PUBLISHED : Monday, 14 April, 2008, 12:00am
UPDATED : Monday, 14 April, 2008, 12:00am

Tamiflu must be used carefully; steroids are safe

We represent two professional bodies of respiratory physicians and we appreciate the determination and efforts of the Hong Kong government in controlling the recent influenza epidemic.

The public should be praised for its willingness to remain vigilant and its adherence to various recommendations from health care professionals. As respiratory physicians, we owe our community a duty of care to provide the right information. We would like to clarify two recent issues regarding influenza.

First, Tamiflu (Oseltamivir), an anti-viral drug against flu A and B, should not be made an over-the-counter drug.

It is useful as treatment, pre- and post-exposure prophylaxis for influenza A and B. However, there is evidence to show that liberal use of the drug could lead to the emergence of resistant strains. According to the most recent report from the World Health Organisation in March, the resistance rate of influenza A (H1N1) to Tamiflu in Hong Kong is 11 per cent, the highest rate in the western Pacific region.

The WHO had reported resistance to Tamiflu in flu viruses before, but at a much lower rate - typically, 0.5 per cent. Thus, we want to send a clear message to the community - Tamiflu should only be prescribed judiciously by adequately trained health care professionals to avoid the emergence of resistance, rendering it ineffective in life-threatening situations.

Though its efficacy in avian influenza (H5N1) awaits further study, Tamiflu forms part of the WHO-recommended treatment for this condition. Its efficacy against influenza must be preserved by appropriate usage.

Second, balancing the overall benefits and risks, the appropriate use of steroids for treatment of asthma is often life-saving. Irrational fears over the exaggerated risk of steroid treatment should be dispelled. Patients on inhaled steroids as maintenance therapy for asthma and chronic obstructive pulmonary diseases should continue to follow instructions from their specialists concerning its usage lest an abrupt cessation should lead to an exacerbation of their illness.

Systemic steroids may be required to stop these conditions getting worse. Steroids can save lives if used judiciously by responsible physicians.

To be able to fight flu and act wisely, we need a bona fide media to disseminate our professional view. As respiratory physicians, we will walk with our community as we did in the days of avian flu and Sars.

Dr Chan Wai-ming, president, and Dr Tam Cheuk-yin, secretary, Hong Kong Thoracic Society; Dr Chu Chung-ming, president, and Dr Maureen M. L. Wong, secretary, American College of Chest Physicians (Hong Kong and Macau chapter)

Give account of consultants' fees

It has been revealed that the government has spent HK$245 million in engaging consultancy services and many of these reports were not made public ('HK$245m consultancy bill raises eyebrows', April 9). Hongkongers have no idea whether the taxpayers' money has been well spent.

A Financial Services and Treasury Bureau spokesman said that they could only engage consultants if the administration did not have the required expertise. This is fair enough, and yet the Commerce and Economic Development Bureau commissioned a law firm to advise on the introduction of a competition law. Why couldn't the legal experts from the Justice Department take on such a task?

Some legislators have questioned whether such studies provided value for money. One of the main functions of our legislators is to vet government spending. However, the money has already been spent. Isn't it a bit too late to be asking this question?

The Executive Council and Legco need to give Hongkongers a satisfactory answer about how our money has been spent.

H. C. Bee, Kowloon Tong

China right to send guards

I refer to Mary Pang's letter on the Olympic torch relay ('Heavy-handed torch guards', April 10). I do not believe that having a relay around the world was the idea of the mainland government.

The International Olympic Committee said China had the right to send its own torch guards. They did not try to subdue protesters by the side of the road. They were just there as a line of defence. The protesters were free to express their views. The guards were there to ensure the torch- bearers should be free to take part in something that means a lot to them.

In Paris, a young girl in a wheelchair defended the torch (''Wheelchair angel' hailed as heroine in defending torch', April 10). I do not call this a peaceful protest, and what about the girl's right to carry the torch?

Susan Chan, Wan Chai

Allow Tibetans their own say

I refer to Elizabeth Cheung's letter ('Beijing's policy misunderstood', April 8).

Despite your correspondent's attempt to polarise the discussion of Tibet into the western camp and the 'transparent' Beijing government camp, the fact remains that the people of Tibet should be allowed to argue their point of view, in a safe way, without accusations of 'western bias' and the threat of retribution.

Ms Cheung says there is a misunderstanding about Beijing's policy, but the fact is it will not allow Tibetans to speak for themselves.

I admit I do not have a deep understanding of the history or culture of this region, but it is hard to acquire such knowledge as it is so difficult to get into Tibet.

David Mason, Tsing Yi

In a muddle over policy

There are times when I feel that the government is not being clear-headed about some of its policies.

That the topic of road pricing has been under discussion since 1980 reflects sluggishness on the part of officials, and an inability and sluggishness in solving this problem - and other similar problems like air pollution, health care and education.

The government makes swift decisions on large infrastructure and financial projects and officials are swift to take credit for their success. Handling social problems is not so glamorous - and is often tough.

So, in the end, we can only concur that a cheaper road price levy would be a means to generate more revenue rather than to reduce road congestion in Central District. What has the government to say about this warped logic?

Thomas Yeo, Tuen Mun

Be proud and show manners

Are Hong Kong people world-class people in this 'world city'?

I doubt it very much. So often I see discourteous behaviour and a lack of goodwill being shown towards others.

If your readers disagree with me, then perhaps they can explain why the MTR has to continue, day in and day out, to remind people to 'please let passengers disembark first'. Can you imagine how many announcements are made each day at each and every MTR station whenever a train arrives?

When I have been in underground stations in other countries I have never heard of such reminders 'to let people off first'. Only in Hong Kong does it appear to be a permanent fixture.

Wake up Hongkongers: show some pride and manners.

Stand aside and let people alight before you charge in to claim a seat.

Ip Shiun-hung, Tung Chung