A leading doctor has warned that the deadly swine flu could become resistant to Tamiflu, the only drug that can treat the virus.
Dr Holden, the British Medical Association’’s lead authority on pandemic flu, cites over-prescription as the reason, reports The Telegraph.
The expert, based in Matlock, Derbyshire, said that he thought the thresholds for issuing Tamiflu [...]
Posts Tagged ‘Andy Burnham’
Over-prescription turning swine flu resistant to Tamiflu
July 28th, 2009 |
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Peers to criticise swine flu response
July 26th, 2009 |
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House of Lords committee expected to accuse ministers of failing to keep promise to set up swine flu helpline by April
A parliamentary committee is expected to criticise the government for the delay in setting up the national pandemic flu helpline and for giving confusing advice to vulnerable groups and NHS staff.
The House of Lords science and technology committee is expected to accuse ministers of failing to keep their promise to set up a flu helpline by April, according to the BBC.
The report will question the confusing and conflicting advice given to the public, in particular to vulnerable groups such as expectant mothers.
The Department of Health was accused of causing confusion after posting a document on its website reiterating previously issued advice to delay conception during the swine flu pandemic.
The DoH said the advice was based on predictions for a pandemic involving bird flu, and denied that its advice to expectant mothers ‑ which says they should not alter their behaviour but should “avoid crowds and unnecessary travel” ‑ was conflicting.
Publication of the critical report comes as ministers attempt to quell swine flu hysteria, amid concerns that the NHS might be overwhelmed by hordes of “unnecessarily anxious” people who could make a full recovery at home.
The health secretary, Andy Burnham, warned that panic itself could push services to breaking point. Health department officials said there was a danger of a “panic pandemic” that could hinder the treatment of serious cases.
The government faced criticism last week when the pandemic flu helpline and website was finally launched. The site was inaccessible minutes after its launch, overwhelmed by demand. It took more than an hour before the technical difficulties were resolved.
Officials said the service was now “working well”, and more than 5,500 people obtained antiviral drugs on the launch day.
The Sunday Telegraph said the NHS would be further strained by European rules limiting the hours doctors can work, which are due to come into force on Saturday. It reported that the changes could leave the NHS short of doctors just as pressure on hospitals caused by the swine flu outbreak intensifies.
The paper said maternity units were planning to cancel home births and planned caesarean sections if the outbreak worsened.
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Minister: swine flu panic is danger to NHS
July 25th, 2009 |
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• ‘Pandemic’ of fear is worsening crisis
• Worried well will swamp GP surgeries
Ministers moved to quell swine flu hysteria last night, as concerns grew that the National Health Service might be overwhelmed by hordes of “unnecessarily anxious” people who could make a full recovery at home.
Amid rising government worry about how NHS staff will cope as the virus spreads, health secretary Andy Burnham warned that panic itself could push services to breaking point. Health Department officials said there was a danger of a “panic pandemic” that could hinder the treatment of more serious cases.
Calling for calm, Burnham said that although swine flu presented a huge challenge for the country, it was not a life-threatening condition for the vast majority of people.
He told the Observer that it was vital not to over-react and claimed the government had the situation under control. “It is very important for everybody to keep a sense of perspective,” he said. “It has been a mild virus in the vast majority of cases, with relatively mild symptoms from which people recover fully fairly quickly.
“If people are made unnecessarily anxious, it makes the lives of NHS professionals, who are already under enormous pressure, far more difficult as people become unduly worried.”
He added: “People should be assured that we have been planning our response to a pandemic for a long time.”
Health officials are also concerned at rising levels of fear among parents who know that children are particularly susceptible to the H1N1 virus.
Doctors last night tried to reassure families that the vast majority of young people would get better without a visit to their GP’s surgery or a hospital.
Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health. said: “Health services struggle when they are overwhelmed by people who don’t need to be there.
“Our first message to parents of young children is to keep this in perspective and keep calm. There are 11 million children in England and 256 of them are in hospital [with swine flu]. For the four families where children have died, it is an absolute tragedy, but if you are talking about a previously healthy child where swine flu has led to their death, there have been none.”
Last Thursday, the Health Protection Agency said that GP consultation rates had risen sharply in the past week, with children under 14 the worst affected group. The over-65s continued to show a much slower rate. The HPA estimated that there had been 100,000 cases in England in the past week. Overall, 26 people have died.
A Department of Health spokesman said that last week’s launch of a helpline for sufferers had already eased pressure on surgeries. Figures released last night showed that the service enabled 5,500 people to receive antivirals on its first day of operation. Some 58,000 people used the service, 89% of whom used the self-assessment scheme on the internet.
Burnham said: “People in need of antivirals are able to get them quickly and conveniently using the new service, and it is freeing up GPs to look after patients in risk groups as well as those with other illnesses.”
He made it clear that he was angry with Andrew Lansley, the Tory health spokesman, for criticising his decision to delay the setting up of the helpline. Lansley described it as “too little, too late”. Burnham said the comment was “unhelpful” and insisted that doctors had urged him to hold back from setting up the line until H1N1 had spread more widely.
Burnham also pointed out that, over the past 12 years, there had been around 8,000 flu deaths a year in England and Wales.
Meanwhile, ministers – afraid of stoking more “crisis” headlines – refused to be drawn on whether Parliament would have to be recalled if the number of cases continued to escalate at the same rate, or on whether the country had sufficient intensive care beds.
Although Stephenson moved to reassure parents, he said contingency plans were in place. These included plans to move children into intensive care beds meant for adults. The NHS has 300 intensive care beds for children and 3,000 for adults.
He also said that hospitals could increase recruitment, while cancelling planned admissions.
Professor Steve Field, chairman of the Royal College of GPs, said that too many people who were not unwell were turning up at surgeries: “There’s too much preoccupation with the threat of death. The numbers of people getting influenza are still tiny. The reality is, that for most people it’s a basically mild illness, and we are losing sight of that.”
Field argued that it was crucial for there to be no unnecessary pressure on GPs or hospitals, partly because they needed to prepare for later in the year. “This is almost like the phoney war at the moment,” he said. “The big danger and real threat is that there will be a big spike in the numbers of people with influenza in the autumn.
“People should regard the phase we’re in now as a practice for far more people having it over a sustained period of a few weeks in the autumn. If that happens, we will have learned valuable lessons from what we’re doing now.”
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Will you call the swine flu helpline?
July 23rd, 2009 |
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A national swine flu help service is being launched today to allow more access to Tamiflu. Do you trust others not to abuse it?
The national swine flu helpline is being launched today and it will enable anyone with the checklist of influenza symptoms to get a coded number for a prescription of Tamiflu. You will also be able to use a website that provides a voucher number for an individual dose of the drug.
Andy Burnham introduced the initiative, hoping it will ease the workload of staff in doctors’ surgeries and hosptials. He has stressed that the service will use an “encryption code” which will only allow one prescription per person.
