Friday, December 31, 2010

Conservative Government Ignores Flu Advice From Doctors

Health Secretary Andrew Lansley
In U-Turn
What is our Tory led Government doing to help protect us during the latest H1N1 "swine-flu" outbreak?

Before the Labour government left office they had organised an advertising campaign advising people, especially those at risk, to take up the seasonal flu vaccine, the Conservatives, scrapped the planned campaign, branding it as "too costly, and unnecessary".

Last night in an humiliating climbdown Health Secretary Andrew Lansley was forced to resurrect the effective "Catch it, Bin it, Kill it" advertising/information campaign that the previous Labour Government had previously run with excellent effect.

Perhaps if prime minister David Cameron, and Andrew Lansley, had not been too busy  cutting, slashing, burning budgets, and axing front-line NHS jobs, they would not have taken their eye off of the ball, and they would have realised the and heeded the numerous warnings that have been issued by doctors, and health pressure groups, as it stands, they have ignored all these warnings. Geoff Martin chair of the pressure group "Health Emergency" said; the Tory Government "have scrapped the publicity to save a few pounds but placed peoples lives at risk".
In another report the Health Protection Agency said the number of flu victims in intensive care has doubled in a week to 738. Twelve more people have died since last week, on top of the 27 victims who have died from the flu virus since October 2010.
To add to the chaos this Conservative Government are causing in the NHS, the British Medical Association (BMA) has warned that if the Government insist on rushing through these radical reforms in the NHS, it will be tested to its limit in 2011.

The Government have known since October what the country could be facing, but they have ignored all warnings and it is simply unacceptable.

On the 21st December 2010 an NHS Central Alert by  the Interim Chief Medical Officer, Dame Sally Davies was sent out to clinicians and other health care professions about the use of  SEASONAL INFLUENZA: PRESCRIPTION OF ANTIVIRALS (2010/11).

"This letter contains information about the prescription of antivirals (oseltamivir and zanamivir) to meet clinical circumstances arising during the current seasonal influenza outbreak. Antiviral treatments for influenza are currently only available from GPs for NHS patients who are in a designated "at clinical risk" category. The most recent surveillance data indicate that higher than normal numbers of patients, who are not in one of the "at clinical risk" groups, are becoming seriously ill with flu – requiring hospitalisation. "

"Regulations currently say that prescribers should not order oseltamivir and zanamivir for patients who are not in the target risk groups. However, the Chief Medical Officer has recommended that the current restrictions -see the Annex to this letter – should be amended to allow general practitioners (and other prescribers) to exercise their clinical discretion so that any patient who their GP feels is at serious risk of developing complications from influenza may receive these treatments on the NHS. "Full text Of Letter Here

That letter was date 21st December, it is now 31st December, noteably the CMO did not copy in Andrew Lansley, I pressume, at least one would hope she is keeping him informed privately?
Why has it taken Andrew Lansley a further 10 days to act?

Urgent Report from the Health Protection Agency: TUESDAY 14th DECEMBER

H1N1 influenza – Report of an HPA-led teleconference 10 December 2010

"The number of cases of H1N1 is increasing. Worryingly, there is a disconnect between the number of cases in the general population (13/1000 incidence, below the threshold to declare a pandemic which is 30/1000) and the impact on ICU of the severely ill. The numbers are increasing especially in the North-West and in the Midlands.

"There have been 12 flu deaths in the UK not including Scotland, 10 of which were confirmed H1N1. (Swine flu)

They ranged in age from 1 – 51 years old; none had had vaccinations. Four had cerebral palsy, one asthma, one alcoholic liver disease, one asthma, one was obese.
"Several pregnant patients have presented needing intensive care. Ten of the 14 nationally available extracorporeal membrane oxygenation (ECMO) beds are occupied by ‘flu patients, three of whom are or were pregnant.
"Although surge funding has been agreed for additional ECMO beds (at Papworth, the Brompton, Aberdeen, Leicester, Wythenshawe) this funding has not been released as yet, and the ECMO units are struggling to maintain their elective surgery as well as deal with pandemic cases.


