UK swine flu cases 'to rise to 100,000 a day by end of August' » Health » 24dash.com

Health Secretary Andy Burnham warned today that swine flu cases could rise to over 100,000 a day by the end of August as he moved the country onto a new "treatment phase".

In a Commons statement, Mr Burnham stressed this was only a projection but said scientists expected to see "rapid rises" in the number hit by the virus.

"Cases are doubling every week and on this trend we could see over 100,000 cases per day by the end of August."

Mr Burnham confirmed there were now 7,447 confirmed cases of swine flu in the UK and a significant number of people had been hospitalised.

Updating MPs on the progress of swine flu, Mr Burnham said antivirals would be offered to all those who have contracted the illness with higher risk patients given priority.

The Government had signed contracts for enough vaccine to cover the whole population.

The first will become available next month with 60 million doses available by the end of the year.

Mr Burnham said last week saw a "considerable rise" in the number of cases with "hot spots" emerging in areas like London, the west midlands and Scotland.

There were now on average several hundred new cases every day.

"As cases continue to rise we have reached the next step in our management of the disease.

"Our national focus should be on treating the increasing numbers affected by swine flu."

Based on expert recommendation, the country would move to a "treatment phase" with immediate effect.

"This will mean that in England the Health Protection Agency will take a step back and primary care will take the lead in diagnosing and distributing antivirals."

Predicting the huge daily rise in new cases, Mr Burnham said: "Cases are doubling every week and on this trend we could see over 100,000 cases per day by the end of August."

He added: "The pressure on the system is such that it is the right time to take this step."

"Scientists can expect to see rapid rises in the number of cases."

The Health Protection Agency will now take a step back from dealing with the outbreak.

The daily updates on confirmed cases will end and "more general" estimates of numbers will be given.

Efforts to trace people who have been in contact with swine flu cases will stop and schools will not need to close when hit by the virus, unless particular circumstances make it necessary.

Following the outbreak, "three people have sadly died", Mr Burnham noted, adding that they had underlying health problems.

There are three stages of swine flu management:

Containment: People with swine flu have their diagnosis confirmed by lab reports. They and anyone who has come into contact with them are given the antiviral drug Tamiflu. Most parts of the UK are still in this phase;

Outbreak management: People are diagnosed by a health professional without the need for lab confirmation, and are given Tamiflu. Swabbing takes place only on a small sample of cases. People who have come into contact with a swine flu victim are unlikely to receive Tamiflu as a precaution;

Treatment: The detail of this phase is still being worked out. The Government envisages that not everybody with swine flu will receive Tamiflu, which may be reserved for at-risk groups.

Tracing of contacts and treating people as a precaution stops. Pressure on GP services is eased as more people receive a diagnosis via other routes. The Government wants this phase to be adopted by the whole of the UK when it occurs.

Mr Burnham said the UK was much closer to the time when the first doses of pandemic flu vaccine would arrive, potentially offering high protection.

In the meantime it was prudent to use antivirals to the "maximum effect" although it was likely a more "targeted approach" would be adopted later.

Mr Burnham said contracts had now been signed to secure enough vaccine for the whole population.

"We expect the first batches of vaccines to arrive in August, with around 60 million doses available by the end of the year - enough for 30 million people to be vaccinated - with more following after that.

"Administering vaccines will need to be prioritised. We will make a decision on this when we know more about the risk profile."

He added: "Most cases of swine flu have not been severe and we are in a strong position to deal with this pandemic.

"But we must not become complacent and, while doubt remains about the way the virus attacks different groups, today's decision on the move to the treatment phase reflects our caution."

Shadow health secretary Andrew Lansley welcomed the measures announced in the statement and said it was "not now realistic" to continue with the containment phase.

But he asked Mr Burnham what guidance was being issued about the cancellation of certain operations, given the increased demand on the NHS.

He said: "Your 130,000 case a day projection would be consistent with anything up to 2,000 hospitalisations a day by the autumn - that would create very considerable pressure on hospitals."

Mr Lansley also asked about stockpiles of antibiotics and pressed Mr Burnham on why the national pandemic flu line was not yet up and running, saying it was meant to be operational at the same time as antiviral distribution arrangements.

"They were both supposed to be ready by the point at which the pandemic phase occurred and they are not ready," he said.

