes around? I admit, I would dearly love to have it in my preps. But I think I’m going to have to fill in my other prep gaps fiirst and then, hopefully I’ll be able to get some or the flu will spare us for another year. (sigh)
My doctor told me that they now have a 10 min test to tell whether you’ve got influenza or not. (I’m assuming the general influenza test would also work for any type of panflu, but don’t know for sure.) That test certainly would come in handy to decide whether to dose up with Tamiflu or not!
Shipping it all back! Why? so the government can control who gets it. - Well isnt that a fine kettle of fish. Wanta bet those same government officials have their own supply. How kind of them to be watching out for us little people, Ill sleep soo much better knowing that the government controls things
JanetN: My guess would be that they are trying to reserve the Tamiflu to “blanket” clusters. I would rather this than having it sit on a shelf somewhere in a pharmacy.
I had a colleague who recently had a sinus infection. Her doctor prescribed Tamiflu….God only knows why. She got the prescription and took it which was a total waste.
I really think if our doctors are willing to give us the prescription, we can still find a drug store that has some. Otherwise, it is best for the government to try and stockpile as much as possible so that they can blanket it out and possibly (very unlikely, but possibly) snuff it out wherever it crops up until we find some sort of interim vaccine.
Again, better to put the drug to use than to just sit in our drugstores - especially in lieu of the fact that most doctors won’t give you a prescription for it.
When SARS was an imminent danger two years ago, there was no medicine that could help. When I saw my small kids gasping for air with bronchiolitis and the ventolin didn’t work, I did not hesitate to give them prednisolon. For the bird flu, only one drug, Tamiflu, might work. I have a full ziplock bag of the stuff stored, expiry date 2010. And another bag of the stuff is on its way because the dosage keeps on increasing. Tamiflu is much cheaper outside of the US by the way.
Nancy the GP made some interesting remarks regarding Tamiflu, probenecid, etc., in the Effect Measure comments thread for “Fixing the Public Health Roof.” I’ve pasted in her comments below, as I can’t link to the actual comment.
“The Tamiflu can only be expected to work if it is given within 48 hours of symptom onset, for regular flu. The available data for H5N1 suggests even that may be too long—better results are seen within 24 hours. Also, you cannot stop the Tamiflu when symptoms subside—you must continue it at full dosage for at least 8 days from onset of symptoms to prevent a relapse and death. Stopping it any sooner than this would also tend to favor the development of Tamiflu resistant flu strains.
Co-administration of probenecid every 12 hours should have the same effect on blood levels as giving a third dose of Tamiflu, because it slows excretion of the active metabolite of Tamiflu. You still need to give the Tamiflu every 12 hours though or the blood levels will vary too much to be useful. So you can use this to get the effect of 3 Tamiflu a day while only using 2 Tamiflu a day, but you cannot use it to get 1 per day to act like 2 per day because of the dosage timing.
The adamantanes and neuraminidase inhibitors can be safely given simultaneously and there may be some beneficial synergy between them—that is, the sum of their effects may be greater than the parts. In addition, the adamantanes can cross the blood brain barrier (Tamiflu does not except in infants, where it may cause brain damage), making them potentially more effective against neuroinfluenza.
Steroids in non-flu infectious-derived ARDS has caused worsened outcomes, so I’d avoid those for treating (hah!) cytokine storm. Control of fever in Japanese children with neuroinfluenza showed a statistically significant reduction in subsequent organ system failure—whether control was by medication or by baths. Mild hypothermia (97F) was helpful.
Etoposide, an anti-cancer drug, has been shown to have some effect against cytokine storm from causes other than H5N1. The folk of Indonesia may wish to create a clinical experimental protocol that can be quickly called into play for each new suspected H5N1 case, so as to ethically test this drug among their cases. I don’t know how expensive the drug is but this should be something that its manufacturer would be eager to do at its own expense.
Supplementing the diet of patients hospitalized with pneumonia at risk for ARDS with a fish oil/borage oil combination (sold in health food stores in the US) statistically reduced the progression to ARDS. This should be cheap enough for Indonesia to try and is unlikely to cause harm.
Revere has pointed out in the past that statin drugs, taken for a month before a bout of pneumonia, also decrease the risk of ARDS. This is another possible study protocol that Indonesia should implement, to see if statins help if given acutely.
Is any of this helpful?” Lisa the GP 05.18.06 - 11:52 pm | #
Albert, you said that Tamiflu is less expensive outside the US. How much does it cost, and where do you order from? I will have to go this route if other Drs will not give us scripts for the rest of the family. I only had to pay $50 for the one course using my insurance.
I want to buy tamiflu by mail…is it possible?…if so, anyone have a link?…thanks for any replies in advance!!
Albert….I am interested in your answer as well….
I purchased mine via “real” pharmacies in Europe. Cost me 28 US$ for a pack of 10, but I purchased via a friend who used his medical insurance and a doctor’s prescription. My second lot comes from a pharmacy in Hong Kong, without prescription, at 30 US $ for a pack of 10.
I need to point out something about my post, quoted above. That post was made for someone in Indonesia who was planning on forwarding it to a press contact and thereby to doctors who might be able to use the suggestions with a degree of sophistication.
You should know that Probenecid interacts with a VERY WIDE variety of commonly used drugs, including those given over-the-counter. Doctors would not use probenecid with Tamiflu without first checking to be certain that no other drugs being given would be affected by the presence of probenecid, OR they would adjust the dosage of those drugs that do interact such that toxic levels are not achieved.
Always consult with your own healthcare practitioner before trying any prescription drug. Don’t anyone go out taking Probenecid like it was Mentos or something. It is a drug with myriad side effects which must be used carefully under the guidance of a licensed practitioner.
lottasox - there’s a farily detailed discussion re use of probenecid here - probably not the link you were thinking of but still well worth a read:
Medical Maven – at 14:08 If you can stand the rigors of a nutritional regimen, that would probably give you just as good or a better chance of making it through an exposure and/or infection.
MM- Could you explain, please? Thanks.
Closing old threads, not an editorial decision! will reopen when needed. Check last post date.