Would you use the service, rather than making a trip to see your GP? And do you trust others not to abuse the system, visiting the website to get a Tamiflu prescription when they don’t really need it?
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Brown braced for defeat in Norwich
July 23rd, 2009 |
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Tory candidate expected to win in poll triggered by resignation of MP caught up in expenses scandal
Gordon Brown is bracing himself for electoral defeat as polls opened today in the Norwich North byelection.
Labour has held the seat comfortably since 1997 but the party is expected to pay a heavy price for the MPs’ expenses controversy in the first Westminster byelection since the Commons was rocked by the scandal.
David Cameron is due to visit the constituency for the sixth time this morning, giving a final boost to a campaign seen by Conservative headquarters as an important test of the party’s ability to withstand a Labour attack based on a “Tory cuts” message.
Unusually, the votes will be counted tomorrow rather than at the close of the polls this evening, partly because staffing a daytime count is easier. This has not happened at a byelection in recent years.
The byelection was caused by the resignation of Ian Gibson, a leftwinger who quit parliament after Labour ruled that he would not be allowed to stand at the next election because he used parliamentary expenses to fund a flat which he subsequently sold at a discount to his daughter.
Gibson, who was popular in the constituency, had a majority of 5,459 in 2005, and Labour’s decision to ban him as a candidate appears to have backfired, with some voters telling the party that they will not vote for his replacement, 28-year-old Chris Ostrowski, because they think Gibson was treated unfairly.
The Conservatives seem confident of victory. But they are nervous of comparisons with the Crewe and Nantwich byelection last year, when the Tories overturned a Labour majority of more than 7,000, winning by 7,860 with a swing of 17.6%.
“Crewe and Nantwich took place against the backdrop of the abolition of the 10p rate of tax and voters were so angry that they came straight over to us. Norwich North is different because, as a result of expenses, the voters are angry with all parties,” said one senior Tory.
Chloe Smith, the 27-year-old Conservative candidate, has responded to the challenge of campaigning in a climate of scepticism about politicians by issuing her own “contract with the people of Norwich North” containing various promises on policy and expenses.
The Liberal Democrats, who were well behind the Tories in 2005, claimed yesterday that it was now a Tory-Lib Dem contest, and that Labour could come third behind their candidate, April Pond.
At the start of the byelection, Labour campaigned aggressively on the theme of “Tory cuts”, in what was seen as a dry run for the general election strategy being planned by Brown. But the Tories believe that this tactic has been unsuccessful in Norwich North because they are winning the argument on public spending nationally.
Labour’s campaign suffered a blow when Ostrowski was taken to hospital with swine flu yesterday. He was recuperating today, but cabinet ministers Andy Burnham and Alan Johnson were in Norwich North campaigning on his behalf.
“I am very confident that we can win this byelection,” said Burnham. Privately, Labour was trying to make life difficult for Cameron by suggesting that anything less than a 10,000 majority would be a disappointment for the Tory leader.
The other candidates are: Peter Baggs (Independent), Thomas Burridge (Libertarian party), Anne Fryatt (None of the Above party), Bill Holden (Independent), Laud Howling (The Official Monster Raving Loony party), Craig Murray (Put An Honest Man into Parliament), Rupert Read (Green), Glenn Tingle (UK Independence party) and Robert West (British National party).
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Labour braces for byelection defeat in Norwich
July 22nd, 2009 |
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David Cameron makes sixth constituency visit to exploit voter anger at banning of Ian Gibson over expenses
Voters will go to the polls tomorrow in the Norwich North byelection with Gordon Brown braced for defeat in a seat that Labour has held comfortably since 1997.
David Cameron is due to visit the constituency for the sixth time in the morning, giving a final boost to a campaign seen by Conservative headquarters as an important test of the party’s ability to withstand a Labour attack based on a “Tory cuts” message.
Unusually, the votes will be counted on Friday, rather than tomorrow night, partly because staffing a daytime count is easier. This has not happened at a byelection in recent years.
The byelection was caused by the resignation of Ian Gibson, a leftwinger who left parliament after Labour ruled that he would not be allowed to stand at the next election because he used parliamentary expenses to fund a flat which he subsequently sold at a discount to his daughter .
Gibson, who was popular in the constituency, had a majority of 5,459 in 2005 and Labour’s decision to ban him as a candidate appears to have backfired, with some voters telling the party that they will not vote for his replacement, 28-year-old Chris Ostrowski, because they think Gibson was treated unfairly.
The Conservatives seem confident of victory. But they are nervous of comparisons with the Crewe and Nantwich byelection last year, when the Tories overturned a Labour majority of more than 7,000, winning by 7,860 with a swing of 17.6%.
“Crewe and Nantwich took place against the backdrop of the abolition of the 10p rate of tax and voters were so angry that they came straight over to us. Norwich North is different because, as a result of expenses, the voters are angry with all parties,” said one senior Tory.
Chloe Smith, the 27-year-old Conservative candidate, has responded to the challenge of campaigning in a climate of scepticism about politicians by issuing her own “contract with the people of Norwich North” containing various promises on policy and expenses.
The Liberal Democrats, who were well behind the Tories in 2005, claimed yesterday that it was now a Tory/Lib Dem contest, with their candidate April Pond, and that Labour could come third.
At the start of the byelection Labour campaigned aggressively on the theme of “Tory cuts”, in what was seen as a dry run for the general election strategy being planned by Brown. But the Tories believe that this tactic has been unsuccessful in Norwich North because they are winning the argument on public spending nationally.
Labour’s campaign suffered a blow when Ostrowski was taken to hospital with swine flu yesterday. He was recuperating today, but cabinet ministers Andy Burnham and Alan Johnson were in Norwich North campaigning on his behalf.
“I am very confident that we can win this byelection,” said Burnham. Privately, Labour was trying to make life difficult for Cameron by suggesting that anything less than a 10,000 majority would be a disappointment for the Tory leader.
The other candidates are: Peter Baggs (Independent), Thomas Burridge (Libertarian Party), Anne Fryatt (None of The Above Party), Bill Holden (Independent), Laud Howling (The Official Monster Raving Loony Party), Craig Murray (Put An Honest Man into Parliament), Rupert Read (Green), Glenn Tingle (UK Independence Party) and Robert West (British National Party).
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Nanny NCT should leave us alone
July 21st, 2009 |
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The National Childbirth Trust’s misguided advice about swine flu, epidurals and breastfeeding is insulting to women
We women are so irresponsible and selfish. First we refuse to breastfeed. Then we scream out for drug relief during childbirth which, as we all know, doesn’t really hurt that much at all. Now the National Childbirth Trust (NCT) wants us to think about our babies-to-be and delay getting pregnant until the swine flu pandemic is past. No longer is the state trying to nanny us. (Health Secretary Andy Burnham has said we should go about business as usual, including trying to conceive). It’s Nanny NCT that’s telling us – or rather, women – what to do.
