The panic is over. We can all get back to living our lives. Last week the World Health Organisation officially declared that the swine flu pandemic is over. Yes, remember swine flu? The infection that, this time last year, had the nation in the grip of mass hysteria? No, I hadn’t thought about it for a long time either. And looking back, it’s all a little embarrassing.
Swine flu never quite managed to live up to the hype. While legions of people were clogging up A&E, begging doctors for Tamiflu, the predicted Armageddon turned out to be rather a damp squib. It was the first flu pandemic to be declared in four decades and it was predicted that up to 65,000 people might die in the UK. As concerns escalated, there were frantic calls for the Government to ”do more’’, and furious complaints that medication and vaccines weren’t getting through to clinicians.
A mass vaccination programme was rolled out and hotlines set up to ease the pressure on medical services. In total, the cost of preparing and responding to the pandemic was £1.2 billion. It actually claimed the lives of 457 people: in comparison, around 12,000 die each year from seasonal flu. Inevitably, the Government is now accused of over-reacting. But, with the aid of that wonderful instrument the retrospectoscope, it’s easy to criticise. Instead, I’m going to come out in defence of the Government’s response.
I believe the Department of Health (DoH) was right to do what it did; the magnitude of the response was wholly justified. What choice did it have, in the face of predictions from world experts that we were due a devastating flu outbreak? It would have been grossly negligent to wait and see how the pandemic played out, responding only when it became evident that it had a high mortality rate.
It is true that there are more than 30 million doses of vaccine left unused, and this can be seen as a tremendous waste of taxpayers’ money. Yet the Government had to stockpile vaccines in preparation, as any delay in placing orders for these could have resulted in a shortfall once the pandemic had reached a critical point.
We were left with this excess because while one of the manufacturers – Baxter – agreed to a ”break clause’’ allowing the Government to cancel orders when the scale of the pandemic became evident, the other manufacturer – GSK – did not, and insisted the DoH take the full order. It would have seemed petty of health ministers to quibble over terms and conditions in the middle of a national panic. Its priority had to be getting vaccines out as quickly as possible.
There are, nevertheless, important lessons to be learnt.The way information was disseminated to clinicians was patchy and its content often contradictory and unclear. Questions have been raised about the value of the ”containment’’ policy at the beginning of the outbreak, whereby everyone who was exposed was given anti-viral medication, despite there being no evidence that this approach was of any benefit in slowing the spread.
Then there was the laughable swine flu hotline, where diagnosis was provided over the telephone courtesy of call centre operators who appeared to have only slightly more medical training than my goldfish. But overall, I think the Government responded in a sensible, responsible manner to what could have been a national disaster.
Much of medicine is inexact, an art as much as a science, and this is true for epidemiology and public health. Statistical modelling and pattern prediction cannot say for sure how an infection will play out in the general population, or how pandemics will take hold, but we must err on the side of caution. There will be another flu pandemic, of that we can be sure. And we can count ourselves lucky that we’ve had a dry run at dealing with this one.