"There was a plea for a national statement from the DH (Department of Health) about the issue".
I will be chasing the issues of the surge funding and a national DH statement later today.

UPDATE 1 Call made to DH at 11.10 am asking about these issues. At 17.51, the following statement was received
No answer there to my question about whether the agreed funding has yet been released.

At 16.45, the following CAS Alert was sent out by DH:
Central Alerting System: Treatment Guidelines For Patients With Influenza 2010/2011

Cascade codes: #GP#, #ACCIDENTEMERGENCY#, #COMMUNITYPHARMACISTS#Category: Non urgent (cascade within 48 hours)
Issue date: 14-Dec-2010

Reference: CEM/CMO/2010/18
From: Chief Medical Officer - Department of Health
(Redacted - See below)

Dear Colleague

Treatment guidelines for patients with influenza 2010/2011.

Professor David Salisbury wrote last week on the use of antivirals for individuals suspected to have influenza, particularly in the context of primary care

The purpose of this letter is to update you on appropriate guidelines for treatment in secondary care and other settings.
Over the last few days, we have been alerted by the Health Protection Agency (HPA) and other sources that the incidence of severe illness due to influenza infection requiring access to critical care services has increased. At the 7th of December 2010, sixteen confirmed cases in 18-35 year olds are in hospital (all due to H1N1 infection), with a number of probable cases currently under investigation. Many, but not all, of those cases have underlying conditions including pregnancy. Eleven of twelve cases currently receiving ECMO treatment are confirmed or probable swine flu (H1N1) cases. Since the beginning of September, eleven deaths associated with influenza infection have been reported in the UK. Ten cases are associated with A(H1N1) 2009 infection and one with influenza B. Ages ranged from four to 51 years including four cases under 10 years.
Based on the reports from colleagues treating such patients about the similarities of the clinical presentations to last year’s A (H1N1) 2009 cases, I recommend that last year's Clinical Management Guidelines should be followed for patients admitted to hospital with symptoms suggestive of H1N1(2009) influenza.

(Redacted) Read Full Letter Text Here:

Yours sincerely,
Chief Medical Officer (Interim)

Below Follows a Letter In Full Letter From  Professor D M SALISBURY  Director of Immunisation

Dear Colleague

Influenza Season 2010/11 – Use of Antivirals

During the 2009/2010 H1N1 pandemic, oseltamivir (Tamiflu) or zanamivir (Relenza) were recommended for the treatment of all clinically diagnosed cases of influenza. Prophylaxis with oseltamivir and zanamivir was recommended for people who had been in recent close contact with a clinically diagnosed case of influenza and who were either pregnant or had a serious underlying medical condition. Once influenza activity dropped to below baseline levels during 2010, the pandemic-specific recommendations for the use of these antivirals ceased and the NICE guidance on the use of antivirals was reinstated.
The H1N1 (2009) virus is now regarded as one of the group of seasonal influenza viruses in general circulation and therefore the NICE recommendations on the use of antivirals for treatment and prophylaxis will apply during the 2010/11 influenza season.

The Current Position

The purpose of this letter is to inform you that the most recent surveillance data from the Health Protection Agency indicate that there is now a substantial likelihood that people presenting with an influenza-like illness are infected with influenza virus. Oseltamivir continues to be recommended, along with zanamivir, for the prophylaxis and treatment of influenza.  For clinicians treating hospitalised patients with suspected influenza, rapid laboratory confirmation with subtype identification is advised to support patient management.
From 1 November 2010, the relevant regulations have been updated so that the list of people 'at clinical risk' from seasonal flu and eligible to receive antivirals prescribed by General Practitioners has been extended to include pregnant women. General Practitioners will wish to note the information on use in pregnancy in the Summary of Product Characteristics of both antivirals. In line with the National Institute of Clinical Excellence (NICE) guidance, the use of antiviral drugs for the prevention or treatment of influenza is now recommended.
Antivirals should therefore be used when:

