I could be pretentious and describe this as a "case-study", but it is really more a rambling anecdote and, as "eni fule kno" (apart, of course, from the BCA and other assorted purveyors of woo) anecdotal evidence is not the sort of thing you should base health policy on.
The subject of this blog was suggested by @carmenego and, since I am quite incapable of resisting flattery from attractive young women, here it is:
I can only assume that I picked up the H1N1 virus at Manchester Airport when dropping off my wife and kids. They were bound for three weeks in Germany with my parents in law. I was bound for three weeks of peace and quiet back home and chance to get a few things done – like building a garden wall.
First sign that anything was amiss was a slight sore throat a few days later. A couple of days after that, the sore throat was much much worse and accompanied by fever, headache, coughing on a scale I've never previously experienced, and those aches and pains and chills that go though every bone and joint in your body.
I got up to feed the cats and myself every so often, but for five days I could do little more than lie in bed. Couldn’t really enjoy TV (though that could have been to do with the fact that 90% of TV is utter rubbish) or reading or anything. I just didn't have the concentration.
Of course the same flu can affect different people in different ways: anywhere on a scale from not noticing you have it to being dead. It all depends on your immune status and what else might be wrong with you. I am in my early 50s and, like most men, suffer from hypochondria. I wasn’t always a hypochondriac. When I was young, I thought I was invulnerable; but then I started getting all sorts of nasty things wrong with me and this made me start to worry about things like my health.
One thing I had wrong with me was sarcoidosis. I won’t bore you with the gory details, but sarcoidosis is not great for your lungs and the fact of getting it rather suggests that something is awry with your immune system. So I worry about things like flu and new insults to my lungs.
I went on the internet and checked the list of symptoms. Of course, I had all of them and several more besides. I have an encyclopaedia of "Family Health" on my book shelf. I have the symptoms of everything in it. I am just like Jerome K Jerome in this respect, except that I have house-maid’s knee too. As I said, I’m a hypochondriac – though I never go near a doctor unless forced to by my wife.
Of course I have not been tested for the H1N1 virus, but H1N1 seems to be the only virus currently doing the rounds whose constellation of symptoms matches what I had.
Anyway, if you tick all the right boxes on the website, and fill in your details, they give you a reference number to pick up a supply of antivirals from your nearest distribution centre. They also said I should ring my GP, but certainly not go there. So I rang my wife for instructions. She also said I should contact the GP (I decided against this; what would be the point? In any case you can never get through to my GP) and that I should collect the Tamiflu. Max (aged 14) suggested that I re-sell the Tamilflu on the US eBay site (I hope he was joking). I decided to go and lie down instead. When I woke up I felt much worse and I decided that I needed something to supplement my diet of analgesics and tap water – and the occasional rum toddy.
Now it ought to be easy to kill viruses. It’s easy enough to destroy nucleic acids and that’s (by and large) what viruses are made out of. Trouble is, nucleic acid is also what some rather vital bits of us are made of too. Viruses can only work if they get inside your cells. Once they are inside a cell, that cell is basically buggered, but to move on to another cell, each virus (having made squillions of copies of itself inside the cell) has to build itself a new protein envelope and escape from the dying host cell. One of the ways of trying to stop viruses (none of which work terribly well) is to try to interfere with the process I’ve described. This is what Tamiflu does …… a bit.
So I rang up my "flu buddy" (she didn't actually know that she was my flu buddy until I rang her up but she very kindly "stepped up to the plate") and sent her off with my reference number, my photo driving licence (swabbed with CD cleaner); and her photo ID to collect my Tamiflu.
My flu buddy "@fiftynotout" came round, posted the Tamiflu through the letterbox, left me a bag of groceries, and painted a black cross on the door. She has been keeping me supplied with groceries all week since she drives out each day with her daughter who is learning to drive. I gather that if you don’t have anyone who can collect the anti-virals for you, you can arrange for somebody from the NHS (or "Death Panel" as Sarah Palin and co would have it) to drop you some off at your home.
(BTW @fiftynotout does not tweet very much. I think she joined because she had a crush on @StephenFry – though I gather she may have transferred her affections to @ProfBrianCox)
Did the Tamiflu work in my case? Impossible to say of course; it’s like the old joke about the man sprinkling elephant powder. But I did get better after taking it: post hoc but not necessarily propter hoc. The first two doses did seem to make me feel very queasy for while, but I did not actually vomit. From the third dose on, I had no problems – they give you ten doses to last five days.
Of course, given that Tamiflu is not terribly effective, can (like any drug) cause side effects (though these seem to be minimal), and will (sooner or later) almost certainly promote the emergence of resistance in the HIN1 virus, there is still an ongoing debate as to the wisdom of mass distribution. On the other hand, H1N1 can be fatal, Tamiflu may already be saving lives, and H1N1 may suddenly mutate a get a lot worse - if we did not have a working distribution system in place we'd be stuffed when this happened. Also, scientist are busy developing a vaccine - which will be very effective in preventing infection. The use of Tamiflu is just a stop-gap.
How bad is swine flu? Well again, I can only report my experience – which may not be yours. Apart from the coughing, I’d say that the acute symptoms get 8/10 – where the worse flu I ever had gets 10/10. The duration of incapacity and general malaise – eight days and counting – and the coughing are, however, much worse than anything I’ve experienced with normal seasonal flu.
Tweeting certainly helps with flu. It provides the vicarious sensation of having lots of people around expressing concern and interacting with you – not to be sneezed at (hah!) when you are stuck at home on your own. Also, though you can’t concentrate (or, in my case, even stay awake) for long enough to read a chapter of a book or watch a TV programme, you can sit up in bed with your laptop for five minutes and fire off the odd flurry of 140 character messages.
Of course I can’t offer medical advice but, I stayed in bed, drank lots of water and took paracetamol (2x500 mg) every eight hours alternated with ibuprofen. (NB Paracetamol is extremely safe if you stick to the correct dosages and extremely dangerous if you don’t!)
In conclusion: Thanks to my family for their frequent concerned phone calls, thanks to the Death Panel of the NHS for supplying me with free anti-viral drugs, thanks to everyone on Twitter who kept my spirits up during this experience, and a really big thank you to @fiftynotout – the best flu buddy anyone could have had.
The rest of you: Keep washing your hands!