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The truth about sports drinks

July 28th, 2009 | No Comments

Sam Murphy reveals how much fluid you need to drink before, during and after a workout, and whether water does the job just as well as sports drinks

Do I really need a sports drink? Won’t water do?

It depends on the intensity and duration of your workout. “Water is generally sufficient for shorter sessions, but for exercise lasting more than 60 minutes, an isotonic sports drink is recommended,” says Wendy Martinson, registered dietician and sports nutritionist.

But Nick Morgan, head of sport science at Lucozade, believes sports drinks can be useful for shorter workouts, too: “If you’ve had a good high-carbohydrate meal in the three-four hours before your workout, you probably don’t need a sports drink”, he says. “But if you haven’t eaten for ages – if, for example, you’ve just got up or have hit the gym straight after work, a sports drink will provide a little extra energy, helping you get more out of yourself and reducing your ‘perception of effort.’”

Just for the record, a study in the Journal of Applied Physiology found that consuming an isotonic sports drink increased treadmill running time to exhaustion by 27% in recreational runners.

What should I look for in a sports drink?

According to Martin Gibala, an associate professor of kinesiology at McMaster University in Canada, there are two key ingredients in a good sports drink: “Carbohydrate, which provides fuel for working muscles, and sodium, which helps to maintain fluid balance.”

But formulation is key. An isotonic drink (such as Lucozade Sport or Gatorade) contains a 6-8% carbohydrate solution, which is absorbed into the body more rapidly than water, as well as providing energy. A sports drink should also contain approximately 50mg of sodium per 100ml, along with smaller amounts of the other electrolytes, such as potassium and chloride, which are lost in sweat.

Morgan highlights another important consideration: palatability. “Studies show clearly that if you don’t like the taste of a sports drink, you won’t consume enough of it.”

Are all sports drinks isotonic?

Confusingly, no. Lucozade Sport Hydro Active, for example, is ‘hypotonic’, meaning it contains a less concentrated carbohydrate solution (1-3%). “This will promote water absorption, but provides less carbohydrate energy and fewer calories,” explains Martinson.

At the other end of the scale are ‘hypertonic’ drinks, with a carbohydrate concentration greater than 10%. “These will have a slow gastric emptying rate, thus decreasing fluid absorption,” says Martinson. Energy drinks – including Red Bull – and soft drinks – such as Coke and Pepsi – come into this category, which makes them unsuitable for use during exercise.

How much do I need to drink?

In 2007, the American College of Sports Medicine, an international authority on sport science, revised its guidelines on fluid intake during physical activity, no longer suggesting specific volumes per hour. “We now know that individual needs vary so much it is impossible to suggest a ‘one size fits all’ amount that will suit everyone”, says Morgan. “Issues surrounding the risks of dehydration on one hand and hyponatraemia (water intoxication) on the other make this dangerous ground.”

So what’s the best way forward? Martinson advises calculating your own personal ‘sweat rate’ (see below) so that you can determine how much you need to drink. “Exercise performance is impaired when there is only a 2% decrease in body weight [due to fluid loss]“, she says. “Determining your own sweat rate will enable you to drink sufficient amounts of fluid to minimise weight loss to less than 2% body weight.”

According to Joseph Verbalis, Professor of the Department of Medicine at Georgetown University Medical Center, you should also listen to your body. “Thirst is a good indicator of your body’s need for fluid,” he says.

Working out your sweat rate

• Record your nude pre-training weight (in kg)
• Record your nude post-training weight, towelling off sweat first.
• Opt for a 30- or 60-minute session, during which you don’t consume fluid. (This makes the maths easier!)
• Subtract your post-training weight from pre-training weight to work out the weight lost, and multiply by 1,000 to convert to grams. The amount you lost in grams is equal to the amount of fluid you lost during that session. If you did a 30-minute session, multiply by two to get your ml per hour figure. This is the amount you should aim to consume in subsequent sessions. For example, if you lost 500g in 30 minutes, you’d be looking to consume 1000ml per hour.
• Bear in mind that the temperature, weather conditions and the intensity of the session will influence your fluid loss – factor this in when determining how much to drink in future sessions.

Should I drink before my workout, or just during?

It’s important to start exercise well hydrated. Research suggests that the body cannot absorb ingested carbohydrate efficiently if the body is dehydrated, so even if you are guzzling sports drinks, they may be of limited benefit. The ACSM recommends drinking 5-7ml of fluid per kg of your body weight in the three-four hours before exercise. (So, if you weigh 60kg that means drinking 300-420ml.) If your urine is still dark after this, they suggest drinking a further 3-5ml/kg. Water will do just fine – but, says Martinson, consuming a sports drink helps to top up carbohydrate stores.

Does it matter if I drink sports drink and water in the same session?

Martinson believes not. “You will still benefit from the carbohydrate and electrolytes in the sports drink even if you drink some water as well,” she says.

Scientists at the Gatorade Sports Science Institute, however, disagree, stating: “Watering down a sports drink dilutes the taste, carbohydrate content and electrolyte level – any of which will diminish its performance benefits.”

What about if I mix sports drinks with gels? Am I destined for the Portaloo?

Despite a belief among many runners and triathletes that you shouldn’t mix drinks and gels, according to Morgan it shouldn’t make any difference. “The important thing is to get enough fluid and enough carbohydrate on board – whatever the source,” he says. But like any nutrition or hydration strategy, you need to test it out in training.

Once I’ve finished exercising, is there any benefit in drinking a sports drink?

“You need to think about what kind of workout you’ve done and when you’ll next be exercising to determine whether a sports drink will help you recover,” says Morgan. If you’ve swanned around the gym for 20 minutes, forget it. If, however, you’ve done a tough session and will probably be doing another one within the next 48 hours, you’ll definitely benefit from taking extra carbohydrate on board within the first hour.

“Research also supports the practice of consuming protein after exercise to promote muscle recovery,” adds Gibala. Proprietary ‘recovery’ sports drinks typically tick both the carb and protein boxes, but research from Northumbria University found chocolate milk to be highly effective in facilitating recovery.

Other recent research, published in the Journal of Applied Physiology, found that athletes who added caffeine to their recovery cocktail had 66% more glycogen in their muscles four hours after finishing an intense workout.

I have ‘tidemarks’ on my clothes after exercise – should I take extra salt on board?

Tidemarks on clothes are an indication of a ‘salty sweater’. But, says Morgan, this alone is not reason to take extra salt on board. “It needs to be considered alongside the volume you sweat: so you could be a salty sweater who doesn’t lose much sweat (so not too much sodium lost) or a non-salty sweater who sweats buckets (increased loss of sodium.) If you sweat profusely and are a salty sweater there may be need for extra salt, but you would probably be suffering from cramping or extreme fatigue if this were the case.”

How to make your own sports drink

This sports drink recipe, provided by Wendy Martinson, will produce an isotonic drink containing 6-7% carbohydrate solution, depending on the type of squash used.

Mix 250ml ordinary squash or 200ml high juice squash (not sugar-free or low calorie) with 750-800ml cold water, or mix 100-110ml standard Ribena with 900-890ml cold water. Add 1.25g salt (1/2 level tsp).

