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