The NCT, which organises ante natal classes, has a history of hectoring. Epidurals, they instruct, should be “used sparingly”. Instead, we should try rocking, walking, massage, aromatheraphy, hypnotherapy and something called “visualisation” while pushing. This is despite the fact that, earlier this year, a Swedish study showed that learning relaxation – exactly what happens at every NCT coffee morning up and down the country – does not reduce the need for an epidural. Even the proportion of natural births and emergency Caesareans was the same between those who took long breaths and those who took drugs during birth. But the NCT is interested in dogma, not evidence. They dismissed the Swedish report on the grounds that it “only” surveyed 1000 women.
Now another NCT dogma is being challenged by an expert. This week, Professor Michael Kramer, an adviser to the World Health Organisation and Unicef, has said that much of the evidence used to persuade mothers to breastfeed is either wrong or out of date. New formulations mean that a bottle is as healthy an alternative as a breast. Yet Nanny NCT continues to try and bully us into breastfeeding, insisting a mother’s milk is the counter to a child developing a whole range of conditions, from obesity to asthma, with allergies and heart disease thrown in.
It’s not only insulting to presume that we aren’t sensible enough to make up our own minds about when we get pregnant, how we give birth and if we breastfeed. It’s also dangerous. Such a superstitious approach presumes that if we just do everything Nanny NCT says – get pregnant outside a pandemic, give birth without painkillers, and breast feed for the first six months at least – then our babies will flourish. These are little more than old wives’ tales. Our actions alone cannot determine how our children turn out. They may have less brains, legs and breath than us, and no amount of conception planning or mother’s milk will make the slightest bit of difference. It’s not the mother’s fault if they have a child who has asthma or heart disease.
One of the most terrifying, as well as most wonderful, aspects about childbirth is that it takes us to a place we can’t control. It makes us realise that, however much we may think we can manage and plan, we can’t really. Having children brings it home how serendipitous the world really is. Nanny NCT may parade itself as a supporter of new parents. In fact, it blames them for things they cannot change.
Let’s hope, with mounting evidence against their various mantras, the NCT will keep its misguided advice to the few believers who attend its coffee mornings. It certainly doesn’t make pregnancy and baby rearing any better. It just makes us feel worse.
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Experts urge swine flu school closures
July 21st, 2009 |
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Infectious disease experts say closures could reduce number of swine flu cases and buy time until vaccine is available
Ministers have been urged to rethink their policy of keeping schools open through the swine flu pandemic after research showed that a shutdown would curb the spread of infection and limit the number of deaths.
As Andy Burnham, the health secretary, announced that a flu helpline to take the pressure off GPs’ surgeries would go live this week, two infectious disease experts said school closures should be considered to reduce the number of cases and buy time until a vaccine is available.
Schools across Britain have now broken up for summer holidays and experts hope this will help to slow the spread of the virus. But there are fears that when classes resume in the autumn the number of cases will increase rapidly.
School closures would cause serious difficulties for working parents, lead to a 1% loss in GDP through absenteeism and see as many as 30% of NHS staff taking time off just when they are needed to treat patients.
In a study published in the Lancet, government adviser Prof Neil Ferguson and Dr Simon Cauchemez, both of the department of infectious disease epidemiology, Imperial College London, said “prolonged” closures could reduce the scale of the outbreak by 13-17% and at the pandemic’s peak the shutting of schools could bring down the number of cases by 38-45%.
“It is therefore hoped that closure of schools during the pandemic might break the chains of transmission, with the following potential benefits: reducing the total number of cases; slowing the epidemic to give more time for vaccine production; and reducing the incidence of cases at the peak of the epidemic, limiting both the stress on healthcare systems and peak absenteeism in the general population, and thus increasing community-wide resilience,” the researchers said.
Such a move would also raise the question of what should be done with millions of schoolchildren during a prolonged shutdown, they added. The authors said that governments in Europe and North America might have to take such a step after they studied the impact of school closures during flu epidemics in other countries stretching back to 1918.
They say that study of the 1918 flu outbreak in America and Australia indicates that shutting schools, in tandem with closing churches and improved hygiene, could have reduced the death toll by between 10% and 30%, and as much as 50% in some cities at the height of the outbreak.
About 100 schools closed after the start of the outbreak in May but soon reopened when official advice changed because swine flu was becoming so prevalent.
The chief medical officer, Sir Liam Donaldson, today responded coolly to the idea, when hew appeared on GMTV. “I think it would take a lot for us to move in that direction. It would be extremely disruptive to society. When would you open them again, given that flu might be around several months?
“If we look at what we did in the west Midlands for example, where we did very aggressively initially close schools, and treat people with Tamiflu who didn’t have symptoms but were contacts of cases, eventually it broke out of the box and spread more widely.”
Sir Liam said: “I think we will obviously keep all of these things under review as we do with any scientific advice, but at the moment I think it is unlikely.”
Ed Balls, schools secretary, said last night: “Now that the virus is established in the community, expert advice is that there is no longer a strong case for closing schools to contain the spread of infection. We will be monitoring the situation closely over the school holidays and will review the evidence in late August.”
The department’s emergency planning group, Cerg, is now solely concerned with orchestrating schools’ response to the spread of swine flu and updating ministers daily on the situation.
Prof Steve Field, chairman of the Royal College of General Practitioners, said ministers should keep open the possibility of school closures. “It’s something that shouldn’t be discounted if it’s the height of the pandemic,” he said. “It would depend on how the pandemic has developed. The Lancet study demonstrates that it would slow down the transmission of the virus and might cut the number of people who get serious illness and who die.”
Martin Ward, deputy general secretary of the Association of School and College Leaders, said schools could set up internet-based classrooms if there were long-term school closures. “But with the best will in the world they are not going to make the progress they would have if they had been in school,” he said.
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Shut schools to save lives, ministers told
July 21st, 2009 |
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Slowing spread of virus would give more time to develop vaccine
Ministers were urged tonight to rethink their policy of keeping schools open through the swine flu pandemic after research showed that a shutdown would curb the spread of infection and limit the number of deaths.
As Andy Burnham, the health secretary, announced that a flu helpline to take the pressure off GPs’ surgeries would go live this week, two infectious disease experts said school closures should be considered to reduce the number of cases and buy time until a vaccine is available.
Schools across Britain have now broken up for summer holidays, and experts hope this will help to slow the spread of the virus. But there are fears that when classes resume in the autumn the number of cases will increase rapidly.
School closures would cause serious difficulties for working parents, lead to a 1% loss in GDP through absenteeism and see as many as 30% of NHS staff having to take time off just when they are needed to treat growing numbers of patients.
In a study published in the today Lancet , Government adviser Professor Neil Ferguson and Dr Simon Cauchemez, both of the department of infectious disease epidemiology, Imperial College London, said “prolonged” closures could reduce the scale of the outbreak by 13-17% and at the pandemic’s peak shutting schools could bring down the number of cases by 38-45%.
