Swine flu (not about me)

The reason we are struggling is because we don't have the capacity. In Feb/March pre swine flu we have no spare appointments and hospital bed occupancy is 100%. They closed hospital beds for increased "efficiency", so more ill people out of hospital under care of GP, & more work for everyone. High demand from helpless patients, increased workload due to imposed changes (eg more intense treatment of chronic diseases inside and outside community. Waiting list targets, A&E waiting times, cancer targets. Ridiculous NHS direct which costs 25% more per patient encounter than cost of GP consult. Stressed staff with high absenteeism rates . Higher patient expectation leding to limitless demand, more litigation, more defensive medicine, higher doctor workload. Morale lower than ever amongst all staff. Patients who don't know the difference between flu and a cold. "You can't be too careful" culture, on background of social change, breakdown of social structures. ("There's no such thing as society" - thanks Maggie).

And that was before 50+ consultations a day in my medium sized practice for swine flu.

I think this is a good point. I have to admit to pondering today on what the difference is between flu and swine flu. And how to pick it out from a bad cold.

I have to admit to being concerned. H is asthmatic and while generally healthy, if he gets a chest infection it can be quite serious. I have a 16 month old who currently has a hacking cough, croaky voice and yesterday had a temp of 39 degrees (which came down with calpol) and while I am normally of the 'If she seems generally ok it is probably nothing' school of thought, I do wonder if I should get her checked out.

What are the warning signs?

Wowsers. I really had no idea that things were that bad. At a loss for words really.

I would hate to be in the American healthcare system, and I love the NHS and what it stands for, however, it would appear that it is at breaking point. Is this something that can be rectified do you think? If so, how? from your insiders POV I mean?

I am a teacher, and there are many things that I would change about the education system if I could... what do you think the answers are from grass roots level?

sudden onset high temp, headache and aching limb. possible dry cough, sore throat, runny nose, diarrhoea

More difficult with children as they frequently get high temps with normal colds, adults don't tend to

http://www.nhsdirect.nhs.uk/Sat/Topics/WizardStepOne.aspx?Host=Nhsd&SyndicationPartnerGuid=d19370ea-a100-407d-9695-b73407f701c7&TopicGuid=8c903315-a302-412a-bfae-9cb576d4b4cd

Thanks Rache.

I may have to call our Docs tomorrow then depending on how she is over night. She is still a bit young to tell me if she has a headache or aching limbs but has definitely had a number of the other symptoms.

Less management interference and stop spending taxpayers money on expensive things that don't make people healthier (eg £12 billion on IT system, £1bn management consultants, £GOK on pointless marketing rebranding reconfiguring and relaunching services that don't work anyway). And though it pains me to say, it, an insurance scheme whereby patients pay Real Money tro see a doctor, with money claimed back off some kind of government health insurance scheme. If you make something free demand is limitless. NHS in current form is heading towards bankruptcy. We must rework the entire system and take advice from other socialised health care systems worldwide, but noone's going to be the government who "breaks up the NHS" so we're in a bit of a sticky situation (to say the least).

Sorry butting in here, do you have to have a temp? Can I say that because I didn't have a temp when I was feeling awful over the weekend (with everything else) that it was just a bad cold?

Wasn't sure whether to call someone to ask so didn't bother in the end. I did wonder briefly though as I'm asthmatic as well.

Couple of cases in Preschool including confirmed cases in family whose party we were at on Saturday, we have a 2 and 4 year old so I'm a little concerned.

Rache, sudden onset high temp - would you include going to bed fine one evening and waking with a high temp unable to move (normal morning wake up time, so 7-8 hours later), sudden enough? Many Thanks.

Yes it might do. but it might not.

HMG seems to think we can diagnose swine flu in children over the phone. Well I can't and won't. I'm not going to be the one who misses a meningitis, so I'm seeing the children in surgery and making sure they don't have tonsilitis, otitis, UTI etc etc. If other symptoms suggest swine flu, then I prescribe. Today I saw four children with ?swine flu. One had a normal viral illess, one had swine flu, one had pneumonia.

