Mythbusters

Even among flubies, who should know better, a certain amount of misinformation circulates, and after a while, becomes a `fact’. Today I’d like to take on some of these myths, and provide the best information we have, as of today. As a pandemic is a fluid event, and the mutation of the avian flu virus could change things, even my `facts’ may prove to be wrong.

Caveat Lector.

Myth #1. Tamiflu doesn’t work.

The evidence to date is, that if given early enough, and in high enough doses, Tamiflu can have a beneficial and therapeutic effect on avian flu patients. The current dose, 10 pills over 5 days, appears to be inadequate, however. Doctors have reported better success with 4 pills a day, for 10 days. This is of course a big problem, as quadrupling the dose cuts the number of doses by 75%.

Tamiflu works by affecting the viruses ability to replicate. If given in the first 12 to 24 hours after symptoms appear, it seems to have a decent affect. The outbreaks in Turkey, and in Egypt, where the mortality rates are much lower than in Indonesia, seem to bear this out. Better, and speedier medical care makes a difference.

No, Tamiflu is not a cure. It has never been touted as one. It can shorten the duration, and the severity of the infection. And for an influenza that kills 60% of its victims, any substantial reduction in mortality is to be greatly appreciated.

Myth #2 H5N1 will gain Tamiflu Resistance and become useless.

Right now, that’s just speculation. H5N1, in certain clades, has shown resistance to amantadine and remantadine, both front line antiviral drugs. This leaves Relenza and Tamiflu available. The WHO is using Tamiflu to blanket areas of outbreaks in Indonesia, and possibly other areas. The fear is, doing so will help spur on a tamiflu resistant strain.

While it’s not unreasonable to worry about this, it hasn’t happened yet. And indeed, it may not happen at all. Until it does, Tamiflu appears to be a reasonable weapon to have in ones armory against the virus.

Myth #3 Avian Flu can be transmitted thru the air across long distances.

Of all of the myths out there, this one seems to be the most popular. It is the stuff that nightmares are made of, and I suppose, when facing a pandemic, our worst fears come to the forefront. I’ve seen some people state with certainty that the virus can travel for 2 miles thru the air.

According to the CDC :

Small-particle aerosols. There is no evidence that influenza transmission can occur across long distances (e.g., through ventilation systems) or through prolonged residence in air, as seen with airborne diseases such as tuberculosis. However, transmission may occur at shorter distances through inhalation of small-particle aerosols (droplet nuclei), particularly in shared air spaces with poor air circulation.

Now, to be sure, the phrase `there is no evidence’ isn’t quite the same thing as saying there is proof that it cannot happen. But it appears highly unlikely that the virus can remain airborne, and viable, for very long. Could the virus mutate into some `superflu’, where the rules change? Sure, anything is possible.

For now, it appears that in an outdoor environment, staying 10 feet away from a flu victim takes you out of the red zone. Is it 100% risk free? No, there is no such thing as zero risk in a pandemic.

Indoors, or in a confined space, where poor air circulation is a problem, then the odds of inhaling the virus go up. That’s why we are being told to avoid crowds during a pandemic. But it should be safe to go outside, walk down your street, or even talk to your neighbor across your fence during a pandemic. Social distancing doesn’t mean strict isolation.

As a good friend of mine constantly reminds me, `we will know when we know’. But for now, the best information available seems to poke some large holes in these myths.

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