“It is therefore hoped that closure of schools during the pandemic might break the chains of transmission, with the following potential benefits: reducing the total number of cases; slowing the epidemic to give more time for vaccine production; and reducing the incidence of cases at the peak of the epidemic, limiting both the stress on healthcare systems and peak absenteeism in the general population, and thus increasing community-wide resilience,” the researchers said.
Such a move would also raise the question of what should be done with millions of schoolchildren during a prolonged shutdown, they added. The authors said that governments in Europe and North America might have to take such a step after they studied the impact of school closures during flu epidemics in other countries stretching back to 1918.
They say that study of the 1918 flu outbreak in America and Australia indicates that shutting schools, in tandem with closing churches and improved hygiene, could have reduced the death toll by between 10% and 30%, and as much as 50% in some cities at the height of the outbreak.
About 100 schools closed after the start of the outbreak in May, but soon reopened when official advice changed because swine flu was becoming so prevalent.
Last night the schools department said it was sticking with the current guidance, which is not to close schools. Ed Balls, schools secretary, said: “Now that the virus is established in the community, expert advice is that there is no longer a strong case for closing schools to contain the spread of infection. We will be monitoring the situation closely over the school holidays and will review the evidence in late August.”
The department’s emergency planning group, Cerg, is now solely concerned with orchestrating schools’ response to the spread of swine flu and updating ministers daily on the situation.
Professor Steve Field, chairman of the Royal College of General Practitioners, said ministers should keep open the possibility of school closures. “It’s something that shouldn’t be discounted if it’s the height of the pandemic,” he said. “It would depend on how the pandemic has developed. The Lancet study demonstrates that it would slow down the transmission of the virus and might cut down the number of people who get serious illness and who die.”
Mick Brookes, general secretary of the National Association of Headteachers, called for a balanced view of the risks. “Even one person dying is a tragedy but if the mortality rate is the same of any other flu that needs to be kept in perspective,” he said. “If more and more people become infected closures may well become inevitable. Younger children are more at risk so it might be right to close early years centres and nurseries first.”
Martin Ward, deputy general secretary of the Association of School and College Leaders, said schools could set up internet-based classrooms if there were long-term school closures. “But with the best will in the world they are not going to make the progress they would have if they had been in school,” he said.
Pregnant women may want to steer clear of crowded places in order to reduce their chances of catching the virus, the government’s chief medical officer, Sir Liam Donaldson, said yesterday. The swine flu virus’s current known level of risk meant that expectant mothers should not stop using public transport, going to work or attending events and family gatherings, he said. But he added: “Some mothers-to-be may wish to continue their day-to-day activities but exercise their choice now, on a highly precautionary basis, to avoid large densely populated gatherings where they have little control over personal contact.”
He was trying to end the confusion over what steps pregnant women should take to avoid catching the virus after conflicting advice from medical organisations .
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Swine flu school closures urged
July 20th, 2009 |
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Slowing spread of virus would give more time to develop vaccine
Ministers were urged tonight to rethink their policy of keeping schools open through the swine flu pandemic after research showed that a shutdown would curb the spread of infection and limit the number of deaths.
As Andy Burnham, the health secretary, announced that a flu helpline to take the pressure off GPs’ surgeries would go live this week, two infectious disease experts said school closures should be considered to reduce the number of cases and buy time until a vaccine is available.
Schools across Britain have now broken up for summer holidays, and experts hope this will help to slow the spread of the virus. But there are fears that when classes resume in the autumn the number of cases will increase rapidly.
School closures would cause serious difficulties for working parents, lead to a 1% loss in GDP through absenteeism and see as many as 30% of NHS staff having to take time off just when they are needed to treat growing numbers of patients.
In a study published in the today Lancet , Government adviser Professor Neil Ferguson and Dr Simon Cauchemez, both of the department of infectious disease epidemiology, Imperial College London, said “prolonged” closures could reduce the scale of the outbreak by 13-17% and at the pandemic’s peak shutting schools could bring down the number of cases by 38-45%.
“It is therefore hoped that closure of schools during the pandemic might break the chains of transmission, with the following potential benefits: reducing the total number of cases; slowing the epidemic to give more time for vaccine production; and reducing the incidence of cases at the peak of the epidemic, limiting both the stress on healthcare systems and peak absenteeism in the general population, and thus increasing community-wide resilience,” the researchers said.
Such a move would also raise the question of what should be done with millions of schoolchildren during a prolonged shutdown, they added. The authors said that governments in Europe and North America might have to take such a step after they studied the impact of school closures during flu epidemics in other countries stretching back to 1918.
They say that study of the 1918 flu outbreak in America and Australia indicates that shutting schools, in tandem with closing churches and improved hygiene, could have reduced the death toll by between 10% and 30%, and as much as 50% in some cities at the height of the outbreak.
About 100 schools closed after the start of the outbreak in May, but soon reopened when official advice changed because swine flu was becoming so prevalent.
Last night the schools department said it was sticking with the current guidance, which is not to close schools. Ed Balls, schools secretary, said: “Now that the virus is established in the community, expert advice is that there is no longer a strong case for closing schools to contain the spread of infection. We will be monitoring the situation closely over the school holidays and will review the evidence in late August.”
The department’s emergency planning group, Cerg, is now solely concerned with orchestrating schools’ response to the spread of swine flu and updating ministers daily on the situation.
Professor Steve Field, chairman of the Royal College of General Practitioners, said ministers should keep open the possibility of school closures. “It’s something that shouldn’t be discounted if it’s the height of the pandemic,” he said. “It would depend on how the pandemic has developed. The Lancet study demonstrates that it would slow down the transmission of the virus and might cut down the number of people who get serious illness and who die.”
Mick Brookes, general secretary of the National Association of Headteachers, called for a balanced view of the risks. “Even one person dying is a tragedy but if the mortality rate is the same of any other flu that needs to be kept in perspective,” he said. “If more and more people become infected closures may well become inevitable. Younger children are more at risk so it might be right to close early years centres and nurseries first.”
Martin Ward, deputy general secretary of the Association of School and College Leaders, said schools could set up internet-based classrooms if there were long-term school closures. “But with the best will in the world they are not going to make the progress they would have if they had been in school,” he said.
Pregnant women may want to steer clear of crowded places in order to reduce their chances of catching the virus, the government’s chief medical officer, Sir Liam Donaldson, said yesterday. The swine flu virus’s current known level of risk meant that expectant mothers should not stop using public transport, going to work or attending events and family gatherings, he said. But he added: “Some mothers-to-be may wish to continue their day-to-day activities but exercise their choice now, on a highly precautionary basis, to avoid large densely populated gatherings where they have little control over personal contact.”
He was trying to end the confusion over what steps pregnant women should take to avoid catching the virus after conflicting advice from medical organisations .
