Faculty Bibliography

Because of the public fear of bird flu, there has been a lot of pressure on Roche to produce more supply -- even political pressure to break the patent on Tamiflu and allow the drug to be sold generically before the patent expires. Tamiflu is the newest of the neuramidase inhibitors, drugs that work by blocking the transmission of the influenza virus from cell to cell. As a drug to treat the fear of, rather than the effect of bird flu, Tamiflu can easily be misused

With all the concern surrounding vaccines, and the public's assumed right to their availability, what is not appreciated are the difficulties drug manufacturers go through to produce them. Vaccines are usually generic products, which means a slim profit margin. Plus, they are regulated for sterility by the FDA, a very expensive process to ensure. Manufacturers are already strained to the limit, and the current technology using chicken-egg culture medium is inefficient. But the necessary genetic technology needed to upgrade vaccine-making capacity is very expensive

The greatest problem among my patients right now isn't bird flu; it is fear of bird flu. The greatest risk of an epidemic is of a fear epidemic. For one thing, comparisons to the terrible scourge of 1918 -- when another bird flu mutated and passed human to human -- have dilated the sense of danger. But there are many differences between 1918 and now. Many of the 1918 flu victims died of pneumonia because of a lack of antibiotics, which we now have in ample supply. There were also no flu vaccines or antiviral drugs back then, and people lived (and died) in wartime conditions of deprivation and sometimes squalor. This is how fear works, how the fear epidemic -- as opposed to a flu pandemic -- spreads. Fear is supposed to be our warning system against imminent dangers, but as a deep-rooted emotion, it interferes with our ability to make sound judgments. And if anything is contagious right now, it's judgment clouded by fear

He acknowledged my suggestion that he go see a gastroenterologist, writing down the doctor's name -- but he never made an appointment. [FRANK] returned to his lifestyle of heavy eating and smoking. He said the negative results in the ER had reassured him, and now he seemed to be in even more denial. He popped a Prevacid whenever he felt the slightest discomfort. He continued to experience chest pains, and after a few months, he was back in the ER. The initial tests were once again negative, but this time I kept him overnight for observation and arranged for a stress test before discharging him. Frank's cycle of worry and denial is common among men with a poor self-image and untreated depression. Many fail to respond to the warning signs, no matter how serious. Luckily, in Frank's case, the second shock of the ER was enough

With bird flu, scientists have been working on the structure of the viruses in an attempt to protect us. Studies published in the journals Nature and Science over the past six years have given scientists a road map with which to track the current bird flu and alert health officials if it mutates further. It is reasonable to try to control the bird flu while it remains in the bird population. There is great value in improving our emergency health response system and upgrading our vaccine-making capacity. Government subsidies in these areas could make the public safer. But, right now, there is no value in scaring the public with Hitchcockian bird- flu scenarios

With bird flu, scientists have been working on the structure of the viruses in an attempt to protect us. Studies published in the journals Nature and Science over the last six years have given scientists a road map with which to track the current bird flu and alert health officials if it mutates further. It is reasonable to try to control the bird flu while it remains in the bird population. There is great value in improving our emergency health response system and upgrading our vaccine-making capacity. Government subsidies in these areas could make the public safer. But, right now, there is no value in scaring the public with Hitchcockian bird flu scenarios. The public must be kept in the loop, but potential threats should be put into context. The worst case is not the only case

The facts are these: The current H5N1 avian influenza virus has not mutated into a form that can easily infect humans, and the 60 people in the world who have died of this bird flu have done so not because this bug is on the road to mutation, but because millions of birds throughout Asia have been infected, and the more birds that have it, the more likely that an occasional human bird handler will be infected. With bird flu, scientists have been working on the structure of the viruses in an attempt to protect us. Studies published in the journals Nature and Science over the last six years have given scientists a road map with which to track the current bird flu and alert health officials if it mutates further. It is reasonable to try to control the bird flu while it remains