• A person with a flu-like illness is in an ‘at-risk’ group and they can start treatment within 48 hours (or within 36 hours for zanamivir treatment in children) of the onset of symptoms as per licensed indications and
• the national surveillance schemes indicate that influenza virus A or B is circulating (as the first part of this letter confirms)

During localised outbreaks of influenza-like illness (outside the periods when national surveillance indicates that influenza virus is circulating in the community), oseltamivir and zanamivir may be offered for the treatment of influenza in ‘at-risk’ people who live in long-term residential or nursing homes. However, these treatments should be offered only if there is a high level of certainty that the causative agent in a localised outbreak is influenza (usually based on virological evidence of influenza infection in the initial case).

The full NICE guidance on the use of antivirals can be accessed at: I would also like to take this opportunity to highlight the importance of GP practices achieving high uptake of the seasonal flu vaccine among their patients in at-risk groups, pregnant women and healthcare workers.

Yours sincerely
Professor D M SALISBURY CB FRCP FRCPCH FFPH Director of Immunisation

You can see from the dates I have found when researching that Andrew Lansley the health secretary has been in receipt of information about the escalating H1N1 virus (swine flu). Of course he would have known for many months that swine flu was going to be a problem this year because it was included in the seasonal flu vaccine.
This year the flu vaccine has been a poor uptake, attributed to two things. 1) The Tory government cancelled the planned information campaign in the press and on TV, reminding people, especially those in the at risk groups to take up their vaccine and 2) because the swine flu strain was included in this years jab. This is why the Labour government wanted to inform people so they could make informed choices to have the vaccine.

In December 2010 former RCGP chair, Professor Steve Field criticised the DH  for its "ill-advised" decision to cut back on the £180,000 it spent last year (2009 under Labour government) on a public awareness campaign.

In response, the DH said "it had no plans to bow to the criticism and launch a marketing drive - and that instead GPs should ring patients individually to invite them into clinics over Christmas, as it was "vital that those at greatest risk are vaccinated as soon as possible".

This was on the 23rd December 2010, the government knew we had a problem, yet still did nothing, it took them 10 MORE days to act!
Obviously it is vital and if so, then why are they leaving it to GPs? All that should be done - yes, but equally Andrew Lansley and the Department of Health KNEW many months about swine flu, so a concerted and organised advertising campaign was urgently needed and they CANCELLED it, saying it was too costly and unnecessary!
In every previous pandemic the major problem has been in the second winter season. So why is it that the Government decided to do nothing at all this year, and then expect  GPs to clean up the mess and chaos they have caused with their belligerent penny pinching?

Questions must be asked of Andrew Lansley - URGENTLY. The House of Commons  should be brought back early and Andrew Lansley should make a statement.

Norfolk Hospital Goes On "Black Alert" Due To Swine Flu Virus


I make every effort to check my facts when reporting and like to give as much background information as possible. The 'Central Alerting System' mentioned at the top of this report  brings together CMO's Public Health Link (PHL) and the Safety Alert Broadcast System (SABS). It enables alerts and urgent patient safety specific guidance to be accessed at any time.

In this instance italics are used to denote quotes and information from other sources, wherever possible I have enclosed links to those sources. Look out for the highlighted links.

Please feel free to copy this where you feel it may help, please always do me the courtesy of providing a link back to here - Many Thanks


Anonymous said...

Thankyou for taking the time and the trouble to put the true facts in the public domain...... sad that this government is putting money before the health of the nation...

Peter Robson said...

Many thanks Gracie, well done

Gracie Samuels said...

This just gets worse, now they are running short of vaccine!

John Green said...
This comment has been removed by a blog administrator.
Gracie Samuels said...

@ John Green

Please do not spam this blog. Your comments can still be read on the other thread, do not spam them, once is enough.