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Baby P report: staff need training to spot abuse
July 15th, 2009 |
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Many NHS doctors and nurses are inadequately prepared to spot and act upon signs of child abuse or neglect, a damning report on the aftermath of the Baby P scandal warns.
The detailed survey by the Care Quality Commission exposes a failure inside the health service even among some paediatric specialists and GPs to get to grips with the challenges of safeguarding children.
It says many clinicians have not received up-to-date mandatory training in child protection, while health visitors are overwhelmed by excessive case loads.
The review was ordered after it emerged that NHS staff in Haringey, north London, including some employed by Great Ormond Street children’s hospital, saw Baby Peter, as he is now known, on 35 separate occasions in his short life and, on all but one occasion, failed to realise he was in danger.
Highlighting the inadequate response by health trusts, Cynthia Bower, the commission’s chief executive, said: “Immediately after the Baby P tragedy, everyone agreed that everything possible must be done to prevent a recurrence. This must not prove to be hollow rhetoric. The NHS has got to play its part by getting these safeguarding measures in place.
“It is clear that safeguarding has not been as high on the agenda of trust boards as it should have been … In some cases NHS staff have not been given the support they need in terms of training and clear procedures for handling concerns. If that were to change, it would be an appropriate legacy for Baby Peter.”
The 17-month-old Baby Peter, who had been also monitored by social workers and police, was seen by a consultant paediatrician, Sabah Al-Zayyat, two days before he died in Haringey in early 2007. She had not been not given the full picture of Peter’s history before the examination, although a subsequent internal Great Ormond Street inquiry said she should have identified his injuries as signs of abuse.
After he died, Peter was found to have serious injuries including a broken back and fractured ribs. His mother, her boyfriend and a lodger were later sentenced for causing or allowing the child’s death.
The report says that only 54% of eligible NHS staff have received basic child protection training, a “worryingly low” proportion. According to the inspectors, in 20 of the primary care trusts surveyed, as few as 10% of GPs were up-to-date with what was said to be a “basic” level of training.
On health visitors, the investigation discovered that 29 out of 152 primary care trusts were dealing with caseloads of more than 500 children each, “well above [the] recommendation of 400″.
Among other findings were that only 37% of trusts have a dedicated budget for training staff in child protection issues, while 65% of GPs either do not have appropriate training or there is no data to say whether they do or don’t. Only 58% of A&E or urgent care staff have adequate training in child protection.
Last year about one in 10 GP consultations were with children aged 14 or under; nearly three million children under 16 attend A&E departments ever year.
In 2008-09, the year that the Baby P scandal erupted, more NHS trusts did admit that they could not comply with national core standards – one of which deals with child protection. The numbers declaring compliance fell marginally from nearly 97% to 94% – suggesting a slight increase in self-criticism.
More than one in 10 trusts “did not appear to comply with the statutory requirement to carry out criminal records bureau checks for all staffemployed since 2002,” the report said. “We are particularly concerned with the large proportion of trusts that do not have a process for following up children who miss outpatient appointments.”
Commenting on the findings, Jo Webber, deputy director of policy at the NHS Confederation, said: “Despite the progress many NHS organisations have made, and the commitment of individuals working in the health service, there is clearly much more that can be done to make sure children are protected properly. This means promoting a culture of questioning amongst staff.”
The Liberal Democrat health spokesman, Norman Lamb, said: “It’s disgraceful that some parts of the NHS are still failing to comply with basic child protection requirements like carrying out criminal record checks on staff.”
The health secretary, Andy Burnham, said: “I want trusts and PCTs to use this report to support a coordinated programme of action to assure and sustain essential levels of safeguarding in activities relating to children.”
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Swine flu vaccine ‘months away’
July 15th, 2009 |
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Head of World Health Organisation casts doubt on government’s claim that first stocks will arrive in August
Vaccines to protect millions of Britons from swine flu will not be available for several months, the head of the World Health Organisation warns today.
Her remarks, in an interview with the Guardian, cast serious doubt on ministerial claims in parliament that the first stocks would arrive in August.
Dr Margaret Chan, WHO director general, said: “There’s no vaccine. One should be available soon, in August. But having a vaccine available is not the same as having a vaccine that has been proven safe. Clinical trial data will not be available for another two to three months.”
One of the world’s most respected influenza scientists told the Guardian that health officials have been surprised by the rapid spread of swine flu in the UK. Dr Alan Hay, director of the WHO’s London-based World Influenza Centre, said the extensive summer outbreak in Britain had not followed expected patterns and warned that the health department needed to be prepared for a more deadly form of the disease.
“We have been a little surprised by the degree of spread of this virus. A few weeks ago we anticipated that this was going to be a short series of outbreaks that would probably peter out before reappearing in the autumn or winter and that has proved not to be the case,” he said.
He said Burnham had been “a bit optimistic” when he told the House of Commons that a flu vaccine would arrive in Britain next month.
Public anxiety about swine flu has risen since the death of six-year-old north-west London schoolgirl Chloe Buckley, who had contracted the virus but had previously apparently enjoyed good health. Sixteen people in the UK have now died after contracting swine flu – although a postmortem revealed yesterday that Bedfordshire GP Dr Michael Day, who was thought to have become the 17th victim, had died as a result of natural causes.
At least 335 people have been treated in hospital after contracting the virus, but tens of thousands are visiting GPs with flu-like symptoms every week, according to the Health Protection Agency.
Andy Burnham, the health secretary, urged people yesterday to keep the threat posed by swine flu “in perspective”, noting the vast majority of sufferers made a full recovery. Britain was “front of the queue” for vaccine stocks, he told GMTV.
But while it is known that the government asked two major drug companies in June to urgently develop a vaccine, trials of preliminary batches of what they hope will be an effective jab have only begun in the last fortnight. A Department of Health spokeswoman said: “We expect delivery of the vaccine in the coming months. Vaccine development can take some time. We hope to have enough vaccine by the end of the year to cover half of the population, but that’s a forecast and it could go up or it could decrease. We can’t be more precise about when it will be delivered and go into people’s arms.”
The government is basing its contingency planning on the UK workforce being reduced by 15-20% at the pandemic’s peak. That could rise to 35% in the unlikely event that every school closed.
The plans are based on the expectation of a 15-week-long wave of illness, but it is impossible to predict how many there will be.
Latest swine flu developments were discussed at cabinet level yesterday. Part of the government’s strategy will see the NHS cancel non-emergency operations, discharge patients early and care for people with swine flu miles away from their homes if hospitals become overwhelmed with people who are seriously ill with the virus.
The Department of Health has agreed the contingency measures with local NHS leaders during co-ordinated efforts intended to help them prepare to cope with a possible huge increase in the number of people who need what would in some cases be life-saving treatment.
Operations involving elective or non-urgent surgery for conditions such as a hernia or varicose veins would be halted and beds earmarked for these patients used instead for people whose health is at risk because they have swine flu as well as breathing conditions such as asthma, bronchitis or pneumonia.
