Only 31 of 181 clinics agree to accept tablets

So far only 31 of the 181 clinics registered for experimental use of oseltamivir have agreed to accept the tablets, for fear that ordinary patients will turn away after learning that they will be treated along with those carrying the novel flu.

Only after the Wednesday deadline will it be known how many private clinics in total will decide to join the government scheme in which all confirmed cases are automatically prescribed with oseltamivir, Dr Somyos Deerassamee, directorgeneral of the Health Service Support Department, said yesterday.Six hospitals run by the Bangkok Metropolitan Administration, more than 100 community clinics and several hundred BMArun public health centres would be ready to provide free oseltamivir tablets and other treatment to people without case confirmation needed, he said.Prime Minister Abhisit Vejjajiva said in his weekly address that the flu situation in Bangkok was under control but the virus may still be spreading upcountry. He dismissed criticism that Thailand was the hardest hit by the 2009 influenza, saying the government was following a World Health Organisation guideline to not regularly report on the fatality rate of the disease.The Public Health Ministry is now requiring all private clinics to ensure that all patients unconditionally wear protective masks while awaiting treatment, and to examine people with suspected flu in a separate area, besides the mandatory use of handwashing gel and protective masks.Dr Itthiphorn Khanajaroen, deputy secretarygeneral of the Medical Council, expressed worry over possible confusion among the public on what conditions would get them free oseltamivir. "It's important to make people aware that not everyone who visits a clinic will be automatically given the tablets," he said.Incorrect dosage for children was also highly possible, because it had to be measured precisely by using a drugdiluting device. "Oseltamivir tablets cannot be cut and given to children in smaller doses like other medicine pills," he said. "There is a great risk of giving a stronger dose to young children who visit clinics without the diluting devices," he added.Deputy Public Health Minister Manit Nopamornbodi said a ministry analysis of fatal cases revealed that those patients without the risk factors of chronic disease, pregnancy or young age, had seen a doctor too late, beyond the twoday incubation period. "People with risk factors including the elderly, those with chronic diabetes, asthma, kidney and heart disease, made up 60 per cent of all fatalities," he said.More than 987,000 public health volunteers now pay house calls three times a week in provinces outside Bangkok to educate people about preventive measures against the 2009 influenza and to hand out information. Starting last Friday, more than two million house visits have been made under this project, Manit said.

Source: The Nation