More information

lucozade.com/sport
gssiweb.com
American College of Sports Medicine on exercise and fluid replacement

Do you swear by sports drinks during exercise, or does water keep you going? Will you change what you drink after reading this article? Let us know in the comments section below.

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Swine flu could fuel rise in litigation

July 27th, 2009 | No Comments

• Experts warn workers who contract virus could sue
• Businesses have been advised on staff welfare

Businesses could face a spate of legal claims from employees hit by swine flu, experts warn, as concerns mount that firms are not prepared to deal with legal issues arising from affected staff.

Personal injury, health and safety, and negligence claims are all likely, according to employment lawyers, as litigation has continued to rise during the recession.

“I can absolutely see claims in personal injury being brought by employees who say they contracted swine flu at work,” said Stephen Robinson, partner in employment law at Davies Arnold Cooper.

Caroline Doran, partner in employment law at Sprecher Grier Halberstam, said: “If employers don’t take some steps to consider what will happen if someone is affected, there are a myriad of health and safety and duty of care regulations that would come into play.”

Employers are already seeing increasing litigation by employees, with almost 190,000 employment tribunal claims last year, an increase of 43%. Lawyers say people most vulnerable from the pandemic – including pregnant women and those suffering disabilities – are particularly likely to sue if they can show adequate precautions, such as flexible working, were not offered by their employers.

“Once an employer knows an employee is pregnant, it has a duty to conduct a risk assessment and make arrangements to protect her safety and the safety of her baby whilst she is at work,” said Claire Dawson, employment lawyer at Russell Jones & Walker.

Last month the Cabinet Office organised a business advisory network for flu, with representatives from 130 business and groups warning of the likely rates of absenteeism as the pandemic spreads.

The news comes as lawyers warn that compared with ordinary seasonal flu outbreaks, the scale of the swine flu pandemic places a high duty of care on employers to take precautions for their staff. The government, however, said it had fully advised businesses about such measures.

“We have certainly done everything we can to provide information to business on what they can do to avoid the pandemic,” a spokesman for the Department for Business, Innovation and Skills said. “We have stressed the importance of contingency planning but operational decisions are up to individual businesses.”

The effects of swine flu on businesses have already caused alarm among many, with the chairman of the Federation of Small Businesses, John Wright, predicting a 5% fall in GDP this year. The news comes as a campaigning organisation said that new European regulations limiting doctors’ hours should be suspended to help the NHS deal with swine flu.

“Millions have been spent on staff call-centres using non-medical staff to diagnose and prescribe,” said Richard Marks, head of policy at Remedy. “But at the same time they are reducing doctors’ working week by one full day. It’s probably the worst time in living memory to do this.”

The Department of Health said there would be flexibility if necessary. “Healthcare staff can work longer hours when they need to. During national emergencies there are special provisions … for emergency situations,” said a spokesman.

The Conservatives claimed that there is “huge variation” around the country in the number of collection points for antiviral drugs. In 10 primary care trust areas, there are more than 30, they said, while in 47 PCTs, there is just one. The shadow health minister, Stephen O’Brien, said the figures raised questions about the government’s handling of swine flu.

The Department of Health said the number of collection points was increasing rapidly, from 330 when the pandemic flu service opened on Thursday, to 1,149 yesterday. “People in need of antivirals are able to get them quickly and conveniently and it is freeing up GPs to look after patients in risk groups as well as those with other illnesses,” said a statement.

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The tough get going

July 27th, 2009 | No Comments

Thousands of tough guys and gals battle through fire, nettles and barbed wire in the annual event


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Iced coffee calories ‘raise cancer risk’

July 27th, 2009 | No Comments

Drinks such as frappuccinos found by World Cancer Research Fund to have as many calories as an evening meal
• Datablog: get the numbers behind this story

Iced versions of normal coffee such as frappuccinos contain so many calories that they increase people’s chances of becoming overweight, the second biggest cause of cancer after smoking, according to the World Cancer Research Fund (WCRF).

A survey of iced coffees sold by high street chains Starbucks, Caffe Nero and Costa Coffee identified the worst culprit as the venti dark berry mocha frappuccino at Starbucks, which contains 561 calories. Even without whipped cream it still has 457 calories.

Health experts advise that a woman should consume about 2,000 calories and a man 2,500 calories per day to maintain a healthy weight.

“The fact that there is an iced coffee on the market with over a quarter of a woman’s daily calorie allowance is alarming. This is the amount of calories you might expect to have in an evening meal, not in a drink,” said Dr Rachel Thompson, science programme manager at the WCRF.

Having such drinks as an occasional treat is fine, she said.

“But if you are having them regularly then they will increase the chances of you becoming overweight, which in turn increases your risk of developing cancer, as well as other diseases such as heart disease and diabetes.”

At Caffe Nero the double chocolate frappe and mocha frappe latte with semi-skimmed milk contains 483 calories, while the skimmed milk version has 452. At Costa Coffee, a massimo coffee frescato contains 332 calories, and a massimo iced mocha with full fat milk has 361.

A spokeswoman for Starbucks did not dispute the calorie counts produced by the WCRF but added that the company sold many low-calorie coffees.

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Fast-tracked flu vaccine ‘will be safe’

July 27th, 2009 | No Comments

• EU accelerates approval process for treatment
• WHO chief warns of dangers of untested jabs

The World Health Organisation has raised concerns about the fast-track production of the swine flu vaccine in Europe, where the treatment is due to be made available at least two months earlier than in the US. Britain is expected to be the first country in Europe to provide the vaccine, with the first of 132 million ordered doses due to be administered next month.

The European Medicines Agency (EMA), the drug regulatory body for the EU, is accelerating the approval process for the vaccine, and countries including Britain, Greece, France and Sweden plan to start using it as soon as it is cleared. The most vulnerable groups, such as pregnant women and young children, will be given priority.

To ensure the vaccine is available as soon as possible, the EMA is allowing companies to bypass large-scale human trials. Amid concerns about bird flu several years ago, the EMA designed a protocol to fast-track the approval of a vaccine. It let companies submit data for a “mock-up” vaccine, using H5N1 avian flu. The idea was to do most of the testing before a pandemic, so that when it hit, the drug companies could insert the pandemic virus into the vaccine.

When the first doses are ready, the EMA will approve them largely based on data from the bird flu vaccine, since both will have the same basic ingredients. The agency will then require regular reporting of the vaccine’s effects as it is being administered, monitoring that is normally done beforehand.

The US government is taking a more cautious approach, calling for several thousand volunteers to be injected with the vaccine in tests beginning in August to assess its safety. Officials say the results should be ready in time for the vaccination programme to roll out in October.

But some US officials believe the European approach is the best option. “The consequences of not having a vaccine if this virus gets worse are very high,” said Leonard Marcus, a public health expert at Harvard University. “If [regulatory authorities] took all the time that was necessary to make sure there are no side effects, ironically, in the effort to save a few lives, many lives could be lost.”

An EMA spokesman said: “Everybody is doing the best they can in a situation which is far from ideal. With the winter flu season approaching, we need to make sure the vaccine is available.”

Dr Keiji Fukuda, the WHO’s flu chief, warned about the potential dangers of untested vaccines. “There are certain areas where you can make economies, perhaps, but certain areas where you simply do not try to make any economies,” he told Associated Press.

