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Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2545 (Published 09 April 2014) Cite this as: BMJ 2014;348:g2545

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Re: Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments

The comments colleagues and I made previously still stand: http://www.bmj.com/content/339/bmj.b2728

Early in the "containment phase" of the pandemic the health secretary promised that everybody with flu-like symptoms would be given antivirals.

The effect of this was that we were obliged to honour this promise. There were not the resources to do this in a timely fashion: most people, while I was involved, were delivered the antivirals a week after the onset of symptoms. We were unable to prioritise high-risk patients.

The government has claimed that the "containment phase" was effective; that the reduction in viral shedding that may plausibly have been a consequence of antiviral treatment slowed the spread of the pandemic.

There is no reason to believe that antivirals given more than 48 hours after the onset of symptoms had any other benefit; although respiratory physicians tell me they believe it may have had some benefit in the most seriously ill patients.

Competing interests: I was seconded to work in a flu response centre early in the 2009 pandemic

20 April 2014
Peter M English
Public Health Physician
N/A (response made in a personal capacity)
260 Chessington Road, KT19 9XF