Hospitals in swine flu hotspots such as London and the West Midlands that become overwhelmed by the sheer number of patients have also put in place plans to transfer some such cases to nearby hospitals, some of which could be 10 or 20 miles away.
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£20,000 fee could fund elderly care
July 14th, 2009 |
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• Three options unveiled to bridge huge funding gap
• Overhaul will bring an end to the postcode lottery
Radical changes to the way care for elderly people is funded were outlined yesterday in a green paper that confronts the soaring costs of looking after an increasingly old and frail population.
Elderly people could be compelled to pay up to £20,000 to insure themselves against the cost of being cared for at the end of their lives. The proposals are designed to replace a system that the government describes as unjust with one that is “fair, simple and affordable for everyone”.
The health secretary, Andy Burnham, said there was an urgent need to reform the structure of funding that forces some people to pay up to £200,000 for care, while others receive it free. At the moment, 50% of people pay more than £25,000 for their end-of-life care, while 20% pay more than £50,000.
Reform is needed because healthy life expectancy is not keeping pace with life expectancy. By 2026, there will be an estimated 1.7 million more adults requiring care and support in England.
“More of us are living longer – life expectancy is going up and advances in medical science mean that people with a disability are living longer. This is worth celebrating but does mean we need to radically change the way care is provided and paid for,” Burnham said.
The green paper stresses that there is not enough money in the system to pay for the care people will need in the future. “If we want to meet the needs of all those who require care in the future then, as a society, we are going to need to pay more for care and support. The question is where this additional money is going to come from,” it says. Three possible funding options are set out in the Shaping the Future of Care Together document, all of them conceived as national proposals, which would bring an end to the postcode lottery that sees local authorities setting out different criteria for financial support. The three options are:
• A partnership approach, which proposes that the government and the individual who needs care share the costs, with the government paying between a quarter and a third or more for people on a low income.
• An optional insurance-based model, which would also see the government paying between a quarter and a third of the costs, but would allow individuals to pay £20,000 to £25,000 to cover themselves against the remaining costs of care.
• A compulsory state insurance scheme under which everyone who can afford it pays between £17,000 and £20,000 – and receives free care in return.
Two alternative ideas were rejected: a scheme whereby everyone pays for themselves (ruled out because it would leave too many unable to afford any care), and an entirely tax-funded scheme (rejected because it places too heavy a burden on people of working age).
The government is not proposing to make new public funding available, but has proposed to end the disability living allowance for elderly people – which is not a means-tested benefit – to free up about £6.1bn that would then be returned to the budget for means-tested social care.
The threshold of £23,000 of assets beneath which individuals might receive care paid for by the state would remain at about that level, said the care services minister, Phil Hope.
Government funding and insurance payments would go only towards the cost of care, while accommodation and food would have to be met separately by individuals – stripping accommodation out of the costs of residential care homes for elderly people, which are calculated together. These costs could be deferred and charged to the individual’s estate when they die.
The green paper proposes creating a national care service, which would emphasise preventing people having to go into care homes by keeping them active and offering home rehabilitation services.
Burnham appeared to apologise for the government’s failure to launch this debate earlier.
“It is a difficult debate that raises difficult questions about funding. Politicians have flinched from this debate because it is difficult. The way that we look after our old people defines what we are as a country and I believe that we could do better,” he said.
Age Concern and Help the Aged welcomed the green paper as an attempt to fix the “broken care system”.
Michelle Mitchell, director of Help the Aged, said: “All political parties and the public must now look beyond the short-term squeeze on our national finances to agree a fairer way to pay for care.”
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BBC bosses ‘leaving staff in despair’
July 14th, 2009 |
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Culture secretary Ben Bradshaw makes strong attack on Mark Thompson and Sir Michael Lyons over BBC licence fee
The culture secretary, Ben Bradshaw, has attacked the BBC director general, Mark Thompson, and Sir Michael Lyons, the chairman of the BBC Trust, for “self-defeating” and “wrong-headed” resistance to sharing the licence fee with other broadcasters.
BBC management had lost the confidence of many of their senior staff who had been left with “almost a feeling of despair”, he said.
Speaking on the eve of the publication of the corporation’s annual report, Bradshaw said Thompson and Lyons were misguided in their resistance to government plans, outlined in Lord Carter’s Digital Britain report, to share some of the £3.6bn licence fee with rival broadcasters.
“[There] are plenty of people within the BBC that do not feel it is a well-led organisation and that is almost for me the most worrying thing,” Bradshaw told the Financial Times.
“And they don’t feel they are being well-led on this issue. It fits into a pattern. It is not the only issue. There is almost a feeling of despair among a lot of highly respected BBC professionals.”
Digital Britain outlined proposals for the BBC to share some of the licence fee with other broadcasters for the first time in its history. Around £130m of licence payers’ money will go towards ITV regional news programmes, and possibly children’s programming.
Thompson accused ministers of having an “ideological” motivation for the plan, while Lyons said the BBC Trust would not “sit quietly by and watch this happen”.
Bradshaw, who succeeded Andy Burnham as culture secretary last month and is himself a former BBC journalist, said: “I don’t know why they have adopted this position. I don’t think it’s sensible.
“I think it’s wrongheaded and will ultimately be self-defeating. And there are plenty of people I know in the BBC who agree with me.
“I think the BBC is far more likely to be able to make a strong case in future for the retention of the licence fee if it sees itself as an organisation that is not just simply always interested in defending its own narrow interests, but has a broader role in terms of defending and providing high-quality public-service content.”
This echoed Bradshaw’s comments at the all-party parliamentary media group’s summer reception last month, where he said he rejected the idea that top-slicing threatened the future of the licence fee. “I think the opposite is the case,” he said. “It is far more likely to secure the licence fee if you share it, rather than end it.”
Bradshaw told the FT that a consultation period lasting until early September was “an opportunity for the leadership of the BBC to show some leadership rather than feel that the bunker is the place they want to be in”.
He said the idea that the top-slicing plans were ideologically motivated was “nonsense”. “We have an ideological commitment to ensuring that the public gets high quality public service provision in those areas which the public tell us matter to them – and local and regional news are at the top of that list.”
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Man is fourth in UK to die from swine flu
July 3rd, 2009 |
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A 19-year-old man has become the fourth person in the UK to die of swine flu and the first in London.
The teenager, from south London, who has not been identified, had serious underlying health problems, as had all those who have died in the UK so far. He tested positive for the H1N1 virus after his death at Lewisham hospital on Wednesday.
So far there have been four deaths among the nearly 7,500 lab-confirmed cases. On Thursday the health secretary Andy Burnham said projections showed that if cases continued to rise at the current rate there would be 100,000 new cases a day by the end of August.
The number of deaths will inevitably also rise, but extrapolation from the four deaths so far would not be statistically valid because the numbers are too few. A Department of Health spokesman said suggestions that there could be 40 deaths a day by the end of the summer were wrong.