The Department of Health said it was “extremely irresponsible” to suggest the UK would use an unsafe vaccine. A spokesman said: “In preparing for a pandemic, appropriate trials to assess safety and the immune responses have been carried out on vaccines very similar to the swine flu vaccine. The vaccines have been shown to have a good safety profile. Over 40,000 doses of the vaccines which the swine flu vaccines are based on have been given without any safety concerns.”

Professor Steve Field, chairman of the Royal College of GPs, added: “I’m sure the vaccine programme won’t be allowed to commence until adequate safety checks have been carried out.”

Earlier this month the head of the WHO, Dr Margaret Chan, said that while a vaccine might be produced next month the clinical trial data to ensure it was safe would not be available for a further two to three months.

Pharmaceutical companies, including GlaxoSmithKline, which is producing the vaccine for Britain, insist they will be able to start shipping the first batches of vaccine before then.

Meanwhile 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 and question the conflicting advice given to the public, in particular to vulnerable groups such as expectant mothers.

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Games tsar will ensure 2012 legacy

July 26th, 2009 | No Comments

The government is to counter criticism that it is failing to deliver on the promises that helped win the 2012 Olympic Games for London by appointing a “sports legacy tsar”, to get more people participating in sport and help attract private sector investment.

Ministers are looking for a high-profile figure who could be a former Olympic athlete or an influential name who has experience of running a sporting body.

With the Olympic flame due to be lit in the new stadium in Stratford, east London, three years from tomorrow, there is increasing optimism that organisers will deliver the games on time and within the £9.3bn budget, despite the impact of the recession. But opposition MPs and senior sports figures have told the Guardian that there remain serious questions over the legacy of the 2012 Games. In particular, there are concerns over promises to use the Olympics to increase sporting activity and fight obesity.

Critics claim that “four years have been wasted” in devising a strategy to deliver on the promise of getting 1 million people taking part in more sport by 2012 and a broader pledge to get 1 million more participating in physical activity, including walking and gardening.

Organisations including the British Olympic Association and the CCPR (Central Council of Physical Recreation), which represents hundreds of governing bodies, have voiced concerns that plans to use the Olympics to make a “once in a lifetime” change in the population’s sporting habits are yet to have any impact at grassroots level. The shadow sports minister, Hugh Robertson, said: “The lack of a proper strategy for delivering our participation promises is the single biggest problem with the Olympics.”

The Liberal Democrat Olympic spokesman, Tom Brake, said “alarm bells must be ringing in government”, which “may have bitten off more than it can chew”. The CCPR chair, Brigid Simmonds, added: “We have been saying for some time that the Olympics will have a long sunrise and a very short sunset. If we don’t get it right, this huge opportunity will be lost. With three years to go, let’s grasp it and let’s get on with it.” In response, it is understood that the sports minister, Gerry Sutcliffe, who remains confident that the targets can be achieved, plans to convene a new team led by a “legacy tsar” to co-ordinate sport participation.

The government believes that it has put all the necessary building blocks in place, including getting the various agencies working harmoniously and doubling sports funding in the three years since 2005, but acknowledges that a more co-ordinated national approach is required.

“Some regions are getting on and doing it and others are sitting back and waiting for something to happen,” Sutcliffe said. “It’s got to be about inspiration as well. The athletes need to be out in their communities inspiring people.”

It will also co-ordinate a drive to get private backers involved in the legacy push. Adidas will announce that it is rolling out its “sportszone” concept around the country following a trial in London, and there are hopes that other Olympic sponsors will want to get involved with legacy projects. Figures released last week by Sport England, the body charged with delivering the 1 million participation increase and investing £480m of lottery and public funds in grassroots sport between 2009 and 2013, revealed that progress appeared to have stalled.

Quarterly figures showed that of 31 sports measured according to how many people played them at least once a week, only table tennis recorded an increase. Nine – including swimming, football, gymnastics and rowing – showed a decline and the rest showed no change.

In order to achieve its target, Sport England must boost the 6.8 million people playing sport for 30 minutes at least three times a week by 1 million. The other 1 million, to be delivered through other government agencies including the National Health Service, must be doing some form of physical activity for 30 minutes at least three times a week. Sport England argues that the quarterly survey is merely a guide and that the next annual survey, due in December, will give a clearer idea of progress under a plan launched earlier this year to invest the bulk of its lottery and public funds directly through sport governing bodies.

It was partly the bold legacy promises made by London Organising Committee chairman, Seb Coe, that the Olympics would transform the East End of London, inspire a generation of young people through sport and deliver health benefits for the entire nation that helped convince International Olympic Committee members to vote for the city in 2005.

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Catacombs may be swine flu morgue

July 25th, 2009 | No Comments

Exeter city council plans to use 19th century burial chambers as emergency mortuary if pandemic worsens

A city council is considering using 19th century catacombs to store the bodies of swine flu victims if the outbreak worsens, it was confirmed today.

Exeter city council has identified the empty underground burial chambers, currently used as a tourist attraction, as a potential mortuary.

A council spokesman said the plan would be implemented if the crematorium and cemeteries could not keep up with funeral demands.

“We have some empty catacombs in an old cemetery in the city,” he said. “These are 19th century underground burial chambers which are normally a tourist attraction. They can, however, be safely used for their original purpose and allow us to temporarily store bodies in the remote possibility that the need should arise.”

So far at least 31 people have died in the UK after contracting the virus. Yesterday, the World Health Organisation said 800 people had now died worldwide from the H1N1 virus and as many as 2 billion people could eventually be infected.

Doctors have warned that NHS intensive care wards could be overwhelmed by severely ill swine flu patients if infection rates climb rapidly.

The growing pressure on critical care beds was underlined this week when a pregnant 26-year-old was flown from a hospital in Kilmarnock to Sweden for life-saving treatment because of a shortage of equipment in Britain. Sharon Pentleton’s family said she was gravely ill, but her doctors believe she has a good chance of recovery.

According to Dr Alan Hay, director of the WHO’s London-based world influenza centre, the first wave of UK infections is likely to peak within the next week or two before re-emerging in the winter.

Research published in the journal Anaesthesia suggests that when the peak comes, demand for intensive care beds could outstrip supply by 130% in some regions, while the demand for ventilators could exceed supply by 20%. Paediatric facilities are likely to become “quickly exhausted” as hospitals confront “massive excess demand”, according to experts in intensive care and anaesthesia from the University of Cambridge, the Intensive Care Society and St George’s Healthcare NHS trust in London.

The Department of Health said the NHS was prepared for the pandemic. “Guidance has been issued which contains information for primary and secondary care services in the UK on managing surge capacity and the prioritisation of services and patients during a widespread influenza outbreak,” a spokesman said.

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Swine flu ‘could overwhelm critical care units’

July 24th, 2009 | No Comments

Intensive care wards could be overwhelmed by severely ill swine flu patients if infection rates in the UK climb rapidly, doctors are warning.

The growing pressure on critical care beds was underlined by the flying of a pregnant 26-year-old from a hospital in Kilmarnock to Sweden for life-saving treatment because of a shortage of equipment in Britain. Sharon Pentleton’s family said she was gravely ill, but her doctors believe she has a good chance of recovery.

