# 600
Two articles, 24 hours apart, give us a better idea on how Japan intends to handle their precious Tamiflu stockpile.
Japan to keep stockpiling Tamiflu
March 28, 2007 - 2:25PM
Japan plans to keep stockpiling the Tamiflu antiviral drug to tackle any future bird flu pandemic, even though it has warned doctors not to give the drug to teenagers, a Health Ministry official says.
The decision was made at a meeting of experts, the official said.
Japan plans to stockpile enough doses within the next year to treat 25 million patients and to prevent 3 million people from being infected with the deadly H5N1 avian flu virus.
Committee decides who should be vaccinated first in outbreak of new influenza (link broken)
03/27/2007
The Asahi Shimbun
With Japan lacking enough anti-flu medicine to cover the entire population, a health ministry committee decided who will get preferential treatment during a possible outbreak of a deadly new type of influenza.
The Ministry of Health, Labor and Welfare had already released a plan for a major outbreak of a new disease, which could be highly fatal if it mutates from avian flu. But after seeking public opinion and receiving about 3,000 comments, a new set of guidelines was compiled Monday.
"Regional containment" of the virus remained a course of action, but the committee acknowledged the difficulties in carrying out such measures given Japan's geographical conditions and population density.
So the committee came up with a list of 30 professions that should be given priority in receiving the anti-influenza drug Tamiflu to deal with the crisis and to keep society functioning.
Among those on the top of the list are health personnel, such as doctors and nurses, and manufacturers and sellers of medicine.
To maintain public security, police officers, firefighters and coast guard officials were put on the list.
Suppliers of electricity, water, gas, oil and food were included, as were risk management officials, such as lawmakers, local assembly members, local administrative chiefs, and central and local government bureaucrats.
To relay information to the public, those in the media and telecommunications carriers will also receive preferential treatment in the distribution of Tamiflu.
Transportation businesses were also included, including railways, bus and cargo companies, airlines and maritime transportation services.
The health ministry will notify all prefectures about the guidelines by the end of March and include the information on its Web site.
The number of people for each job title will be decided upon later, depending on surveys by prefectural governments.
With a population of 127 million people, the 25 million courses would cover roughly 20% of the population. Of course, that assumes that a 10-pill course is sufficient. If, as suspected, it requires 40 pills, they could cover 5% of their citizens.
What is interesting is the proposal to provide prophylactic Tamiflu to 3 million people who work in essential sectors of the workplace.
Prophylaxis requires 1-75mg pill a day, for the duration of the exposure. I've seen no numbers on how long they anticipate that exposure would last, but we frequently hear that a pandemic wave could last 6-12 weeks, and that multiple waves could be expected over one or two years.
Of course, no one really knows.
Any way you slice it, to adequately provide ongoing prophylaxis for 3 million workers will require a lot of pills. To handle two 6-week waves would require an additional 250 million pills. Which would require doubling their current stockpile.
It's a tough decision, with no easy answers. I personally like the idea of providing prophylactic Tamiflu to those on the front lines, but I recognize how quickly that will eat up the limited supply.
Who knew that basic math could be so depressing?
