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Swine flu: expect the unexpected

Lynn Young
Primary Healthcare Adviser for the RCN

Experts at the World Health Organization are co-ordinating events around the spread of swine flu internationally, which enables us to collect the clinical data needed to make the best possible decisions regarding the prevention of spread and the management of the illness.

Plans are well and truly in place to manage this pandemic efficiently, and issuing orders and getting services implemented quickly is relatively easy in our well-developed health service. For the last three years, the Department of Health has been busy planning away, quietly and behind the scenes, to prepare for the unexpected and the uncertain – not an easy task. It is so easy for us in the West to be complacent about issues relating to the nation's health. We all have access to clean water, nutritious food, modern, highly effective drugs and a breadth of health services that are the envy of most of the rest of the world.

And yet, dear Mother Nature is far smarter than mere human beings and could catastrophically outwit us with this new and unknown pandemic. It is true that, so far, most people have suffered from fairly mild symptoms of swine flu. They simply need to stay at home for a few days, rest, keep away from people as much as possible, self-medicate on paracetamol and drink plenty of fluids. Recovery is usually quick
and complete.

So far, so good; we are managing to cope very well with swine flu within the UK thanks to excellent planning, impressive brains, commitment and the infrastructure of the NHS. However, this autumn and winter could present us with many more challenges, as the experts inform us that given the nature of viruses there will be further mutation and spread due to a new strain developing. What is more, the colder weather encourages greater illness.

The Department of Health sets the policies for the management of the flu but there is scope for local decision-making and determination. The Health Protection Agency in England and local health protection units (HPUs) provide the scientific evidence necessary for making decisions regarding closing schools and nurseries. It is interesting to note that in deciding to close a school, the HPU can only advise and, legally, the final decision rests with the school governors.

Come the autumn, our communities and health services may be tested in terms of how willing and capable we are to respond to a huge increase in severe illness and deaths. People with suppressed immune systems and those with long-term conditions are likely to die prematurely, which could severely shake a generation who, until now, have not experienced the death of friends and family.

Think back on the pandemic of 1918, which, with its tragic viciousness, managed to kill more people than the large-scale slaughter of the First World War battlefields. People are different now; we are far better nourished and have access to the type of healthcare service that our grandparents only dreamed about. Nevertheless, Mother Nature is in charge; we need to respect her and be absolutely prepared for the unexpected.

For more information, visit the Royal College of Nursing website (