An anti-viral stockpile without a well-developed logistic strategy and resourcing for effective early delivery for treatment of cases and prophylaxis of contacts is not an adequate plan for successful limitation of viral spread in a population, especially considering that the high proportion of cases with asymptomatic and mild infections will not be identified. Moreover, as we have seen with seasonal H1N1 viruses, resistance may develop to NAIs and a resistant virus may retain viral fitness allowing it to become widespread. This would render stockpiles useless. Revised pandemic plans should therefore consider limiting the use of NAIs to treatment of those with more severe influenza infection or medical conditions that make them more vulnerable to complications. Dependent on the availability of NAIs and access to appropriate medical care, treatment should be commenced early in the course of the illness. In Germany the median delay between symptom onset and antiviral treatment was significantly longer in fatal cases than non-fatal cases [43] . Prophylaxis should probably be reserved for closed communities, with any plan for wide-scale use of prophylactic NAIs dependent on a large workforce able to perform contact tracing and a detailed logistics plan for early delivery.