Julie Iovine, a writer, but more important, the daughter of a doctor, sat down her two sons, 10 and 12, last week and gave them a lecture on the dangers of avian flu. “I drilled it into them as hard as I could they need to wash their hands,” she says. “They seemed to listen to me.”
Avian flu is the bogeyman of the moment, spreading from Asia to Europe to Canada to dinner-party conversations across the city. Whether through painful memory, civic ego, or the creeping fear that “The World’s Second Home” is not such a great place to be during a pandemic, New Yorkers expect to be at the epicenter of any avian-flu outbreak. And though it is clearly too early—and too useless—to panic, some city dwellers have started to prepare for the worst. And at this stage, preparation means Tamiflu, a drug that has shown some laboratory success against the avian-flu virus, though its effectiveness may change depending on how the virus changes—and if the avian-flu virus mutates into a form that is easily spread among people, the virus will have changed significantly.
Michel Cohen, a Tribeca pediatrician, says he’s been receiving lots of requests for Tamiflu prescriptions. “It’s a little like Cipro when we had the anthrax,” he explains. “People are stockpiling. I tell them, ‘You can have it, but it’s probably not going to be effective.’ ”
Gary Halpern, a pharmacist at Caligor on the Upper East Side, says he has a daily average of 30 phone calls about Tamiflu, ranging from simple questions to people filling their $96 ten-pill, five-day prescriptions. “People want to know if I have it in stock. Usually, I get a prescription for each member of the family.”
One woman says she got a prescription at the insistence of her boyfriend, who already had his. “This is just precautionary,” he explains, asking that they not be identified because he works for a TV network and doesn’t want to be subjected to ridicule by his peers. “One doesn’t take it until the proverbial shit hits the fan.”
But some local doctors are refusing to write Tamiflu prescriptions. “There’s a limited amount out there,” says Dr. David Calfee, the epidemiologist at Mount Sinai. “If everybody gets a prescription for ‘just in case,’ there won’t be enough for people who get regular flu.” Furthermore, he continues, “When you’re using it for prevention, it’s only going to be effective when it’s in your system. You need to be taking it every day for six weeks if the outbreak is six weeks.”
And though a number of promising flu vaccines are in development, “right now there is not a bird-flu vaccine,” says Jennifer Morcone, a spokeswoman for the Centers for Disease Control. “The production time is still a ways off.”
Which raises the question: Who gets whatever medicine we do have first? The assumption is that the young and the elderly are at greatest risk. But the strain that mutates, if it does, could surprise. “We generally think of older citizens being at the greatest risk of complications from influenza,” says Calfee. “But in the 1918 influenza, people in their twenties and thirties had a much higher death rate than usual. One theory is that when you’re in your twenties and thirties, your immune system is at its peak. So they mounted such a good immune response that they basically overwhelmed themselves. They developed pneumonia and died from that.”
Dr. Isaac Weisfuse, deputy commissioner of disease control in the city’s Department of Health and Mental Hygiene, suggests people practice what he calls “respiratory etiquette.” “Cover your cough, cover your sneezes, wash your hands,” he advises. “Although those sound like old-fashioned things, they are actually important in terms of interrupting transmission of a respiratory agent like flu.”
And those who really take precaution seriously might want to just hightail it out of the city and start homeschooling their kids. “If you went to your country house and stayed there the whole time, your risk of exposure is pretty low,” Calfee says. “You wouldn’t have the same risk as somebody riding the subway with hundreds of people every day. The less human contact you have, the lower your risk.”
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