Yesterday, the World Health Organisation said 800 people had now died worldwide from H1N1 flu and as many as 2 billion people could eventually be infected.

According to Dr Alan Hay, director of the WHO’s London-based world influenza centre, the first wave of UK infections is likely to peak within the next week or two before re-emerging in the winter.

Research published in the journal Anaesthesia suggests that when the peak comes, demand for intensive care beds could outstrip supply by 130% in some regions, while the demand for ventilators could exceed supply by 20%. Paediatric facilities are likely to become “quickly exhausted” as hospitals confront “massive excess demand”, according to experts in intensive care and anaesthesia from the University of Cambridge, the Intensive Care Society and St George’s Healthcare NHS trust in London.

Hospitals on the south-east coast, and in the south-west, east of England and east Midlands are likely to be worst hit, they said. Dr Ari Ercole, of the University of Cambridge, said: “Early experience of the present strain suggests that the attack rate is particularly high in the young and that this virus may severely compromise the immune systems of people who contract it.”

Up to 15% of those admitted to hospital with swine flu require intensive care treatment, according to figures from Australia.

Another problem also emerged yesterday. Professor Mike Morgan, who chairs the British Thoracic Society, warned that patients with pneumonia could be misdiagnosed as having swine flu and given anti-viral drugs rather than antibiotics. “Among all the people with swine flu there may be people who have pneumonia and get missed,” he said. “Antibiotics are used against pneumonia and the concern is that people will be given Tamiflu instead.”

It has been revealed that Sainsbury’s will opt out of distributing Tamiflu over fears of encouraging people with swine flu into its stores. Tesco and Asda have signed up some pharmacies as collection points. But while some Sainsbury’s pharmacies are supplying the drug there are no plans for the chain to become an official collection point. A spokesman said: “A supermarket, with thousands of daily visitors, is not a suitable collection point as it would lead to increased risk to shoppers and colleagues.”

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First swine flu wave may have peaked

July 24th, 2009 | No Comments

Flu expert says cases could drop in next fortnight before virus returns in the winter
• Datablog: swine flu cases where you live

The number of swine flu cases in Britain may drop within the next two weeks before a return of the virus this winter, a flu expert said today.

Alan Hay, of the World Influenza Centre in London, suggested the first wave of illness may have already peaked but could not predict how far levels would fall in this phase of the pandemic.

His remarks came the day after the government said about 100,000 people in England caught swine flu last week, nearly double the figure for the previous week.

Hay told Radio 4′s Today programme: “I think we will see a peak in this country in the next week or two, if not already. It will reduce. We don’t know to what extent the level will drop down to a background level. We’ve seen in the US, although they peaked many weeks ago, that the level of infection in some of the states is still quite widespread.

“So it is a bit early to predict the trough that we will see before we see the virus re-emerge in this country.”

Hay, talking about the government’s response to the pandemic, said: “We’ve only really observed this over the last few weeks so, in terms of response, of course people could have done more sooner but that again might have raised greater alarm over the population.”

Current levels of flu infection were the highest since the 1999-2000 winter season. One of the differences was that swine flu appeared to adversely affect under-45s. “There is some information which suggests that people over the age of 60 or so may well have some immunity against the virus because of some prior exposure to a similar virus.”

Meanwhile, a 26-year-old pregnant woman who is critically ill with swine flu is undergoing specialist treatment in a Swedish hospital today because there are no spare beds at the UK unit.

The Scot was admitted to hospital in Kilmarnock, near Glasgow, last week where she was put on a ventilator because of an extreme reaction to the H1N1 virus. The specialist care team there recommended she received a procedure called extra corporeal membrane oxygenation (ECMO). This technique is used when a patient’s lungs are working poorly even with ventilation and high levels of oxygen. It involves circulating the patient’s blood outside the body and adding oxygen to it artificially. The national ECMO centre in Leicester has five beds but all are being used.

Under pan-European arrangements for sharing scarce medical resources, a bed was found in a similar unit in Stockholm. Robert Masterton, executive medical director of NHS Ayrshire and Arran said: “The family have been fully involved in this decision and support the referral. They have asked for privacy while they concentrate on the patient’s treatment and recovery.”

The government’s swine-flu diagnosis website for people in England was running smoothly today after an inauspicious launch yesterday. The service was suspended within minutes because it could not cope with the traffic, with 2,600 people trying to access it every second.

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Hospitals face swine flu bed shortage

July 24th, 2009 | No Comments

Children’s units in hospitals will be particularly vulnerable, researchers predict

The swine flu pandemic could cause a severe shortage of intensive care beds in hospitals, especially in children’s units, experts warned today.

More than double the present number of beds may be needed in some regions, while there could also be shortages of ventilators to help patients breathe.

Facilities for children were likely to become quickly exhausted, while hospitals could face massive extra demand, researchers said in the journal Anaesthesia. Hospitals in the south-east, south-west and east of England, as well as the east Midlands, were likely to be hardest hit.

The predictions came as a pregnant woman from Scotland, critically ill with swine flu, was flown for specialist treatment to Sweden because the five beds at the UK specialist centre for her condition in Leicester were full.

As Alan Hay, an expert in swine flu, suggested that the first wave in the UK may be passing its peak before returning this winter, specialists in intensive care and anaesthesia from the University of Cambridge, the Intensive Care Society and St George’s Healthcare NHS Trust in London said English hospitals might be unable to cope with the number of people who fell ill with swine flu.

At present, the government says 840 people are in hospital in England – 63 in intensive care. An estimated 100,000 people fell ill last week, double the previous week’s total.

The intensive care experts predicted London would have enough beds and ventilators but demand for beds could be 130% above supply in the South East Coast Strategic Health Authority area and 120% above supply in the south-west. Similar levels of demand could occur in the east Midlands and east of England. Across the whole of England, demand for beds could be 60% above numbers available. The government has insisted it can cancel non-emergency operations to free up beds for swine flu patients, but the experts did not believe this would be sufficient.

“Only 10% of critical care beds in England are in specialist paediatric units, but best estimates suggest 30% of patients requiring critical care will be children,” said their paper.

“Paediatric intensive care facilities are likely to be quickly exhausted and suggests that older children should be managed in adult critical care units to allow resource optimisation.”

Ari Ercole, from Cambridge University, who worked on the study, said the researchers recognised the pandemic was in its early stages. “However, based on figures provided by the 10 regional health authorities and using the Flusurge model developed by the Centres for Disease Control and Prevention in the US, we can see that hospitals would face a massive excess demand even if the pandemic lasted an optimistic 12 weeks.

“Paediatric intensive care facilities for children under 15 would be quickly exhausted, as they make up 10% of our current provision but could face 30% of the demand for pandemic related beds. Early experience of the present strain suggests that the attack rate is particularly high in the young and that this virus may severely compromise the immune system of people who contract it.”

The team behind today’s UK research calculated an average of 4.5 critical care beds per 100,000 people in England would be needed. In London, there are 7.5 per 100,000, 5.9 in the north-east, five in the north-west and 4.4 in Yorkshire and the Humber.

