Page last updated at 11:38 GMT, Tuesday, 28 April 2009 12:38 UK

NHS on alert for swine flu spread

By Nick Triggle
Health reporter, BBC News

Telephone
The NHS has started receiving calls from people worried about swine flu

The calls have started trickling in. But staff in GP practices and those working for NHS advice lines fully expect them to become a flood in the coming days as fear over swine flu rises.

On Sunday, 88 people called NHS Direct in England about swine flu. By Monday that figure had topped 1,300.

In fact, the hotline is so concerned about the demand for help and information that it has banned its staff from booking any more leave over the coming weeks.

And in Scotland, where the only two confirmed cases in the UK are, the NHS 24 telephone line has seen the total number of calls jump by a fifth in the past 24 hours to 800.

Doctors and nurses who are assessing patients are already operating under a standard protocol issued by health protection officials.

The system involves taking nose and throat swabs for testing if an individual displays flu-like systems and has been to one of the affected areas.

There are also strict rules on isolating the patients either in hospital or at home.

But the reality facing the NHS is that this could just be the tip of the iceberg.

Risk

The World Health Organization has already warned that swine flu cannot be contained and the risk of a pandemic is "significant".

The health service has responded by launching the first stage of it contingency plans.

Patients are being advised to phone their GPs or NHS Direct and NHS 24 if they are concerned they may have swine flu instead of turning up to health centres in person to minimise the potential spread of the virus.

Any face-to-face assessments are meant to be done using facemasks and gloves.

But already questions are being raised about whether the health service is ready.

We need everyone to make sure they are ready. We are not at the pandemic stage yet, but we are on alert and calls are coming in
Dr Maureen Baker, of the Royal College of GPs

A flu line capable of handling 6m calls each week is meant to be set up when the danger of a pandemic is at phase five - it is currently at four - but it will not be available until the autumn as it is several months behind schedule.

Stephen O'Brien, a shadow health minister, said the information line could be "crucial" in the coming days and weeks.

"It is a legitimate concern that a key part of that plan is some way off being implemented."

And not all GP practices have ordered facemasks for staff and nor is each surgery thought to be ready to introduce other measures, such as providing separate waiting rooms for staff in the event of patients swamping clinics.

Dr Maureen Baker, the pandemic flu lead at the Royal College of GPs, said: "Some GPs will have done the preparations and be ready, but we know that will not be the case everywhere.

"We need everyone to make sure they are ready. We are not at the pandemic stage yet, but we are on alert and calls are coming in.

"GPs should be saying to people not to panic, that we are well prepared and that most people who get ill with flu will have a nasty bout of flu and get better within a week, even if it is swine flu."

Doctors have also been asked to ensure they have measures in place to work with neighbouring surgeries to share resources.

Dr Baker added: "Staff may have to be moved around, GPs may find themselves working in different practices. Staff can be affected like everyone else and we have to make sure the system keeps running."

Worst-case scenario

This is very much the worst-case scenario for the NHS and will more than likely happen when a pandemic has been declared.

For that to occur, the virus has to be passed on from human-to-human - something which has not happened in the UK yet although tests are still be carried out on the people who came into contact with the Scottish couple who were diagnosed with swine flu on Monday.

Chief Medical Officer Sir Liam Donaldson said if that happened on a large scale the NHS would ramp up its plans.

WHAT YOU SHOULD KNOW
The symptoms of swine flu are similar to seasonal flu - sore throat, coughing and fever
If you have these symptoms and have recently been to one of the affected areas phone your GP or NHS Direct
Also, avoid contact with other people as much as possible, cover your nose and mouth when coughing and wash hands frequently
Treatment is available in the form of anti-virals. These are not a cure, but evidence from elsewhere shows that they lessen the symptoms and shorten the illness

Under the contingency measures drawn up, the NHS will cancel non-urgent operations if necessary and give people access to stocks of anti-viral drugs, which while not a cure can lessen the symptoms.

People will be asked to appoint a "flu buddy" to collect the treatment from designated centres around the country.

Sir Liam said: "We have been preparing for the possibility for a number of years and are among the most prepared countries in the world."

But he added at this stage it was important to concentrate on simple steps.

"There are simple steps that everyone can take to help prevent catching colds and flu based on good respiratory and hand hygiene. Always use a tissue to catch your sneezes, throw away used tissues, in which germs can linger and regularly wash your hands.

"Most importantly, if you have come back from Mexico or one of the affected countries and have flu-like symptoms, stay at home and call your GP or NHS Direct."



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