“Scientific and clinical experts can use sophisticated modelling techniques to help us understand how the virus may behave, but that is all they can do – be a guide, not a prediction,” he said.
Those whose immune systems are compromised, for instance through cancer treatment, or who have breathing problems, like asthmatics, or who are otherwise frail are at greatest risk from the virus. The south London teenager is the second youngest victim, after nine year-old Sameerah Ahmad, who was born with a rare life-threatening disease. The first victim was 38-year-old Jacqui Fleming, who died in hospital in Glasgow where she had been in intensive care since giving birth three months prematurely. The baby also later died, but not from swine flu.
The Department of Health said that it was possible to catch swine flu in hospital, where many people might be at risk because of their poor state of health. “Like any other place where there are lots of people, you could get it in hospital,” said a spokesman. “But we’re making sure that people with swine flu are isolated away from other patients and staff are very meticulous in their cleanliness.”
Another death is likely to add to the alarm created by the soaring numbers of cases, but chief medical officer Sir Liam Donaldson warned that people should not attempt to buy antiviral drugs such as Tamiflu over the internet.
Donaldson pointed out that the UK has one of the biggest stockpiles of the drug in the world and certainly enough to treat all cases of the disease here. He warned on Thursday against buying antiviral drugs on the internet.
All those who fall ill will receive Tamiflu, even though some experts think treatment is warranted only for those with other health problems. However, some of those who have become seriously ill and at least one who died elsewhere were apparently healthy before their infection.
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Public warned off web swine flu drugs
July 3rd, 2009 |
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Fourth death in UK as chief medical officer says Britain has enough Tamiflu and online pills may be counterfeit
The government’s chief medical officer has warned the public against panic-buying swine flu drugs online after it was revealed that the number of new cases of the virus could reach 100,000 per day.
Professor Sir Liam Donaldson said Britain had a large stockpile of Tamiflu, the antiviral drug used to combat infection with the H1N1 virus, and there was no need for people to buy what were likely to be counterfeit medicines on the internet.
His comments came as a 19-year-old man was confirmed today as the fourth person with swine flu to die in the UK. The teenager from south London, who had other serious health problems, tested positive for the virus after his death on Wednesday.
The health secretary, Andy Burnham, yesterday told MPs the spread of swine flu in the UK could no longer be contained.
He said predictions showed the figure of up to 100,000 new cases diagnosed every day could be reached by the end of next month.
In a Commons statement yesterday, Burnham said the country had moved into the “treatment phase” of its response to the flu pandemic.
No more schools will be closed unless forced to by a lack of staff or if pupils are especially vulnerable.
Families and others in contact with infected people will not be given preventative antiviral drugs – a move some doctors predict could push people to go to internet pharmacies.
Donaldson told GMTV there was considerable concern that people might buy counterfeit drugs.
“People shouldn’t buy Tamiflu from the internet,” he said. “We have got a massive stockpile in this country, and everybody can have access to it through the National Health Service.”
The Royal Pharmaceutical Society’s director of policy, David Pruce, said most Tamiflu for sale online was probably fake because no legitimate online pharmacy would sell it.
“These sites could be based anywhere in the world,” he told BBC Radio 4′s Today programme. “They could be selling anything from sugar to rat poison.
“Counterfeiters are very good at producing goods that look like the genuine article. When it’s counterfeit medicines and you’ve got really no idea what’s in the tablet or the capsule, you’re taking your life in your hands.”
Pruce added that while people could get a private prescription for Tamiflu from their GP, there was no point in taking the drug unless they had symptoms.
There are now 7,447 diagnosed cases in the UK, but the number is doubling every week.
People who think they may have flu are advised to go online and check their symptoms on the NHS website or call the swine flu information line on 0800 1 513 513.
Anyone still concerned after that should phone their GP, who can provide a diagnosis over the phone.
If swine flu is confirmed, they will be issued with an authorisation voucher, which a “flu friend” can take to an antiviral drug collection point, which may be a pharmacy or a health centre.
The first doses of swine flu vaccine will arrive in the UK in August. Although the government has ordered enough for the entire population, it will arrive in batches.
At-risk groups – especially those vulnerable because of diseases which have compromised their immune systems or affect their breathing, such as asthma – would get it first.
The shift in the government’s swine flu strategy came as the World Health Organisation warned that the spread of swine flu was now “unstoppable”, with a total of 112 countries reporting nearly 77,201 infected people and 332 deaths since April.
Dr Margaret Chan, the WHO director general, told an international conference on swine flu in Mexico: “With well over 100 countries reporting cases, once a fully fit pandemic virus emerges its further international spread is unstoppable.”
Chan said there was “good reason to believe” the swine flu pandemic would be “of moderate severity, at least in its early days”.
But she said that while most deaths had so far occurred in people with serious underlying medical conditions, there were a few exceptions that raised alarm.
“For reasons that are poorly understood, some deaths are occurring in perfectly healthy young people,” she said.
“Moreover, some patients experience a very rapid clinical deterioration, leading to severe, life-threatening viral pneumonia that requires mechanical ventilation.”
So far, the fatality rate appears to be low. In the UK only four people have died. All had significant underlying health problems.
Jacqui Fleming, 38, of Glasgow, was the first person in the UK to die after contracting the virus. Fleming died last month, two weeks after her son, Jack, was born 11 weeks prematurely. The boy died later but had not contracted the virus.
The second victim was a 73-year-old man from the Inverclyde area of Scotland. Then a week ago today six-year-old Sameerah Ahmad, who was born with a rare life-threatening disease, became the youngest UK victim to date.
Health experts believe more people have caught swine flu but have shown no symptoms.
In the US the official figures show 27,725 Americans have contracted H1N1, with 127 deaths.
The Centres for Disease Control and Prevention, in Atlanta, estimate that one million Americans may have caught swine flu but not been to a doctor, suggesting fatality rates are as low as 0.012%, Burns said.
The European Centre for Disease Prevention and Control reported on Thursday that of 69,177 cases which had been detected worldwide only 328 people had died – a fatality rate of 0.47%.
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Swine flu ‘can no longer be contained’
July 2nd, 2009 |
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More than 100,000 people could be diagnosed with swine flu every day by the end of August, the government said, announcing that the disease can no longer be contained in the UK.
A Commons statement by the health secretary, Andy Burnham, marks a watershed in the spread of the flu. No more schools will be closed, unless forced to by the lack of staff or if the pupils are especially vulnerable. Families and people in contact with those with flu will not be given preventative antiviral drugs.
The new policy of treatment for those with diagnosed illness, rather than containment, has already begun in the hotspots – chiefly London, Birmingham and Scotland.
The change of tactic is the predicted response to the swelling number of people infected. There are now 7,447 diagnosed cases in the UK, but the number is doubling every week. If they continue in this way, said Burnham in his statement, “we could see over 100,000 cases per day by the end of August”. He later stressed that the figure “is a projection. It is not a fact. This is how the disease could develop and we don’t know.”
