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Japan: Aggressive Measures Credited With Low H1N1 Fatality Rate

 

 

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Although further analysis may change the picture, right now it appears that Japan has a much lower case fatality rate (CFR) from the h1N1 virus than does the United States or the UK.  

 

By some estimations, the CFR in the US is more than a dozen times higher than Japan’s.

 

While there is always the possibility of reporting bias and gaps in their surveillance, for now the difference in CFRs does appear to be real, and significant.

 

Jason Gale  along with Kanoko Matsuyama of Bloomberg News bring us intriguing details on the Japanese aggressive response to the pandemic  virus, which some there are citing as the reason for their lower fatality rates.

 

 

Japan Mask Wearing, Tamiflu Rush Beat Back Swine Flu Threat

By Kanoko Matsuyama and Jason Gale

Dec. 11 (Bloomberg) -- Eight hours after Tokyo office worker Shungo Yamamoto started feeling feverish and faint, he got a diagnosis of swine flu, received antiviral drugs and embarked on three days of self-imposed isolation last month.

 

“I knew it was influenza immediately” because of the fever and joint pain, Yamamoto, 25, said. His doctor confirmed the diagnosis with a nose swab test and prescribed five days of Roche Holding AG’s antiviral drug Tamiflu. When he left the doctor’s office, Yamamoto put on a mask, bought a three-day supply of food, rented DVDs and headed home, where he stayed for the duration of his illness.

 

Japan’s aggressiveness against H1N1 influenza, the result of hygiene standards, social etiquette and a willingness to test and medicate immediately, means the country has fared better than the U.S. or the U.K. in battling the first pandemic in 41 years. A World Health Organization report shows Japan’s mortality rate is 2 deaths for every 100,000 people. The rate is higher by 11 times in the U.K., 16 times in the U.S. and 43 times in Australia.

(Continue . . . )

 

 

While a lower CFR is something everyone would like to see, there are some downsides to the liberal dispensing of Tamiflu. 

 

  • Tamiflu is expensive, and in relatively short supply
  • Many patients who probably don’t really need the drug will be taking it and risking adverse effects.
  • There are fears that overuse could promote the creation of resistant strains of the virus, which could render the drug useless in the future.

 

Obviously there is more going on in Japan than just early treatment with antivirals.  In the UK, Tamiflu is liberally dispensed as well, yet their CFR is reportedly 11 fold higher than Japan.  

 

Some of the difference may well be due to cultural attitudes towards illness, and prevention.

 

There will doubtless be pandemic post-mortems conducted on many cultures and societies, to determine what worked and what didn’t, what was cost-effective or practical, and what practices turned out to be ill advised.    

 

These early numbers suggest there may be some important lessons to be learned out of Japan.  Whether they can translate to other societies and cultures is something we will have to see.

 

Regardless, we are watching a great global biological and societal experiment unfold, and we should come out of this pandemic with a lot of data and hopefully some better solutions for the next pandemic threat.

 

Let’s hope we take these lessons to heart.

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