Blimey, you are a little bit thick or you are hideously uninformed. Either way you are pretty well damn uncompassionate. I hope the door hit your butt hard as you flounced out for gross incomprehension on this thread.

The reason this is different is that this has been declared a pandemic, it's not a pandemic "scare."

And that the number of people contracting the disease is increasing exponentially in this country, in months when flu is usually at a low. And elsewhere.

And that flu is a killer disease even when it's not pandemic. And that people, like yourself with asthma, have a greater risk of serious illness than most people.

It's pandemic flu not panic flu, but if Rache is worried, and GOKs she has more knowledge about this than most, then I am too.

In all honesty, yes I am very worried. Panicky? Totally because I know that if I get Swine Flu, it may kill me. I have chronic asthma and chronic bronchitis. A chest infection unfortunately means a 1-3 week stay in hospital. I stay in about 3 times a year.

I am slightly annoyed by your blase attitude to it actually Mel. Unfortunately, I have to go to work and (I have never been a worrier before) I will stay worried about if/when I catch it and am hospitalised.

My Dad has emphysema too, and a week heart. And my wee Granny, she has horendous asthma. So it really worries me about these types of people. Especially as my Dad would probably deny that he had any sort of flu (this is the man who walked - or rather limped - about with a broken leg for 3 weeks before giving in and going to the hospital)

I briefly worked at a place called SCIEH - Scottish Centre for Infection and Environmental Health. We used to receive daily stats from GPs about illnesses. It would be a very interesting place to be right now.

I'm so worried about this, it's on my mind a lot. Izzy is asthmatic, under 5 and very tiny so I'm terrified for her. I'm worried for myself too if I'm honest, I'm a teacher and around kids all day who sneeze, cough and never wash their hands. My asthma has been very bad recently too, I've tried putting my head in the sand over it but it's not working at the moment at all. There has been one confirmed case at the infant school attached to mine, and two cases of suspected SW in the teachers.

Mmm - i am quite worried about it - we have confirmed cases now where i live and my sister (pregnant) has just had it and has been extremely ill - she is coming out the other side now but it really has been appalling

i am asthmatic so i will get help and hopefully a vaccination - but what was quite scary is that children over 6 will not get tamiflu - my youngest is 6 today and while not diagnosed asthmatic gets horrible chest infections and had pneumonia last winter with breathing complications

i am trying not to be hysterical about it - but i must confess that i am scared - the clever, clever patronising chit chat about it just pisses me off

I know what you mean, a friend of mine told me the other day that she thinks it's "ridiculous" that "they" have declared a pandemic. Because obviously WHO should change their definition of a pandemic based on her opinion. Also: "I've never had flu before so I'll be fine".

I am close to hysteria at times but I am trying very hard to keep it under control. I admit that I have stockpiled a small stash of flu/cold tablets, just because if H and I came down with it at the same time we'd have no-one to go and get some for us. That probably sounds neurotic to some but I don't care.

I have to agree with everything that Rache has said. I don't think we've scratched the surface with SF, I really don't. I'm a nurse in A&E, and despite all the media saying don't go to A&E we still have people turning up to A&E. I wouldn't mind if they were poorly or even had symptoms of SF, but they don't. I still have to get gowned from head to foot, do the initial triage, report to the doc, doc gets gowned up, patient gets sent on, and room has to be 'deep cleaned'. And we've not even hit the winter months, I AM DREADING IT. One of the Drs who works in Xray thinks she has SF, and is desperately worried about it (apparently) However, she has still been to the A&E dept twice today, demanding to be swabbed, and is still treating patients...... Now if health care professionals can't get it right, how can you expect 'the public' to?

I feel awful for the GP service, I've no idea how they are going to cope. It is inevitable that front line staff are going to get SF, but it needs to be prevented for as long as possible. I feel desperately sad for the people in the at risk groups, it must be really quite scary. My H is asthmatic, and really suffers when he has colds/coughs etc.

