Saturday, July 25

Our Man in Lancashire reports on Swine Flu Front in England

Before he left for a ten-day stay in England I asked physician and Pundita reader "DocJim" to tell me, on his return to the USA, his impressions of how the British were coping with swine flu. Here is his report, just received:

Having boarded a flight in Manchester, UK, yesterday morning, I took one of the offered newspapers. There was ONE mention of swine flu in this Thursday evening paper: on the sports page. A local football (soccer) team's coach was voicing concerns about what swine flu could do to his team if several members became infected.

This was Manchester, after all, not London. The London papers continually had front page scare stories about swine flu each day for the week my wife and I spent in Lancashire.

BBC had daily long interviews and panels on swine flu. On Thursday evening in an airport hotel we could see SkyNews and Granada TV in addition to BBC. They were all talking swine flu.

A bookshop clerk in Lancaster was asked on Monday about concerns about swine flu? "None," she replied, and she went on to say, "It's all about a coverup."

Of what? "The economy." She had spent the weekend in London and says it was business as usual to her eyes and she was amused by several young Asian men wearing masks. "They were students just off the plane, no doubt."

It would be fair to say that the UK epidemic of swine flu slowed last week, because the schools ended there term for summer holiday. By the end of the week, some commentators were reporting that locales with huge increases in caseloads the week earlier were now showing lesser growth, while some newer areas were accelerating in cases.

The Brown government is blamed for both hyping the swine flu story and doing too little about it. There has been mass confusion. Government politicians like Sir Liam Donaldson have reversed positions sporadically and people in general are feeling let down by the NHS.

The newest UK plan is to offer Tamiflu packages at a nearby pharmacy to anyone who calls the national "hotline" and passes the verbal test of symptoms. "Experts" set up the dichotomous key that begins with "Do you have high fever?"

Unfortunately, I could not find the definition of high fever. Presumably, all Brits know exactly what that means.

The call center personnel were folks out of work who had received a six hour training session.

As it opened on Thursday, the website was jammed by hits and the call center had immediate busy signals. One enterprising person at SkyNews called with carefully predetermined symptoms of strep throat and was offered Tamiflu at a local pharmacy.

One other horror story was of a teenage girl given Tamiflu for 5 days with no improvement and her family took her to the Accident and Emergency Ward where she was hospitalized with meningitis.

The London newspapers were now carrying a story about the millions paid to one UK vaccine manufacturer of swine flu vaccine. That company had shown a profit for the current quarter while they had received the government millions for the swine flu vaccine doses which they are in the process of producing.

As a physician, I can understand that free Tamiflu and an excited populace had overwhelmed the nation's GPs. Early last week they were reeling from phone calls and emails from patients. Many simply wanted to have a supply of Tamiflu on hand, in case they became ill.

No one knows with real certainty why there is a surge of influenza in the colder months of the year. One study suggests the virus is more infective when the nose breathes in colder air. They have some data to 'prove' that theory but I remain a sceptic. The UK experience in the London vicinity schools -- which were rarely closed with large cases of flu and where case rates fell off the week after schools closed -- seems instructive.

Two stories about UK school groups traveling to foreign countries made the local news during the week: in China the group was quarantined for a week when two children had symptoms of flu on arrival and in the second case a group traveling to France was sent home with masks on their faces, amid taunts by French people seeing them in the airport. It didn't do much positively for Anglo-French relations, but that has never bothered the French.


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