H1N1v in the United Kingdom Professor Lindsey Davies National Director of Pandemic Influenza Preparedness

H1N1v in the United Kingdom

Professor Lindsey Davies

National Director of Pandemic Influenza Preparedness

Overview Current position UK approach to swine flu Achievements and challenges

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

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%

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-

Planning and preparation

1997-

Slowing the spread

April-June 2009

Managing outbreaks

June 2009

Focus on rapid treatment

July 2009-

Defence in depth Reducing spread Distance, hygiene, masks Reducing infection Vaccines Reducing illness and complications Antiviral drugs, health care Reducing Deaths: Antibiotics Health care

Response is informed by : Science Surveillance Service monitoring

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

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-

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

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

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

Vaccination programme First deliveries expected this month Vaccination programme expected to start in autumn No vaccinations until licensed by EMEA Priority groups first

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

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

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

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