Just a quick question for other Health care proffesionals - Will you be getting the vaccine when it becomes available?

i was trying so hard not to worry but we have got a case at our school now and it makes me twitchy, thinking should i keep my kids home just in case but then the case might not be confirmed.

i am an asthmatic that can be quite unstable at times ans both of my children, 4 and 7 have other medical issues that could put them at risk if they were to get it so now i am terrified.

i think if the family that lost the 6 yr old and think well it happened to them despite what anyone says but it might not happen.

would you send them to school or not risk it?

RuthG I will be taking the jab if offered.

I will be too. I'm front line and also immunocompromised.

There are some scary stories being revealed on a doctors' site I go on. Not about swine flu, but as we're predicting, non swine flu casualties, misdiagnosed as swine flu because of the huge workload. 1 x meningitis, 1 x DKA, 1 x appendicitis. There will be more.

I must admit I am worried about it. I am not sure if it is swine flu itself, or the fact that everything seems to be being labelled as swine flu at the moment. I have a young child, and I have to say, if she was ill, I would want her seen, as I dont know if I would automatically assume it was swine flu! Reading the symptoms, it could cover many things.

Rache, on that note, I am so glad you posted (just read more before posting). I cant even think how difficult your job must be at the moment, to be overstretched, to not be protected, to be put in an situation I guess that the assumption at the moment is that everything is Swine flu.

I am just trying to avoid the news, try not panic, and try and watch over my family as I would have before this all came to light, as I can feel my panic levels rise if I dont.

Rache, I really had no idea how bad things are.

I'm worried because I'm 33 weeks pregnant so I'm worried about getting it now but also getting it with a newborn, I don't even know if newborns could get it but the thought terrifies me tbh. I also have an 87 year old Grandad and I dread to think how he would cope.

Today's Daily Mail gives the advice to go to A&E and not to call first 'as the shutters will go up'. I was gobsmacked at that advice which goes against all official advice I have seen.

Not sure if you will see the image

I have a cold and feel a bit crap but comments from my customers at work have been driving me crazy tonight.

locally its been really badly managed cheesecake, docs now think my bil and neice had it 6 weeks ago (high temp, in bed 3 days) but they missed it and they were given antibiotics- now his ex has it (neice' mum) and docs have revisited bil symptoms. i am asthmatic but not badly (i self control rather than meds) but its cait (4) and my nan (79) im worried about. ive beentrying to tell myself not to worry but today im starting to stress a bit- seeing the hitched sensible bods saying there could be issues is worrying me.

| can see why they don't want people to go to A and E/ Doctors surgeries etc, however, if I am understanding it correctly, the idea that GPs will diagnose people, especially children over the phone is ridiculous. It puts both the GP and the patient at added risk.

That picture that Shiny has posted is very Dailmailesque, however, there is a point in there that I agree with - I will try and manage it at home if it comes into our household, but if I feel that extra medical support is needed then I would go to A and E.... what else could I do?

There appears to be no contingency plans within the NHS for episodes such as this, which means that frontline staff such as Rache are put under undue pressure - pressure to perform, to diagnose, to not diagnose....

I dont know what the answers are. Things such as walk in clinics operating in local village halls for people who suspect that they have swine flu may be an answer - but it is too late anyway to start to think about setting such things up. Plus the time and expense incurred at doing such a thing. However, would the costs be outweighed by the pressure and costs relieved on GP surgeries and A and E departments. This idea is just a musing rather than something that I think could really operate in the real world, so please dont jump on me for it! LOL

St K - I think that could work quite well -but would require huge funding - we'd have to requisition locum GPs and A&E docs, and agency nurses to work it. but it could be done I think.

Blimey some of the things you are saying Rache are really really scary, I feel extremely sorry for the medical profession actually.

Our surgery are pretty fab usually, even for cases like conjunctivitus or the like they still always want to see MissSun before diagnosing over the phone and treating so I have every faith (in normal situations at least) that they would diagnose properly.

I just hope we don't get it. To be honest, i'll be glad when MissSun has her last playgroup session tomorrow.

