Moral questions of influence

Moral questions of influence The period for influenza is the Italian word for "miasma", or "bad air". It would be a bad wind that blows on the man if the bird flu or another variety, changes to allow the spread from person to person. Humanity has experienced 31 influenza pandemics since 1580, or about one every 14 years. The last occurred in 1968. We must. The natural reaction is to prepare. Vaccines, antiviral drugs, hospital and medical services, public health infrastructure and the like are at the forefront of any discussion of the preparation. Which often receives only nominal attention, however, are matters of morality and ethics. The decisions taken at the beginning of the epidemic will affect the lives of millions. Scientists, doctors and public health officials are better equipped to advise us about the mechanisms of disease and to avoid treatment, but there are many perplexing questions about how to implement them. The best time to resolve them before an emergency. The influence is a chameleon of viral pathogens. This is a virus whose genome copy RNA enzymes are actually designed by nature to make mistakes. The male is often inserted amino acids in a protein. Most of these copying errors are harmless. Some causes of death from the virus. But some changed the virus' antigenic makeup that allows you to reach for a higher rate and avoid the immune system. Preparation of a viral attack, which have no way of knowing exactly which enemy we face, that the vaccine and what the job antivirals are effective. Even at best, we can expect a shortage of medicines for use. What we have right now must be rationed. The options on how best to use them will be difficult, controversial and difficult for our moral conscience. Some that come immediately to mind: if the influence is started on a large scale in a developing country, we can send to our limited number of drugs, or do we have that we reserve for our own use? Where are the travel restrictions in a country where one type of influence is there? If so, declaring quarantine, and that applies? How? Whether to send medical supplies to a poor country, how can we be sure that a corruption of the govement not to use the material for their own gain or monetary policy? The best treatment for any disease is to avoid in the first place. The vaccine is effective in preventing influenza correct. Unfortunately, since the virus can change their identity, for they know not what is now the correct vaccine. Preparing for a flu vaccine using traditional methods takes time. The virus must be cultivated in hens' eggs, incubated for several months, harvested, killed, protection of human health and the injection. If we know the structure of a virus and infect started today with a traditional vaccine approaches, it would be 4 or 5 months before a product is ready for use. That is too long. Much work is underway on new formulations of influenza vaccine. Many take part in a flu virus, inserted into another organism, and the production of the vaccine in this way. It is the basis of genetic engineering. The catch, of course, is that these new methods of production of vaccines, while capable of producing a product more quickly, has not been demonstrated in a large number of people. The safe vaccine side effects. They directly affect the immune system and the immune system of every person is unique. Most of us can eat a bag of peanuts and are not a problem. However, some people may be just a hint of peanuts and go into a hyper-immune condition called anaphylaxis and almost die. Each vaccine to millions of people could have serious cause immunological complications. At what point in a threat to the influence that choose to vaccinate millions of people? If you use one of the most recent, perhaps unproven, means of production of vaccines, or wait for the more traditional? Many people refuse to be vaccinated. Should be subject to quarantine restrictions or travel? How do I identify them? The influence can be treated with antiviral drugs that directly inactivate the virus. One of them is called oseltamivir, also known by its trade name Tamiflu. This drug inactivates protein called neurominidase that the virus uses to escape from the human cell. Neurominidase is the N in H5N1. But like the rest of the N gene of the virus can change through mutation. So while Tamiflu may work today, tomorrow, the virus may be resistant to it. We need to save hundreds of millions or billions of dollars worth of Tamiflu hours realize that it may be useless when we need it? Like any drug Tamiflu has an expiration date. Expiry dates are conservative estimates of the product life cycle. If a product has passed November 2, is so bad in November 3? What about December 2? The drug not only go wrong during the night. Months or even years after the end there is still some 'activity on the left. What we do with Tamiflu obsolete? It 'just give to someone who might otherwise get nothing, hoping that some are still good? How do you decide who gets new things and to receive the old style? The Swiss pharmaceutical company Roche has the patent on Tamiflu. If they are obliged to allow other companies to make the product? What is fair compensation for Roche? Tamiflu is not a panacea. If you take after coming down with influenza can not be remedied immediately. Just do not get as sick. This method works very well, however, the prevention of the disease after being exposed to the virus. If Tamiflu is still effective against the virus, but in short supply, should be used more for treatment and those who are sick, or back to the contacts of infected people to prevent the spread of the virus? Newer antiviral drugs such as peramivir and A-315675 was developed. It seems that work on the virus strains that are resistant to Tamiflu. Usually, new drugs must undergo rigorous testing before being allowed on the market. If we are in a real league of Tamiflu resistant flu, where new drugs that can be used before starting the custom control? If so, nobody should be held responsible if something goes wrong? When they are seriously ill, the first place most of us is the head nearest hospital. Unfortunately, hospitals do not have Saturday waiting for the next influenza pandemic. Seats are occupied, even in times of influence. During a pandemic, hospitals and the communities they serve, will face a series of difficult decisions. The number of patients that exceed the capacity of the bed. The disease is highly infectious and the staff and patients will be at risk of contracting the disease. Many people will show up in the emergency room of the test, even if only a common cold, the overwhelming personal. We need to appoint some hospitals in the community to become acute respiratory hospitals? If so, how to decide which one (s)? Where are those who need hospital beds when they are not available? If a hospital visit rights were severely restricted to prevent the introduction of the virus in the hospital? Many people have no health insurance. Not receive the same level of attention than those who do? How doctors and hospitals be compensated? Most of us get our information through the media. With the current system goes through news reporters and editors before us. In cases where the govement or another body to be allowed to dictate the news about the flu, or if the current system be left alone? How to correct the misinformation? Should the media be subjected to some form of control to avoid unnecessary panic? If, within the medical and public health are raised, what is the role of the media in reporting? In this country of great value for our individual rights. During a severe outbreak, however, some of these rights must be suspended for the good of the community. Free from quarantine, travel restrictions, closing some schools and leisure and entertainment companies will likely be necessary. What is the best way for law enforcement and public health officials to enforce such restrictions? Who decides which companies to quit and for how long? In cases where companies and communities that are most affected by these decisions (think of Las Vegas) would be compensated for their losses? If yes, how? If essential business, such as pharmacies or grocery stores nearby, for fear, when they are forced to stay open? Those of us in the medical profession are well aware of the threat of legal action. Defensive medicine is a practice. As laxity of the existing rules will be allowed to address an emergency situation of influence? If someone is that Tamiflu is outdated and dying, can the hospital and the doctor being sued? In the event that the doctor feared that a case from being sued for cutting a coer or two? Most people who live in a developed country today have never had a true pandemic influenza or any other thing. Our laws, medical practices and behavior have developed the hypothesis that infectious diseases are the most controllable and manageable. But with an epidemic of influenza mortality rate of 2.5% in a population without immunity profoundly alters the status quo. Preparing for a pandemic is not like a deck to the rear to meet earthquake standards. There are too many variables and unanswered questions. Now is the best time to take into account not only science but also the ethics of the next pandemic.