Antivirals in the 2009 pandemic – lessons and implications for future strategies

Abstract

The World Health Organization's declaration of an imminent swine‐origin influenza A pandemic in April 2009 triggered the global launch of national pandemic preparedness plans. An integral component of pandemic preparedness in many countries was the targeted use of antiviral therapy for containment, disease mitigation, and treatment. The 2009 pandemic marked the first pandemic during which influenza antivirals were available for global use. Although most national pandemic plans included provisions for antiviral treatment, these pre‐determined protocols required frequent updating as more information became available about the virus, and its susceptibility to antiviral agents, the epidemiology of infection, and the population groups that were most susceptible to severe disease. National public health agencies in countries with both plans for use of antivirals and pre‐existing stockpiles, including those in Japan, the United Kingdom, and the United States, operated distinctly different antiviral distribution and treatment programs from one another. In the 3 years following the pandemic, there is still little comparison of the diversity of national antiviral treatment policies and drug distribution mechanisms that were implemented, whether they had any mitigating effects and which might be most efficient. The purpose of this study is to outline roles of antiviral medicines in a pandemic period, provide insights into the diversity of antiviral treatment and distribution policies applied by selected countries between April 2009–July 2010, and to stimulate discussion on whether these policies remain appropriate for implementation in future pandemics.

Public preferences for vaccination and antiviral medicines under different pandemic flu outbreak scenarios

“…For example, in the UK uptake of vaccination among clinically at-risk groups was 37.6% [ 5 ]. For those who contracted pandemic influenza, antiviral medicines were recommended as a treatment, and the provision of antiviral medicines (also as a preventive measure) was a major component of emergency plans in many countries [ 6 ]. Data from the UK National Pandemic Flu Service (NPFS) indicated that of the 1.8 m courses of antiviral medicines that were authorised, only 1.16 million were collected and many patients failed to complete a full course [ 7 ].…”

Recognition of plausible therapeutic agents to combat COVID-19: An omics data based combined approach

“…COVID-19 pandemic has destabilized the social, political and economic spheres globally ( Ren et al, 2020 , Berera and Zambon, 2013 , Andersen et al, 2020 ). SARS-CoV-2, the causative agent of this pandemic, can undergo frequent mutations, adaptations and transmission, which will, unfortunately, pose a continuous risk of outbreaks ( Gurwitz et al, 2020 ).…”

Pandemic Influenza Vaccines: What did We Learn from the 2009 Pandemic and are We Better Prepared Now?

“…However, challenges remain for timely manufacturing of vaccines and understanding of the immunogenicity of vaccines containing novel HAs. Hence, other measures such as antivirals [75] and non-pharmaceutical interventions [76] will continue to be important components of any future influenza pandemic planning and response. Even with these challenges we are very fortunate to have systems in place for the ready production of influenza vaccines to the next pandemic threat, unlike the current pandemic threat with the novel coronavirus, SARS-CoV-2.…”