I have no idea how NHS costings work Rache - would it be significantly more expensive to do than have all these people turning up at A and E, being seen by several different people in the A and E system? Or alternatively, being seen by you and your colleagues?

Your response does sound dismissive and comes across just because YOU are not concerned then why should anyone else.

Do you only have yourself to worry about? I am not in the slightest bit concerned about me catching the flu. I am getting concerned about my 3 1/2 and 1 year old children getting it. When it comes to my kids and protecting them from harm I find it hard to stay rational at times. I am trying to but given that my children at within the at risk bracket I defy any parent not to feel concern about the possible risks of catching swine flu.

But have you even considered that aspect to peoples feelings.........................?

Part of the problem though is that people's perception of the risk is skewed - because we can all easily bring to mind a case of death from swine flu we believe that it will happen, and happen to us. However, even if swine flu kills 100 000 people in the UK, in a population of over 60 million that's still a tiny percentage and the chances of it being 'you' are very small. You're probably (I don't know the actual probabilities - this is an illustrative example only) more likely to be struck by lightening than die of swine flu but most of us don't spend our lives worrying about that possibliity.

The whole thing has been horrendously handled by the media - they've created a panic which is preventing the front line NHS from being able to deal with those who actually need them. There are contingency plans in place to deal with the 'worried well' - I was involved in creating them for my last hospital. One of the scenarios we faced was actually having to barracade the hospital - with police / army - to prevent it being over-whelmed by panicing members of the public who didn't need to be there.

The worry, as Rache has already said, is those people who don't have swine flu but who don't get the treatment they need for the illnesses they do have. I'm currently working with a hospital whose plans for coping with swine flu include increasing bed capacity by 100 - but those beds have to come from other specialties. There is no slack in the system - and the likelihood is that wards will end up being staffed by agency or staff from other hospitals as resources are spread around trying to cover from ill frontline staff. People's treatment will be delayed, things will be missed, mistakes will be made - it's inevitable. I've had to complete a questionnaire detailing my skills, ability to get to certain sites (assuming that there will also be impacts on public transport) and willingness to be drafted in as support when / if swine flu hits with a vengeance. The NHS is doing its best to cope but what it really needs is for people to be rational and not to panic - all the money in the world isn't going to bring in the extra capacity at this stage so we have a communal responsibility not to waste the resources that we do have.

I work as an anticoagulation/thrombo nurse and in our hospital we have all been approached to find out what other skills we have, so out of of a team of 3 of us in a very busy area, 2 of us will be pulled out to work clinically if needed, I suspect in a couple of months my colleague and I will be moved to clinical work which will in turn severely stuff our service up.

I am also very concerned about my relatives, my Mum has COPD I know swine flu could potentially kill her.

On the radio this morning they were saying that the death-rate (there must be a better word for that, but my brain isn't working this morning) for this flu is no higher than normal flu, although they admitted that the error bars on that were pretty huge, as they were only going on the officially confirmed numbers, and there were a lot of mild cases that weren't being reported.

THey are still counting cases in tens here (apparently 30 new cases in a 24 hour period) at the moment. I'm sure that will change though.

Rache that sounds scary, it's actually good to get some of the view from a healthcare side.

I am in an at risk group (had astham medication in the last 3 years) and have just tried to eat better etc and look after myself to prevent anything. I personally haven't had full blown flu for a long time more often than not I get lots of ear infections and colds/coughs. I am guess I am worried about my H, he had flu 2 years ago, isn't in an at risk group but he was VERY poorly. He literally couldn;t get up for 5 days. And my mum too, she is disabled I worry about her getting it. I ring her several times a day at the mo to check she is ok (paranoid icon).

I know people say not to panic, but I can see why people do. Especially those with children. I admit I don;t think the media helps, I was watching the BBC news this morning and thinking rather than blaming people for what might go wrong why can't we all work together to try and help in whqatever way we can?

St K I, like you, wondered about drop in clinics that were in church halls etc. I think that might help alot of people, but yeah it would cost money.