International

national pandemic flu center, call center
Richard Pohle/The Times
Workers at one of the 19 National Pandemic Flu Service call centers answer calls from people
concerned about swine flu, London.

British Strategies Against Swine Flu Instructive for a US Outbreak

July 24, 2009 11:00 AM
by Jill Marcellus
As Britain introduces a national helpline to combat its record swine flu outbreak, what are the plans and prognosis for the U.S. this fall?

England Launches National Pandemic Flu Service

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To reduce the strain on general practitioners (GPs), the British government has set up national call centers for people who suspect they might have swine flu. According to the BBC, the call centers’ 1,500-person staff will use a checklist to determine if callers have the flu, and then prescribe drugs in suspected cases.

Prescriptions will be issued through voucher numbers, which friends or family can bring to collection points. Alternatively, people can both answer the checklist and receive their voucher numbers online.

In addition to combating GP overload, the National Flu Service aims to limit the virus’s spread by keeping suspected sufferers at home. Swine flu cases have doubled this week in England, swelling from 55,000 the week before to 100,000 new cases. Eight hundred forty British patients are currently hospitalized due to the virus, and children have been hardest hit.

A Helpline for the U.S.?

With a major outbreak expected this fall and 263 deaths reported in the U.S. so far, a helpline might be necessary in the United States as well. Although the government is focusing on its vaccination plan, and will run clinical trials for vaccines in August, as ABC News reports, officials and experts worry that there will not be enough doses of the vaccine for everyone.

According to The New York Times, officials “plan to triage [the vaccine] to people who are the most vulnerable, like pregnant women and people who are the most likely to encounter the flu, like health care workers.” ABC News further warns that “there’s always concern about rare but dangerous side effects with a new vaccine that’s being rushed into production.”

Currently, experts expect swine flu cases to skyrocket as schools start in September, rather than during the normal flu season. According to The New York Times, major cities like New York are preparing by clearing out more room in hospitals, since the spring outbreak filled emergency rooms, raising fears that hospitals will be overwhelmed this fall.

A national helpline could mitigate these concerns, but diagnosis-by-checklist raises its own problems, including abuse of the service and misdiagnoses. Christopher Head, chief executive of the Meningitis Research Foundation, warns, “With swine flu cases on the increase, there could be more cases of meningitis.”

Meningitis symptoms, which include “cold hands and feet, severe pain in the limbs and joints, and pale or mottled skin,” could easily, and perhaps fatally, be mistaken for swine flu by a checklist.

Dr. Richard Vautrey of the British Medical Association told the BBC, however, “What we have to remember is that this is a unique situation.” The need to keep people away from emergency rooms may outweigh the problems created by a helpline.

Related Topic: Global strategies

The World Health Organization declared the swine flu a pandemic in June, and recently announced that deaths from the virus have doubled worldwide in the past three weeks.  Countries, with the help of the United Nations, have thus been scrambling to develop a range of anti-viral measures, The Associated Press reports.

Many strategies focus simply on limiting social congregation. Flu rates in Philadelphia spiked in the wake of a parade held during the spring outbreak, and nations are considering the cancelation of major sporting and concert events. 

School closings are another common possibility, and the AP notes a report by researchers at London’s Imperial College that argues, “closing schools can help break the chain of transmission, slowing the pace of the disease, lessening the burden on health care systems and reducing the peak in worker absenteeism.” Massive and sustained school closures may be impractical, though, due to the “considerable economic costs” of parents staying at home with their children.

Closing down mass transportation has been dismissed as an option in New York City, The New York Times reports, but officials are still contemplating staggered work hours, a strategy used against the 1918 Spanish influenza.
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