The lowest number of beds is in the south-east, which has three per 100,000 people. They said that, using numbers based on historical assumptions, “it has been shown that a flu epidemic could potentially overwhelm critical care bed and ventilator capacity in England”.

While extra beds could be made available by cancelling routine operations, “this would have important implications for ongoing acute and elective service provision”.

They said the total number of critical care beds in England currently stands at 2,030 adult beds and 265 for children.

An additional 1,607 adult high dependency beds are also available alongside 43 high dependency beds for children, which could be used to ventilate people.

“Nevertheless the calculations still show that even this number could be far too small to cope with demand.

“Additionally, since many intensive care units (and acute hospital beds) run at high occupancy, much of this capacity would not be available during a pandemic,” the paper said.

“Whilst regional variations in critical care provision exist, the data suggests that these are small and so inter-hospital transfer is unlikely to provide a solution to an overwhelming pandemic.”

Professor David Menon, one of the authors from the University of Cambridge, said the figures used in the research could fall on the conservative side.

It was possible that four times as many patients would be admitted to hospital as suggested, of whom about half would need intensive care.

He also said that between 10% and 50% of patients in intensive care with swine flu were suffering renal failure and requiring kidney support.

“If it’s 10% then we should be able to cope reasonably well but if it’s 50% then it would be a big task,” he said.

“We don’t have the equipment to deliver that level of support.”

In an accompanying editorial, Dr Jonathan Handy, a consultant at the Chelsea and Westminster hospital in London, said the predicted demand levels suggested immediate action was needed, from stockpiling supplies to looking at how medical students could play an active role in patient care.

A spokeswoman for the Department of Health said: “We can’t be certain how the current pandemic will develop, but we have to prepare for the reasonable worst case.

“As part of our preparations, guidance has been issued which contains information for primary and secondary care services in the UK on managing surge capacity and the prioritisation of services and patients during an influenza widespread outbreak.

“The guidance also identifies how maintaining an essential health service will be a community effort involving self care, support for those for whom hospital admission is not deemed appropriate, and supporting early discharge of patients from hospital.”

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New swine flu cases double in a week

July 24th, 2009 | No Comments

About 100,000 people caught swine flu in England last week, the chief medical officer revealed today, as the government’s online diagnosis service crashed within minutes of launch when thousands of people tried to log on at the same time.

The rapid spread of the virus was confirmed as the National Pandemic Flu Service – dispensing advice and anti-viral prescriptions over the telephone and online – went live to relieve pressure on GPs.

The world’s first government-run swine flu diagnosis website could not cope with the volume of traffic when it opened for business at 3pm today. Designed to handle 1,200 hits a second, the service was suspended just four minutes later when 2,600 people tried to access it every second.

The service’s inauspicious launch came as new official figures on consultation rates with GPs showed that:

• the infection has spread broadly across the country from the hotspots where it was initially concentrated;

• under-14s are the most affected;

• 840 patients in England are receiving hospital treatment for illnesses associated with the H1N1 virus, of whom 63 are in intensive care. Comparable figures for the previous week were: 652 in hospital and 53 in intensive care.

In another development, a pregnant woman critically ill with swine flu was transferred to Sweden for specialised treatment after suffering a rare complication.

The 26-year-old Scot was flown out because all five beds were occupied at the national unit in Leicester that provides the highly specialised procedure known as extracorporeal membrane oxygenation (ECMO), which involves circulating the patient’s blood outside the body and adding oxygen to it artificially.

Nationally, the Department of Health said there were hopeful signs, producing a revised death rate that showed lower than anticipated fatalities and suggesting there could be a lull in infections over the summer.

Following a rigorous investigation of reported fatalities, Sir Liam Donaldson, the chief medical officer, said there had been 26 “provisionally validated” swine flu deaths in England since the beginning of the outbreak. Combined with four deaths reported in Scotland, the UK total stood at 30.

Unlike normal seasonal flu, which is a threat primarily to the pneumonia-prone elderly, the H1N1 virus appears to affect the young more severely. Of those who have died in England, a third were under the age of 15 while only 17% of fatalities have been among pensioners.

Within the same sample of 26 deaths, two-thirds of the victims had what were described as pre-existing “severe conditions” such as leukaemia, and only 16% were described as fully “healthy”.

The infection rate has almost doubled from an estimated 55,000 new cases in the previous week to 100,000 fresh cases. A slight dip in daily consultation rates with GPs within the last few days has given some health officials hope that the first wave of infections may have peaked in Britain, Donaldson said. “You will see a suggestion of a downturn but I don’t think you can read too much into it at this stage,” he added.

A scenario anticipated by Department of Health officials and those from other departments who meet regularly in the Cabinet Office’s emergency planning committee, Cobra, is for a slowdown in the infection rate during the summer when schools are closed. The outbreak may pick up pace again in the autumn.

Donaldson said there was no evidence of the virus becoming more virulent and stressed that for most people it would be relatively mild. He denied there was a danger of a shortage of respirators for children in intensive care beds. “We can expand capacity somewhat in the event of an emergency by cancelling some routine operations,” he added.

The fact that rates of influenza-like illness are running at a far higher level than those normally observed during high summer remains a puzzle for scientists. In previously severe outbreaks activity dipped.

“This level in July and August is highly unusual,” Donaldson said.

Tower Hamlets in east London continues to be the primary care trust with the highest number of GP consultations for people with flu-like illness. It is seeing 792 consultations for every 100,000 people, followed by Islington in north London with 488 consultations for every 100,000 people.

Other parts of England that are severly affected include Greenwich, south-east London, Leicester, and Telford and Wrekin, Shropshire. In Wales, 3,075 people contacted their GPs in the past week with symptoms of the H1N1 virus.

Swine flu infection rates in Scotland appear to have reached record levels, with the virus spreading uniformly across the country, despite hopes the outbreak may have peaked.

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840 people being treated for swine flu in hospitals

July 23rd, 2009 | No Comments

• Latest figures show 100,000 cases recorded in past week
• National Flu Pandemic Service can take 1m calls a week

The website for the new national pandemic flu service in England crashed on launch today as the government announced that the number of new swine flu cases had doubled in a week and that 840 people were seriously ill in hospital.

People trying to access the site, which was officially launched at 3pm, were told it is “currently very busy and cannot deal with your request at this time”.

Viewers were told to try again “in a little time”. The website crash is potentially extremely embarrassing for the government, which promised it would be launched only when it had been proved capable of coping with the expected traffic.

The service is designed to take pressure off GPs, help patients diagnose themselves and gain access to antiviral drugs without formal prescriptions, although callers are issued with identification numbers.

Liberal Democrats said the website crash raised serious questions about the robustness of the system. “The government claims the reason for the delay in setting up this service was because they needed to thoroughly test it to ensure this wouldn’t happen,” said health spokesman Norman Lamb. ” It is absolutely vital that the public has access to a reliable source of information on swine flu to provide reassurance and take the pressure of GP surgeries.”

Meanwhile the government’s chief medical officer said in the UK as a whole, 840 people were seriously ill in hospital with swine flu and 100,000 new cases had been recorded in the last week. The number of people in hospital included 63 in intensive care.

