I understand from my recent discussions with Public Health bod over the
weekend when I was doing OoH shift for Herts Urgent Care (HUC) that - in
England- once there are >3000 proven cases, there will be a shift in there
no longer needing to be nasal & throat swabs. The diagnosis can be made on
clinical grounds. At this rate should be in 10-14 days I guestimate.

Mike

(Mike Walton, GP St Albans, Hertfordshire)



-----Original Message-----
From: GP-UK [mailto:[log in to unmask]] On Behalf Of Paul Miller
Sent: 11 June 2009 10:11
To: [log in to unmask]
Subject: Re: H1N1 2009

I read on the BBC News that GPs in Paisley and other affected areas
are to be allowed to make the diagnosis purely on clinical grounds,
and treat close contacts with prophylaxis on this basis.  Not yet
received an updated algorithm or mailshot, and nothing as yet on the
GGaC HB flu web site advising this.

http://www.nhsggc.org.uk/content/default.asp?page=s1309_2

Still, I am sure this will follow.  Not in the practice today, so
could be a fax or whatever that has not yet reached my laptop or
inbox.

Also of interest from this story:

http://news.bbc.co.uk/1/hi/scotland/8094585.stm

"Of the 311 confirmed cases in Scotland, 18 have been admitted to
hospital for clinical reasons, giving us a hospitalisation rate
broadly in line with that seen in the United States."

which is about 1 in 20 of those affected (though not 1 in 20 of those
exposed, with up to 2 out of 3 people showing no symptoms, I
understand).  Back of a Tamiflu packet calculation would mean
somewhere in the region of an additional 65000 admissions (in
Scotland) over the course of the pandemic, if all things stay the
same. (Assuming 75% exposure (figure plucked from the ether), 1 in 3
get it, and 5% need hospital)  These figures are probably wildly
inaccurate.  Has anyone got a better handle on the projections now
based on what we know?

Virologist on Radio 5 stating that 'diabetes' and 'obesity' were risk
factors for more serious illness.  Not sure of the evidence base for
this, although DM would be a given, I would have thought.

Keep washing your hands, folks :)

-- 

Dr Paul Miller
Tel: 07711-346-928
http://visionblogged.blogspot.com



2009/6/11 Julian Bradley <[log in to unmask]>:
> At 20:31 10/06/2009, you wrote:
>>
>> --0016e6d647b1efde7d046c03857b
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>>
>> IN Scumton we have been kept in the loop well and are aware of the
>> algorhythm change. AS from today we can also PRESCRIBE antivirals.
>> OUr public health docs are not staffed to do the swabbing.
>> I was told by someone who should know, that once we get to 1800 cases
>> nationally then all this epidemiological work stops and we just go to
>> treatment mode,
>>
>> Must be close to pandemic stage 6 now?
>>
>> John
>
>
> We've been told swabbing stops at 3000 cases nationally - but never seen
> anything written down.
>
> News says Pandemic will probably be declared tomorrow.
>
> Public health aren't staffed to do the swabbing - I agree.
>
> Is general practice staffed to do this either?
>
> While it's all theoretical / minimal many have tolerated it, but 3000
cases
> may not be reached until some GPs have taken several dozen swabs just for
PH
> reasons* - that seems pretty tough on them.
>
> Julian
>
> *two factors - several swabs per confirmed case, and case clustering hence
> some GPs affected far more than others before 3000 cases reached.
>