Baker definitely knows facts on this topic that we don’t, so I’d take his advice quite seriously

Well, so did Dick Cheney. There’s a question of judgment and intent that’s also extremely relevant in evaluating such remarks. Now I don’t follow Baker’s blog, and this comment is not an insinuation against Mr. Baker, just a remark about your suggestion.

I read somewhere that Tamiflu doesn’t work very well. Back to the drawing board.

Nick

Cheers,

Do you just tell your physician you are stockpiling in case of an anthrax attack and ask him to write you a prescription or three?

Our GP gave us a prescription for some super antibiotic and strong painkillers, because we explained we hike in remote areas where medical help may be some days away. I’m not sure there is as much potential for abuse as people think: if you have talked your doctor into such a deal, and you use them for the sniffles, you no longer have them for an emergency.

I concur that casual use of antibiotics is a very bad thing.
This article suggests that more restrained use of them could save upwards of 19000 deaths a year.

I also concur that being the victim of an anthrax attack is a negligible risk.

Or does Heller mean that the FDA can’t interfere with your right to antibiotics for self defense?

:-)

mack: The ironic thing about the worry about resistant infections and uncontrolled use of antibiotics is that the last I knew from personal experience and from family experience is that such antibiotics are available over the counter in many other countries around the world — including mexico and brazil — also I guess if you are hard up in this country one could get many of the common antibiotics over the counter in pet and fish stores — albeit not meant for human consumption — though I have met individuals who have used them — wouldn’t personally recommend it.Do have a doctor aquaintance, who unsolicited five or six years ago, offered to write scrips for antibiotics for myself and my family for an emergency supply.He thought it was prudent — didn’t avail myself of the opportunity at the time as didn’t want to lay out the money and then have to replace them down the road anyway.Hey, if things get that bad — just knock over a pharmacy — like bonnie and clyde. ;)

That doctor acquaintance should be disciplined for unprofessional behaviour. It is precisely that sort of attitude which leads to antibiotic resistance and big problems. It is also precisely overuse of antibiotics in agriculture and in other countries where they are available over the counter and in the United States where family doctors succumb to whinging, whiny patients by writing out unnecessary prescriptions which is the major source of problems with resistance. Resistance is bound to happen since bacteria do evolve. However antibiotic overuse has lead to resistance occurring much faster than it otherwise would have done.

This is a public health matter and as is so often the case with public health, the needs of the many outweigh the needs of the few, or the one. The needs of the many dictate that antibiotics should not be stockpiled in this way as it will lead to resistant bacteria proliferation. The needs of the one dictate that antibiotics should be stockpiled in this way because it would likely allow survival of an anthrax attack. The resistant bacteria problem will occur and indeed has occurred: this would make it even worse. The anthrax attack is extremely unlikely to occur, and even if it did occur the likely deaths would be in the hundreds at most due to the difficulty of using weaponised anthrax and its lack of human-to-human transmissability.

One scenario would certainly occur and would certainly lead to tens of thousands of deaths. One scenario might occur and would possibly lead to hundreds of deaths. The former is from stockpiling antibiotics in the fashion suggested and the latter from an anthrax attack. Which course of action is it more prudent to take? Definitely the latter.

Monty: While the risk may be low, the potential harm is enourmous. An attack at a major sporting event could expose 75,000 people. A coordinated attack on a major city? Hundreds of thousands on the low end. If untreated, your looking at a 92% potential mortality rate.

Yes; that’s one way to fan the flames of hysteria: make worst-case scenario estimates as though they were realistic. Why on earth would it be “untreated”?

Also, anthrax does not have a mortality rate nearly that high, and given that it’s not directly communicable, how on earth are you getting “hundreds of thousands” of people infected?

Now he seems to be allowing a partisan dislike to lead him to making irresponsible suggestions for irrational reasons.

Don’t take my word for it – he’s been very vocal on the net for a long time.

That doesn’t necessarily mean it’s a bad idea, just oddly timed if it is good advice.

Still, I’m skeptical this is a serious risk, at least as described. Inhalation Anthrax, though scary, is something of pain to deliver, since the spores have to be inhaled, and it doesn’t spread person-to-person. If terrorists have a mechanism for aerosolizing and distributing spores to hit thousands of people, there’s a fair chance they could simply use a toxin like Sarin (remember Aum Shinrikyo?) instead.

And what if it’s a different contagion. Drug resistant TB spreads person-to-person. Heck, an TB outbreak could happen accidentally. Should you stock every antibiotic that you might need?

What if some acountability measure was implemented to ensure that no one misused the drugs?

This raises slippery slope issues. It may be possible to go from antibiotics with accountability to antibiotics without accountability, even though directly allowing antibiotics without accountability would never pass.

I can just imagine the news headlines about how some poor person opened their antibiotics and couldn’t afford to pay the fine, and besides they didn’t hurt anyone, so why not waive the fine instead of make their children go hungry.

What if some acountability measure was implemented to ensure that no one misused the drugs? Offer sealed packages of the anti-biotic, and require that the receiver agrees to return the package unopened at the end of drugs shelf life. Then have them acknowledge that if they open the package, absent an anthrax attack, they will be fined some amount of money, enough they they really wont open it. Make it strict liability, your responsible for the package, regardless.

It is already the case that tens of thousands of people worldwide are killed each year by MRSA and similar bugs. It is not the case that tens of thousands of people worldwide are killed each year by anthrax sent through the post. This policy would certainly see the tens of thousands of people escalating into hundreds of thousands and possibly millions. An anthrax attack has already happened, albeit in a relatively minor way: it hardly killed tens of thousands of people despite some large mail distribution centres being hit with the spores.

If a stockpile plan like that led to even 1% of households in the U.S. taking unnecessary antibiotics for minor ailments, it would quickly decrease antibiotic effectiveness, itself directly contributing to future deaths.

Do you just tell your physician you are stockpiling in case of an anthrax attack and ask him to write you a prescription or three?

Or does Heller mean that the FDA can’t interfere with your right to antibiotics for self defense?