The figures were given by Sir Liam Donaldson during a press conference at the Department of Health, to provide a weekly update on the progress of the disease throughout Britain.

The number of deaths associated with the swine flu outbreak has risen to 30. Last week the government announced there had been 29 deaths in total and 55,000 new cases in the previous week.

The National Flu Pandemic Service for England, which started today, will be capable of answering more than a million calls a week, it was confirmed today. It will be staffed by more than 1,500 people, with the option of recruiting 500 more.

They will, it is hoped, be capable of answering more than 200,000 calls a day. There will be an alternative internet service where people answer a questionnaire to receive a diagnosis of swine flu and are given a unique code authorising the release of antiviral drugs.

The details emerged as scientists suggested the outbreak may have peaked for in Scotland, implying that the surge in cases in England could also subside within weeks. One of the planning scenarios used by the DoH assumes the figures will fall during the summer, when schools are on holiday, and then surge again once term starts in the autumn.

People whose holiday plans have been wrecked by swine flu, because of a diagnosis through the pandemic flu service in England, will have to keep the label from the anti-flu drugs they collect if they are to claim from insurers, the Association of British Insurers (ABI) said last night.

Insurers usually require a medical certificate from a GP or other medically qualified staff, and had raised concerns that people would be given diagnoses and access to drugs by people who were not medically qualified.

Nick Starling, the ABI’s director of general insurance and health, said it had been told by the government the service would authorise an anti-flu prescription only to those genuinely displaying signs of flu.

“On that basis, travel insurers will accept an individual’s unique ID number generated by the national flu service together with the label on their anti-flu drugs which states their name and date of issue, as proof of diagnosis to validate a travel insurance cancellation claim.”

The archbishops of Canterbury and York have recommended the suspension of the sharing of the chalice at communion as the spread of swine flu continues, it was announced today.

The archbishops have written to bishops in the Church of England setting out the new measures following DoH advice not to share “common vessels” for food or drink.

The letter said it aimed to offer guidance at a national level about how church worship could “best take into account the interests of public health during the current phase of the swine flu pandemic”.

Some bishops have already taken the step to limit the spread of the virus.

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‘After losing my hair I was bullied’

July 23rd, 2009 | No Comments

For me, losing my hair wasn’t the hard bit – learning to live with it as a teenager was. I don’t remember losing my hair when I was five. My mum thinks it could have been linked to her separating from my dad or a bad bout of chickenpox, but I’m not sure.

She found the first bald patch, the size of a two pence piece, four months before my sixth birthday, and eventually I only had wispy strands left that I wouldn’t let her shave. I don’t remember getting upset, though. I was just a normal little girl, with no hair.

We tried lots of treatments for this alopecia – steroids and medication called Minoxidil. I can remember wearing funny caps with creams underneath when friends were round. I never minded. But when I was nine, a doctor bluntly told me my hair would never grow back.

As a younger teenager I was happy and popular. Friends chattered to me about hair and makeup and never treated me differently. I was fine without hair. Then, when I was 14, two girls picked on my cousin and I stuck up for her. They called me “too gobby for a girl with no hair”, and I was followed, threatened and bullied. Things died down but months later, in June, I was badly beaten. We were hanging out and someone shouted, “Jade, run!” One of the girls was running at me with a huge crowd. The last thing I remember is her smashing my head against the ground. I ended up in A&E and afterwards my head was covered in lumps, bumps and grazes and I had a big black eye.

But it was the after-effects that hurt the most. When I took off my makeup, my eyelashes came off on the baby wipe. It was like experiencing alopecia for the first time. Every time I wiped, more eyelashes came out – every last beautiful one. They were my pride and joy. My friends had joked I spent longer on my mascara than they did styling their hair.

After that I wouldn’t leave the house. I wouldn’t sleep alone and I couldn’t face school. When I tried to return, a boy innocently said I looked different and I couldn’t go back for weeks. Before, I coped with people staring but without my confidence, I couldn’t take it. I started drinking and coming home late. Then, one awful night, I argued with mum, ran upstairs and accidentally dropped a glass. That’s when I did it – slashed my arms and legs, still crying.

The next day, I felt so ashamed. I had to tell my mum the truth, although I knew it would hurt her. She rang the doctor and organised counselling for me. That was a turning point. I worked hard to deal with my feelings and I also met my boyfriend Ryan, who I’ve been with for two years.

Before, “wig” was a dirty word in our house – I thought it was like hiding – but when I was 15, I decided I wanted hair for my prom. I had read about a treatment that sounded great, but cost £1,500. My mum’s colleagues held fundraisers for me and I had the treatment on my 16th birthday. The hair was tied to fine lace and fixed with tape. Ryan hadn’t wanted me to have a wig, but he was so pleased to see me happy.

Later I started having problems with the hair. It was unnaturally thick, the tape kept peeling off and it attracted dirt. I had to keep getting new hair tied into it, and they used any colour. The final straw was when it dropped off in the bath, in a knot of dreadlocks.

I was finally ready to try wigs.

I found a realistic one with a silicone back in a shop near my home in Heywood, Greater Manchester. It was expensive but the shop’s owner said I could have it for free if I modelled it for her website.

The wig is perfect. I can take it on and off, and get it glued on if I want. I’m not so bothered about having alopecia now. Actually, I think God helped me out because if I had to do my hair every day, it would drive me mad!

I’d always wanted to be a hairdresser but I thought dealing with other people’s hair would be too painful. Now that I have my wig, I know I can do it. I’ve met other people with alopecia and they often lack confidence. They shouldn’t – they can do anything they want.

As told to Victoria Holman

For more information: alopeciaonline.org.uk

• To respond to this article or if you have a story to tell about your life email my.story@guardian.co.uk. If possible, please include a phone number

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840 people treated in UK hospitals due to swine flu

July 23rd, 2009 | 1 Comment

• Latest figures show 100,000 cases recorded in past week
• National Flu Pandemic Service can take 1m calls a week

There are 840 people seriously ill in hospital with swine flu and 100,000 new cases have been recorded in the past week, according to the government’s chief medical officer.

The number of people in hospital includes 63 in intensive care.

The figures were given by Sir Liam Donaldson during an early afternoon press conference at the Department of Health, providing a weekly update on the progress of the disease throughout Britain.

The number of deaths associated with the swine flu outbreak has risen to 30. Last week the government announced there had been 29 deaths in total and 55,000 new cases in the previous week.

The National Flu Pandemic Service for England, which started today, will be capable of answering more than a million calls a week, it was confirmed today. It will be staffed by more than 1,500 people, with the option of recruiting 500 more.

They will, it is hoped, be capable of answering more than 200,000 calls a day. There will be an alternative internet service where people answer a questionnaire to receive a diagnosis of swine flu and are given a unique code authorising the release of anti-viral drugs.

The details emerged as scientists suggested that the outbreak may have peaked for now in Scotland, implying that the surge in cases in England could also subside within weeks. One of the planning scenarios used by the DoH assumes that the figures will fall back during the summer, when schools are on holiday, and then surge again once term starts in the autumn.

One of the UK’s leading bacteriologists, Professor Hugh Pennington, said this morning that Scotland was “possibly through the worst of this phase of the virus”.

