H1N1v in the United Kingdom
Professor Lindsey DaviesNational Director of Pandemic Influenza Preparedness
Overview
• Current position• UK approach to swine flu• Achievements and challenges
Current position: England
As at 27 August:– Estimated 5,000 new cases in England in previous
week (range 3,000 – 12,000)– Downward trend in cases continuing– 218 patients in hospital, 31 in critical care– Majority of cases continue to be mild– 57 confirmed swine flu related deaths
Planning assumptions for first major pandemic wave(published July 2009)
– Clinical attack rate: 30%– Complication rate: 15% of clinical cases– Hospitalisation rate: 2%– Case fatality rate 0.1-0.35%– Peak absence rate: 12%
UK preparation and response
Planning and preparation
1997-
Slowing the spread
April-June 2009
Managing outbreaks
June 2009
Focus on rapid treatment
July 2009-
Reducing spread
Distance, hygiene, masks
Reducing infection
Vaccines
Reducing illness and complications
Antiviral drugs, health care
ReducingDeaths:
AntibioticsHealth care
Defence in depth
Response is informed by :
Science Surveillance Service monitoring
Slowing the spread
Laboratory confirmation of cases Treating all suspected and confirmed cases Collecting detailed case data Tracing close contacts and offering prophylaxis Closing schools Public health campaign
UK preparation and response
Planning and preparation 1997-
Slowing the spread
April-June 2009
Managing outbreaks
June 2009
Treatment phase
July 2009-
Move to treatment
Antiviral treatment for people with symptoms.
Limited prophylaxis
Launch of National Pandemic Flu Service
Local risk assessment informs other measures
National Pandemic Flu Service (NPFS)
On-line and phone self care service for the public which allows them to check their symptoms and access antivirals if required, or receive advice on symptom relief
Mobilised when needed
Capacity adjusted in response to demand
0800 1 513 100
Vaccination programme
First deliveries expected this month
Vaccination programme expected to start in autumn
No vaccinations until licensed by EMEA
Priority groups first
Vaccination: priority groups
1. Those at highest risk of severe illness:
People aged six months and up to 65 years in the current seasonal flu vaccine clinical at risk groups
All pregnant women, subject to licensing considerations on trimesters
Household contacts of immunocompromised individuals People aged 65 and over in the current seasonal flu vaccine
clinical at risk groups
2. Frontline health and social care workers
NHS preparedness
High levels of demand on primary care, reduced by launch of National Pandemic Flu Service
Exercising and testing of plans
Critical care strategy
To summarise….
Planning has paid off
But uncertainty about timing, scale and impact of next phase(s) remain
And we must continue to prepare for a range of scenarios in this pandemic - and the next