Those sorts of numbers would put a heavy burden on the NHS, which is already feeling the strain in some areas. The new strategy will help keep those with possible symptoms out of GP surgeries.
People who think they may have flu are now being advised to go online and check their symptoms on the NHS website or call the swine flu information line, on 0800 1 513 513. Anyone still concerned after that should phone their GP, who can provide a diagnosis over the phone. If swine flu is confirmed, they will be issued with an authorisation voucher, which a “flu friend” can take to an antiviral drug collection point, which may be a pharmacy or a health centre.
But health officials in Scotland doubt the virus will spread dramatically across the UK, as it seems to have peaked in Scotland, which saw the first big outbreaks, and the first two deaths in Europe.
The rapid spread of the virus has slowed down in Paisley, which suffered the second largest outbreak, and it has disappeared in Dunoon, where a coachload of football fans were infected. In Glasgow, until recently the worst affected area of the UK, infection rates have stabilised. After infection rates peaked at 111 confirmed cases on 25 June, the rate in Scotland has remained steady at an average of about 60 new cases a day over the last week. There is no evidence that infection rates in Scotland, where the virus first arrived in late April, were doubling.
Dr Harry Burns, Scotland’s chief medical officer, said he was “now optimistic that sometime over the next few weeks, the rate of transmission will begin to slow down” [in Scotland].
It was entirely possible, he added, that the outbreaks elsewhere in the UK would also slow down in a matter of weeks.
The fatality rate also appears to be low. In the UK, only three people – all with significant underlying health problems – have died out of 7,447 confirmed cases. Health experts believe more people have caught swine flu but shown no symptoms.
In the United States, the official figures show 27,725 Americans have contracted H1N1, with 127 deaths. The Centres for Disease Control and Prevention, in Atlanta, estimates that a million Americans may have caught swine flu but not been to a doctor, suggesting that fatality rates are as low as 0.012%, Burns said.
The European Centre for Disease Prevention and Control reported on Thursday that of 69,177 cases which had been detected worldwide, only 328 people had died – a fatality rate of 0.47%.
However, Sir Liam Donaldson, the chief medical officer, said that it was not yet possible to work out the death rate from the virus, “given the unreliability of the data”, but that it would become clearer in the coming months.
The first batches of vaccine will arrive in August.
Although the UK has ordered enough for the entire population, it will arrive in batches. At-risk groups would get it first, said Donaldson: those especially vulnerable because of diseases which have compromised their immune systems or affect their breathing, such as asthma.
New flu strains cannot be eradicated. They simply become part of the seasonal flu mix. Donaldson said that swine flu could continue to cause extra deaths for five years. “We will need the vaccine in years to come,” he said.
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Swine flu ‘can no longer be contained’
July 2nd, 2009 |
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More than 100,000 people could be diagnosed with swine flu every day by the end of August, the government said, announcing that the disease can no longer be contained in the UK.
A Commons statement by the health secretary, Andy Burnham, marks a watershed in the spread of the flu. No more schools will be closed, unless forced to by the lack of staff or if the pupils are especially vulnerable. Families and people in contact with those with flu will not be given preventative antiviral drugs.
The new policy of treatment for those with diagnosed illness, rather than containment, has already begun in the hotspots – chiefly London, Birmingham and Scotland.
The change of tactic is the predicted response to the swelling number of people infected. There are now 7,447 diagnosed cases in the UK, but the number is doubling every week. If they continue in this way, said Burnham in his statement, “we could see over 100,000 cases per day by the end of August”. He later stressed that the figure “is a projection. It is not a fact. This is how the disease could develop and we don’t know.”
Those sorts of numbers would put a heavy burden on the NHS, which is already feeling the strain in some areas. The new strategy will help keep those with possible symptoms out of GP surgeries.
People who think they may have flu are now being advised to go online and check their symptoms on the NHS website or call the swine flu information line, on 0800 1 513 513. Anyone still concerned after that should phone their GP, who can provide a diagnosis over the phone. If swine flu is confirmed, they will be issued with an authorisation voucher, which a “flu friend” can take to an antiviral drug collection point, which may be a pharmacy or a health centre.
But health officials in Scotland doubt the virus will spread dramatically across the UK, as it seems to have peaked in Scotland, which saw the first big outbreaks, and the first two deaths in Europe.
The rapid spread of the virus has slowed down in Paisley, which suffered the second largest outbreak, and it has disappeared in Dunoon, where a coachload of football fans were infected. In Glasgow, until recently the worst affected area of the UK, infection rates have stabilised. After infection rates peaked at 111 confirmed cases on 25 June, the rate in Scotland has remained steady at an average of about 60 new cases a day over the last week. There is no evidence that infection rates in Scotland, where the virus first arrived in late April, were doubling.
Dr Harry Burns, Scotland’s chief medical officer, said he was “now optimistic that sometime over the next few weeks, the rate of transmission will begin to slow down” [in Scotland].
It was entirely possible, he added, that the outbreaks elsewhere in the UK would also slow down in a matter of weeks.
The fatality rate also appears to be low. In the UK, only three people – all with significant underlying health problems – have died out of 7,447 confirmed cases. Health experts believe more people have caught swine flu but shown no symptoms.
In the United States, the official figures show 27,725 Americans have contracted H1N1, with 127 deaths. The Centres for Disease Control and Prevention, in Atlanta, estimates that a million Americans may have caught swine flu but not been to a doctor, suggesting that fatality rates are as low as 0.012%, Burns said.
The European Centre for Disease Prevention and Control reported on Thursday that of 69,177 cases which had been detected worldwide, only 328 people had died – a fatality rate of 0.47%.
However, Sir Liam Donaldson, the chief medical officer, said that it was not yet possible to work out the death rate from the virus, “given the unreliability of the data”, but that it would become clearer in the coming months.
The first batches of vaccine will arrive in August.
Although the UK has ordered enough for the entire population, it will arrive in batches. At-risk groups would get it first, said Donaldson: those especially vulnerable because of diseases which have compromised their immune systems or affect their breathing, such as asthma.
New flu strains cannot be eradicated. They simply become part of the seasonal flu mix. Donaldson said that swine flu could continue to cause extra deaths for five years. “We will need the vaccine in years to come,” he said.
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Will you call the swine flu helpline?
A national swine flu help service is being launched today to allow more access to Tamiflu. Do you trust others not to abuse it?
The national swine flu helpline is being launched today and it will enable anyone with the checklist of influenza symptoms to get a coded number for a prescription of Tamiflu. You will also be able to use a website that provides a voucher number for an individual dose of the drug.
Andy Burnham introduced the initiative, hoping it will ease the workload of staff in doctors’ surgeries and hosptials. He has stressed that the service will use an “encryption code” which will only allow one prescription per person.
Would you use the service, rather than making a trip to see your GP? And do you trust others not to abuse the system, visiting the website to get a Tamiflu prescription when they don’t really need it?