Cases in the worst Scottish hotspots – Glasgow and Paisley – began to tail off earlier this month. That is one of the reasons why Scottish health ministers are not following moves in England to set up a national flu pandemic helpline – existing NHS services are able to cope with the current rate of cases.

The H1N1 virus caught hold in Scotland more quickly, after the first cases in the UK emerged in the small town of Polmont near Falkirk in April, and the first death of a swine flu patient outside the Americas.

To the surprise of experts, the virus was confined largely to three clusters, in southern Glasgow, Paisley and Dunoon, which erupted in May and June. The outbreak in Dunoon subsided quickly. Reported flu cases in the greater Glasgow area – which saw the first swine flu deaths in the UK – have also declined.

Last week the Scottish health secretary, Nicola Sturgeon, said the overall rate of people reporting flu-like symptoms was not significantly higher than normal for this time of year. She said there were “encouraging signs” that cases were declining in the Glasgow area.

Prof Pennington, speaking on BBC Radio Scotland this morning, also cautioned against the rush to set up mass vaccinations of the population before the vaccine had been fully tested – a move being considered by ministers.

He said proposals to bypass normal testing procedures were laid out in the flu pandemic plan, but this virus was not proving as fatal or virulent as predicted in the plans. Pennington suggested it may be wiser to wait until the vaccine had been fully tested and if necessary altered before rushing it out.

The Archbishops of Canterbury and York have recommended the suspension of the sharing of the chalice at communion as the spread of swine flu continues, it was announced today.

The archbishops have written to bishops in the Church of England setting out the new measures following DoH advice not to share “common vessels” for food or drink.

The letter said it aimed to offer guidance at a national level about how church worship could “best take into account the interests of public health during the current phase of the swine flu pandemic”.

Some bishops have already taken the step in a bid to limit the spread of the virus.

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Will you call the swine flu helpline?

July 23rd, 2009 | No Comments

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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Will you call the swine flu helpline?

July 23rd, 2009 | No Comments

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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Scottish swine flu ‘may have peaked’

July 23rd, 2009 | No Comments

Expected decline in cases could be followed by similar tailing off in England within weeks
• Datablog: full list of swine flu cases

The current swine flu outbreak may now have peaked in Scotland, experts believe, suggesting that the surge in cases in England will subside within weeks.

One of the UK’s leading bacteriologists, Professor Hugh Pennington, said this morning that Scotland was “possibly through the worst of this phase of the virus”.

Despite a steep increase in cases in England, it is expected the latest Scottish estimated figures will show a decline when they are released later today after cases in the worst hotspots – Glasgow and Paisley – began to tail off earlier this month.

As a result, Scottish health ministers are not following moves in England to set up a national flu pandemic helpline because existing NHS services are able to cope with the current rate of cases.

The H1N1 virus caught hold in Scotland more quickly, after the first cases in the UK emerged in the small town of Polmont near Falkirk in April, and the first death of a swine flu patient outside the Americas.

To the surprise of experts, the virus was confined largely to three clusters – in southern Glasgow, Paisley and Dunoon, which erupted in May and June. The outbreak in Dunoon subsided quickly. Reported flu cases in the greater Glasgow area – which saw the first swine flu deaths in the UK – have also declined.

Last week, the Scottish health secretary, Nicola Sturgeon, said the overall rate of people reporting flu-like symptoms was not significantly higher than normal for this time of year. She said there were “encouraging signs” that cases were declining in the Glasgow area.

Prof Pennington, speaking on BBC Radio Scotland this morning, also cautioned against the rush to set up mass vaccinations of the population before the vaccine had been fully tested – a move being considered by ministers.

He said proposals to bypass normal testing procedures were laid out in the flu pandemic plan, but this virus was not proving as fatal or virulent as predicted in the plans. Pennington suggested it may be wiser to wait until the vaccine had been fully tested and if necessary altered before rushing it out.

The Guardian revealed today that Scotland’s flu pandemic plans – drafted last year before the swine flu outbreak – had predicted that the next major outbreak could kill between 5,100 and 63,570 people in Scotland alone, in a matter of weeks.

But the highest mortality rate was based on the virus infecting 50% of the population and killing 2.5% of those infected. The mass vaccination plans are based partly on this official modelling. However, the H1N1 virus is far less virulent, although officials do fear the mortality rate could increase this winter, and get close to the 5,100 figure.

Pennington said: “Once the initial tests have been done I think there is a possibility – laid out in the pandemic plan – that we could use emergency procedures just to rush it through before all the test results have been analysed and completed.

“I’d be concerned about that because the pandemic plan was looking really at a virus that was much higher mortality than the one we’re seeing now, the one we’re seeing now is basically no different in that respect from seasonal flu.”

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Swine flu help service launched today

July 23rd, 2009 | No Comments

Government move comes as pressure grows on GPs and hospitals

A national swine flu help service that aims to speed up access to drugs for thousands of infected people will be launched today.

The government’s national flu pandemic service, which can be accessed by phone and internet, will be staffed by more than 1,500 people. Another 500 workers will be brought in if needed.

The service – which will only cover England – is being launched to help relieve mounting pressure on the NHS.

Its introduction comes amid what is expected to be a jump in the UK’s swine flu death toll, which currently stands at 31.

New figures showing the number of people contacting their GP, and the numberdying from the disease, will be released later today.

Workers staffing the service will have a checklist of symptoms, allowing them to diagnose callers and give out a numbered code enabling them to get Tamiflu anti-viral medicine.

More serious cases, such as pregnant women, people with health conditions and very young children, will still be referred to GPs.

Members of the public will also be able to use a website to access the checklist and get a voucher number.

The freephone number will initially only be operational during the day, but the Department of Health said it would be able to operate on a 24-hour basis if needed.

Details of the website address and helpline number have yet to be released.

The launch of the service was announced last week after a dramatic rise in swine flu-related calls and consultations piled pressure on GPs and hospitals.

A poll of health workers revealed that only around four out of 10 believed their organisation was managing to cope with the extra flow of patients.

The survey of almost 1,500 NHS managers, nurses and doctors, carried out by the Health Service Journal and the Nursing Times, showed that only 37% of clinicians, including doctors, nurses and midwives, agreed or strongly agreed that their organisation was coping well.

Another 30% neither agreed or disagreed, while 13% disagreed and 5% strongly disagreed.

However, many doctors and nurses said the government had provided useful advice to help them cope with the pandemic and most would not stay away from work if other staff became ill.

Staff were asked to rate their confidence on a series of questions on a scale of one to 10, with one not at all confident and 10 extremely confident.

In answer to the question “how confident are you that the NHS as a whole is well prepared to deal with the greater demand on services expected later in the outbreak?”, the average score was five.

Asked “how confident are you that there will be adequate supplies of swine flu vaccinations to protect the population?”, the average score was 4.8.

And in response to “how confident are you that there will be a practicable logistical plan to vaccinate all those who need immunisation?”, the average score was 4.6.

Yesterday, Gordon Brown said the government was making an “enormous effort” to tackle the pandemic.

The prime minister insisted “robust plans” were in place to fight swine flu and measures were being taken in a “calm and organised and ordered way”.