And with Parliament soon to break for the summer recess, Mr Lansley said a "virtual statement" system should be introduced.

This would allow Mr Burnham to provide updates and allow politicians to ask questions in "real time", he said.

Mr Burnham said there were plans in place to allow for the cancellation of elective surgery as "circumstances require".

He said antiviral collection points would be in place within seven days and added that the Government was on track to build up a stockpile of antibiotics to cover 31% of the UK population by the end of September.

And Mr Burnham agreed there was a need for a mechanism to keep MPs updated over the summer, adding: "Perhaps we need to find a way ... whereby we can get those virtual statements as you referred to them to any Hon Member who wants one."

For the Liberal Democrats, Sandra Gidley also welcomed the "cautious approach" outlined by the Government.

"It is a difficult decision, it's a finely-balanced one, but we support the conclusion ministers have come to," she said.

Ms Gidley raised questions about preparations for NHS staff and asked whether a new information campaign would be launched - perhaps involving the reissue of flu advice leaflets.

And she said: "There has been some publicity in the media about something called a flu party. It strikes me as particularly bizarre that parents actually want to try and improve their children's chances of contracting flu - have you had any advice on whether this is a good or a bad thing?"

Mr Burnham replied: "The best thing I think I can say to anybody is that if you receive an invitation to one, politely turn it down.

"The Chief Medical Officer said yesterday, 'It is seriously flawed thinking to allow the virus to spread unabated through swine flu parties', and we hope that message will be heard loud and clear by anybody planning one or anybody planning to attend one."

He also said the position regarding NHS staff was currently under consideration and agreed it was important to reiterate flu advice.

Several MPs returned to the issue of public information campaigns, with concerns raised about the need to separate guidance relating to seasonal flu.

Liberal Democrat Richard Younger-Ross (Teignbridge) said it was important that people with swine flu realised they should stay at home rather than going to work or other public places.

He asked Mr Burnham: "Could you therefore talk to people such as the churches and others, because churches still encourage people to go to church every Sunday.

"And we might be sending some of them to meet their maker earlier than we want them to if we take our flu virus and give it to the person sat next to us."

The Health Secretary said it was "incredibly important" that people knew the right course of action to take.

"We don't yet know enough about it. We can say it's a mild condition - although some have been more severe - so the advice is very much go home, take rest, the usual things that we all do, plenty of fluids, and paracetamol.

"That is the advice to people if they are symptomatic. They really shouldn't be continuing with their normal lives because that could add to the spread of the disease."

And Labour's Dr Howard Stoate (Dartford), a practising GP, warned: "There is a problem that primary care could well become overwhelmed if the pandemic takes off in a way that is being predicted.

"Can I ask you to ensure that the public is informed through a regular public information campaign, on a daily basis, to let them know precisely what they should do in certain circumstances."

Mr Burnham reiterated that public information was important and said advice could be sought on the internet and over the phone.

But he acknowledged that not everyone used websites and would want to visit their GP.

Later, the Government's Chief Medical Officer, Sir Liam Donaldson, said a vaccine was at an advanced stage and denied that the outbreak was out of control.

Speaking at a press conference at the Department of Health, he added:
"We are continuing to take a very firm grip on this situation. We have the advantage of a centralised healthcare system which, when it needs to, can take control.

"We have a big stockpile of anti-virals, the biggest probably in the world.

"We have vaccine at an advance stage of production."

When asked if the disease was out of control, he added: "It is following a predictable path - it isn't out of control, but flu viruses cannot be put back in their box once they are out."

Mr Burnham said it was not yet known what the cost of tackling swine flu would be.

He added: "We are in a strong position to deal with this pandemic. We are the only country in the world to be able to offer anti-virals to everyone as well as those at greater risks.

"People should be reassured and should not be alarmed by this change."

Sir Liam said that he could not currently give an expected mortality rate at this point, but should be able to in the next few months.

Asked why certain areas such as the West Midlands had become hotspots for the virus, Mr Burnham suggested that close family ties could be to blame.

After visiting Birmingham over a fortnight ago, he said that he learned "because of the social profile of the area, where lots of families are intergenerational in social contact and there's more social contact on a daily basis, particularly among the Asian community, that perhaps has contributed".