Posts Tagged ‘Swine Flu’

Plenary session 2 at the Faculty of Public Health annual conference, on Wednesday 7 July.

Chaired by Dr Liz Scott, Treasurer at Faculty of Public Health, and panel members Tony Jewell, Chief Medical Officer Wales, Laura Donnelly, Health Correspondent of the Sunday Telegraph, Sarah Boseley, Health Editor of the Guardian, and Lindsey Davies, Former National Director of Pandemic Influenza Preparedness.


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Doctors and other health professionals should look after themselves as well as their families and patients. The fact about swine flu is that there is no way that you can tell whether you will fall ill and become seriously ill or not.

Whilst death rates remain low for normally healthy people, you are likely to be ill for seven or so days (shortened by 1 day with Oseltamivir as NICE guidance states).  Data from the HPA shows that this is ‘proper flu’ in those in whom the disease is confirmed, and it is a debilitating illness as flu always is.

The swine flu vaccine remains a good match against the currently circulating swine flu.  Why would you want to become ill when there is a safe and effective vaccine available?

  • Dr Philip Monk is Consultant in Health Protection and Member of FPH Health Protection Committee

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Here I am, enjoying a little summer frivolity up at the Edinburgh Fringe, and it seems to me there isn’t a stand-up standing who hasn’t made some play with swine flu or obesity or the crack-down on binge drinking. From Rhod Gilbert to Rich Hall, from Jason Byrne to Stewart Lee, they’ve all had a go at public health one way or another.

Meanwhile quite a few of the musical cabarets are getting in on the act too. The Oompah Band are sending up the credit crunch with lots of brassy references to redundancy, repossessed homes and the horrors of being down-and-out. Fascinating Aida do a hilarious song about health and safety on children’s outings and a wonderful calypso about the impact of climate change in the Shetlands. And yes, the comedy group I’m singing in, Instant Sunshine, can’t resist joining in with a number about the perils of the demon drink.

But what a strange time I’m having. One minute I’m talking seriously on the radio, down the line from the BBC’s Edinburgh studio, about ham sandwiches, candle wax and the risk of cancer, and the next I’m up on stage singing a silly song about a showjumper who’s lost his horse. One minute I’m on Sky News debating the joys of the NHS versus the inequities of the US healthcare system, and the next I’m impersonating the Queen opening a desperately unfinished Olympic site in 2012.

But hey, that’s showbiz for you. Instant Sunshine’s stuff is gently humorous, utterly inoffensive and, let’s face it, a little dated. We first came here in 1975 and have been back every other year since, thanks to a small but faithful following. There have been thousands of acts on the Fringe, but we are probably the longest-serving. Certainly our queue has by far the most zimmer frames.

 It’s all great fun and utterly frivolous. And I suppose, if it makes people happy for a while, it’s public health – kind of – isn’t it?

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As widely predicted, swine flu appears to be plateauing and slipping from the headlines – for a while at any rate, helped largely by the school holidays. Time for some well-earned R&R all round.

What have we learned so far? What lessons to help us face a possible second, more virulent wave in the autumn?

I think perhaps the main lesson is that despite about five years of preparation, scenario planning and multi-agency live exercises, we didn’t expect the unexpected.

Whilst flu experts were anxiously monitoring poultry farmers in south east Asia and bird migration patterns across the globe, the pandemic surprised everybody by popping up in Mexico, from pigs.

For reasons still unclear the UK rapidly became the most affected country outside the Americas, with outbreaks centring largely on schools, fuelled by the number of young people returning from trips to America.

When WHO raised the level to 6, despite repeated reassurances that for most people the resulting illness is mild and recovery fairly rapid, a few high-profile deaths and a news-hungry press combined to whip up a huge surge of demand for diagnosis and antivirals that threatened to overwhelm the system. Primary care was swamped and the national flu line was not yet ready to take the load. It became more a pandemic of worried well than swine flu.

Then, with the policy of giving antivirals to anyone whether they were in a priority group or not, we had concerns about wasting them on people who didn’t need them or wouldn’t benefit from them, and worries about developing resistence or unnecessarily risking side-effects.

This gave the press another opportunity, this time highlighting the ‘confusion’ over the official advice for pregnant women  – actually caused more by statements from various professional bodies rather than the Department of Health. Nonetheless, the government got the blame.

And most recently the focus has shifted to whether the vaccine will be deployed in time and whether there are enough intensive care beds and ventilators to see us through a potential double whammy of swine flu plus seasonal flu this coming winter.

So, as we enter a strange lull, there’s lots to reflect on and learn, not just about managing the pandemic, but perhaps mostly about managing public expectations and the media. Thank goodness the virus was relatively mild.

And another lesson, for those who decide these things. Local public health teams and health protection units have been at the forefront of the fight against the pandemic and have thoroughly proved their worth. All the more reason therefore to beef up the public health workforce nationally, increase its capacity and capability, and develop its leadership.

As with the Stanley Royd salmonella outbreak 25 years ago which ushered in a new era for public health, it’s an ill wind that blows nobody any good.

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