The UK pharmaceutical giant GlaxoSmithKline said the first batches of its vaccine would not be available until September, with further shipments in 2009 and 2010.

The government has ordered up to 132m doses of the vaccine from GSK and another drug company, Baxter.

More than 700 people worldwide are known to have died after contracting swine flu, which the World Health Organisation says is spreading faster than any previous flu pandemic.

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Private lives

July 22nd, 2009 | No Comments

For me, losing my hair wasn’t the hard bit – learning to live with it as a teenager was. I don’t remember losing my hair when I was five. My mum thinks it could have been linked to her separating from my dad or a bad bout of chickenpox, but I’m not sure.

She found the first bald patch, the size of a two pence piece, four months before my sixth birthday, and eventually I only had wispy strands left that I wouldn’t let her shave. I don’t remember getting upset, though. I was just a normal little girl, with no hair.

We tried lots of treatments for this alopecia – steroids and medication called Minoxidil. I can remember wearing funny caps with creams underneath when friends were round. I never minded. But when I was nine, a doctor bluntly told me my hair would never grow back.

As a younger teenager I was happy and popular. Friends chattered to me about hair and makeup and never treated me differently. I was fine without hair. Then, when I was 14, two girls picked on my cousin and I stuck up for her. They called me “too gobby for a girl with no hair”, and I was followed, threatened and bullied. Things died down but months later, in June, I was badly beaten. We were hanging out and someone shouted, “Jade, run!” One of the girls was running at me with a huge crowd. The last thing I remember is her smashing my head against the ground. I ended up in A&E and afterwards my head was covered in lumps, bumps and grazes and I had a big black eye.

But it was the after-effects that hurt the most. When I took off my makeup, my eyelashes came off on the baby wipe. It was like experiencing alopecia for the first time. Every time I wiped, more eyelashes came out – every last beautiful one. They were my pride and joy. My friends had joked I spent longer on my mascara than they did styling their hair.

After that I wouldn’t leave the house. I wouldn’t sleep alone and I couldn’t face school. When I tried to return, a boy innocently said I looked different and I couldn’t go back for weeks. Before, I coped with people staring but without my confidence, I couldn’t take it. I started drinking and coming home late. Then, one awful night, I argued with mum, ran upstairs and accidentally dropped a glass. That’s when I did it – slashed my arms and legs, still crying.

The next day, I felt so ashamed. I had to tell my mum the truth, although I knew it would hurt her. She rang the doctor and organised counselling for me. That was a turning point. I worked hard to deal with my feelings and I also met my boyfriend Ryan, who I’ve been with for two years.

Before, “wig” was a dirty word in our house – I thought it was like hiding – but when I was 15, I decided I wanted hair for my prom. I had read about a treatment that sounded great, but cost £1,500. My mum’s colleagues held fundraisers for me and I had the treatment on my 16th birthday. The hair was tied to fine lace and fixed with tape. Ryan hadn’t wanted me to have a wig, but he was so pleased to see me happy.

Later I started having problems with the hair. It was unnaturally thick, the tape kept peeling off and it attracted dirt. I had to keep getting new hair tied into it, and they used any colour. The final straw was when it dropped off in the bath, in a knot of dreadlocks.

I was finally ready to try wigs.

I found a realistic one with a silicone back in a shop near my home in Heywood, Greater Manchester. It was expensive but the shop’s owner said I could have it for free if I modelled it for her website.

The wig is perfect. I can take it on and off, and get it glued on if I want. I’m not so bothered about having alopecia now. Actually, I think God helped me out because if I had to do my hair every day, it would drive me mad!

I’d always wanted to be a hairdresser but I thought dealing with other people’s hair would be too painful. Now that I have my wig, I know I can do it. I’ve met other people with alopecia and they often lack confidence. They shouldn’t – they can do anything they want.

As told to Victoria Holman

For more information: www.alopeciaonline.org.uk

• To respond to this article or if you have a story to tell about your life email my.story@guardian.co.uk. If possible, please include a phone number

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France loses love for topless sunbathing

July 22nd, 2009 | No Comments

Health concerns and new feminist priorities mean French women are covering up on the beach

For some it’s the stuff of naff Cote d’Azur postcards. For others it’s a symbol of the feminist struggle in France. Topless sunbathing was once the summer battleground of French post-1968 society – educated middle classes insisted that peeling off was a women’s right, while family groups claimed exposed nipples would scare children.

For decades, France has prided itself on being the world capital of seaside semi-nudity. Now the nation is facing a bikini-top backlash. A younger generation of women are covering up, citing new feminist priorities, skin cancer fears and a rebellion against the cult of the fetished body beautiful.

French academics and historians have spent the early summer months pondering the sociological meaning of the demise of France’s once-favourite piece of beachwear, the “monokini” – the bottom half of a bikini with no top.

Since the 1970s, when the French state refused to ban “le topless” on beaches, women’s semi-nudity has become a symbol of summer in France. It was a point of national pride that the same freedom to strip off in public was off-limits in other more prudish nations such as the US.

Women’s bodies have always been the centre of national social debates in France. Jean-Marie Le Pen’s far-right Front National once produced a poster warning against immigration which showed carefree French topless sunbathers in the 1990s against a doomsday prediction of burka-clad women invading French beaches in the year 2010.

But modern French 18- to 30-year-olds are rejecting toplessness, boosting the sales of two-piece bikinis and old-fashioned bathing suits.

A poll found 24% of women were perturbed by toplessness on beaches, while 57% said it was OK in a garden. Along the artificial summer beach Paris Plages, which opened on the Seine this week, topless sunbathing is punishable with a fine. The mayor of Saint Tropez has argued that the postcard myth of the feminine “charms” of the southern elitist sunspot are outdated as fewer women go topless.

French media insist that it tends to be the over 60s – women involved in the initial women’s lib struggle – who dispense with tops. One swimsuit saleswoman said that going topless is no longer seen as a feminist act, as young women see equal pay and work-family balance as more pressing battlegrounds.

At the heart of this summer’s cover-up phenomenon is historian Christophe Granger’s new book, Corps d’été, a social history of the beach and the body in France.

He said: “In the 1960s and 1970s, toplessness was linked to the women’s liberation movement, sexual liberation and a return to nature.

“Historical feminist writing details how the row over toplessness was a struggle for women to do what they liked with their bodies. What has been projected on to it today are different values, identified, not with equality but desire, sexualisation of the body, voluptuousness and the body perfect.

“It’s less about women feeling at ease and free. It has been linked to the harsh cult of the body beautiful, where no imperfection is tolerated.”

In some areas, the battle goes on. Les Tumultueuses, a group of young militant feminists, are still fighting for topless bathing rights in public swimming pools, denouncing the fact that men and women’s bodies are treated differently. “My body, if I want, when I want” is one of the slogans they have borrowed from the 1970s struggle. Two months ago, when a group of them removed their tops and dived in to Les Halles public pool in Paris, pool assistants tried in vain to get them to cover up.

Previous topless commando raids on public pools have seen police intervene to stop them. Attendants at Paris’s notoriously strict public pools have argued that if toplessness was allowed, swimmers would take more and more liberties such as arriving with no swimming hat or trunks.

For and against, G2 pages 10-11

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