Updated 14 October
H5N1, also known as bird or avian flu, is a new influenza variant that first infected humans in HongKong in 1997 from chickens. Since then it has become endemic in wild birds in South East Asia. Based on everything we know about flu, H5N1 needs to make a few changes to spread readily from humans to humans, and then to kill much less than the current 52% so that it becomes an efficient propagator. The smart money is that this is a matter of time. I have been monitoring events in Asia daily since US President Bush mentioned the start of US Tamiflu stockpiling in mid September. In September I obtained Tamiflu for myself, my wife and my family. According to our pharmacy, his supplier has now run out of Tamiflu. Some worrying signs have emerged in the past few weeks that some of the H5N1 samples are Oseltamivir resistant. Consequently I have also obtained Relenza, which seems to work for the Tamiflu resistant strains and an older antiviral Amantadine. If we get this thing we will hit it with a cocktail of all three anti-virals at once. Experience with recent disasters shows that you need to act early. Once everyone becomes aware of the threat a panic starts. That has already happened in New Zealand and Australia where people are hyper ware of the threat and have been stockpiling Tamiflu. I have been monitoring contacts in other parts of the world. There seems to be no level of public knowledge in some parts of the world. In the US, there is growing public knowledge. The US has of course been distracted by hurricanes Katrina and Rita.There are other efforts underway right now for H5N1. Test kits and vaccines are being developed.
One problem right now is that there is up to a two year wait for the Tamiflu manufacturere to fill backorders. Supplies available to the public are, or soon will be, exhausted. Tamiflu is under patent, so no other drug companies can manufacture it.
I think the best thing that could happen now is a worldwide panic. That would then accelerate vaccine efforts and create pressure to waive the Tamiflu patent. This post is an effort to start that panic. If the panic does not start until we get human to human transmission it will probably be too late. In 1918 about 50 million people died of “Spanish flu”, actually H1N1 influenza. This time it might be an order of magnitude higher.