http://www.guardian.co.uk/world/2010/dec/21/swine-flu-top-doctor-crisis
Tuesday 21 December 2010 Boseley, Sarah
'Shockingly few' health professionals have been vaccinated as more than 300 people lie in critical care beds
The NHS may become unable to cope with the rapid spread of influenza because shockingly few people, including health professionals, have been vaccinated, a senior doctor warns today.
Professor Steve Field, who until last month was the chairman of the Royal College of General Practitioners, spoke out as the Department of Health revealed there are more than 300 people in critical care beds with flu and 17 people have died.
Field said the decision not to encourage the public to have a jab to protect themselves was "ill-advised" and needed to be urgently reversed.
The NHS should have acted more decisively to encourage people to have the jab because it was known that H1N1 swine flu was still circulating and that few NHS staff had the swine flu vaccine when it was offered to them late last year.
"Rates of uptake are shockingly low," said Field. "It was ill-advised not to have the public awareness campaign on seasonal flu jab uptake that we usually have, because we knew that the public and healthcare professionals were likely to become complacent after last year's swine flu pandemic wasn't the serious attack on the country that we thought it could be. With the added winter pressures on the NHS, we need NHS staff to be vaccinated as soon as possible, so that they can continue working,and we also need pregnant women and people who are vulnerable to have a flu jab that includes the swine flu vaccine as soon as possible."
He warned that there could be big problems after Christmas as the numbers build. "This is getting to the point where it's becoming an emergency for the public's health and also the NHS's ability to cope, and we want to avoid that," he said.
Yesterday, health secretary Andrew Lansley briefed the cabinet on flu and told colleagues the NHS had plenty of capacity to cope with an upsurge in cases. David Cameron told a press conference at Downing Street that the flu figures were a little worse than last year, but that despite a doubling of cases in the last week, the Department of Health had things under control. "I think there is a very good grip in the Department of Health on this issue. Andrew Lansley has a great grip over that department," he said.
The government's interim chief medical officer, Sally Davies, said at a briefing that England was experiencing a normal flu season. It was "just winter flu" but with swine flu as the dominant strain. "We have not got a pandemic," she said.
Of the 17 deaths so far, 14 have been confirmed as due to swine flu and none of the victims have been 65 or over. Eight are known to have been considered "at risk", such as people with asthma or heart problems – but that leaves nine who appear to have been previously healthy.
Most of those now in critical care are younger than is usual for a flu outbreak. While 23 of the 302 are aged 65 or over, 243 are aged 16 to 64. There are 12 children between the ages of five and 15 and 24 under-fives.
Take-up of the flu vaccine, which includes H1N1, has been very slow. Last year, on the back of the flu pandemic, the government spent £177,573 on advertising to persuade the elderly and those in at-risk groups to come forward.
This year, it was left to primary care trusts and GPs to tell people the vaccine was available. Davies said the Department of Health had been constrained by government spending curbs. "The government freeze on media meant we had to decide how best to use our resources, which were ploughed into local campaigns and local work. At the end of the winter we will have to assess where we are for future years," she said.
Professor Lindsey Davies, president of the UK Faculty of Public Health, said not enough had been done to persuade people to be vaccinated. "It may well be that the lack of a national campaign is making the difference to the take-up at the moment, and that's regrettable." It was "disappointing" that last year's Catch It, Bin It, Kill It anti-swine flu campaign had not been continued, she added.
The shadow health secretary, John Healey, said the government needed to "get a grip" on the outbreak. Lansley had been , suggesting he had been obsessed with reorganising the NHS and had "The only attention he's paid to the preparations for this winter's flu outbreak is to axe the autumn advertising campaign to encourage people to get vaccinated and make them aware of the risks. He made the wrong judgement and it's "left too many people without the flu protection they should have".," he said.
Davies sought to reassure people on the spreading flu outbreak, saying "the numbers are not massive and we are not at anything like capacity [in the NHS]".
However, she urged at-risk groups to get themselves protected. "We want more people to come forward for the vaccine, particularly pregnant women," she said.
But critical care beds around the country have come under pressure as the numbers taken ill have increased. In some places, this has led to the suspension of routine heart surgery and other procedures where critical care beds are essential for recovery.
For some of the sickest victims of swine flu, a procedure called ECMO, in which blood is oxygenated outside the body, has been used. But the UK has only a small number of ECMO beds. The main centre is Glenfield hospital in Leicester, which has five ECMO beds. Last week, because of demand, extra beds were commissioned at four other major centres – Papworth, the Royal Brompton in London, South Manchester and Newcastle. There are now 16 patients on ECMO treatment in England.